Orthopedic Exam

Question 1

When observing a patient, what 4 things do you look at from a distance?

Answer 1

Demeanor
Body and limb position
Body condition
Joint and soft tissue symmetry

Question 2

What should you do prior to starting a full orthopedic exam?

Answer 2

A general PE

Question 3

Why do you do a gait analysis?

Answer 3

Because lameness may not be readily apparent

Question 4

What are 6 things you watch and listen for during a gait analysis?

Answer 4

Lameness
Head bob ("down on the sound")
Shortened stride/limb carriage
Dragging of toes/nail scuffing
Ataxia
Weakness

Question 5

What are 4 activities you might ask for from a dog during gait observation?

Answer 5

Walk
Trot
Stairs
Walk in circles

Question 6

What is the difference between gait abnormality and lameness?

Answer 6

Lameness is associated with pain

Gait abnormality is associated with anatomical malformations

Question 7

What are 5 things you would palpate for on a standing exam?

Answer 7

Asymmetry
Heat
Misalignment
Muscle atrophy
Joint effusion

Question 8

When performing your recumbent exam, where do you start?

Answer 8

Distal on the normal limb

Question 9

What 4 things do you palpate for on the joints during a recumbent exam?

Answer 9

Crepitus
Effusion
Range of motion pain
Instability

Question 10

What 5 things will you check on the forelimb?

Answer 10

Paw and carpus
Antebrachium
Elbow
Brachium
Scapulohumeral joint

Question 11

What 4 things do you check on the hindlimb?

Answer 11

Digits
Tarsus
Stifle
Hip

Question 12

What does a cranial drawer sign indicate?

Answer 12

Cranial cruciate tear

Question 13

What is a tibial thrust?

Answer 13

When you flex up the tarsus, you will feel the tibial tuberosity move forward if you have a complete or partial tear

Question 14

What is the most common type of coxofemoral luxation?

Answer 14

Craniodorsal luxation

Question 15

What does an Ortolani sign look for?

Answer 15

In dogs less than 1yoa, feeling to see if you can subluxate the coxofemoral joint (will feel it klunk back into place

NOTE: joint subluxates with the limb adducts and reduces when the limb is abducted

Question 16

What 2 things are your base diagnostic recommendations based on?

Answer 16

Hx

Exam

Question 17

What should you tailor your diagnostics to?

Answer 17

The problem

Question 18

When should you take your RADs?

Answer 18

AFTER the problem area has been identified

Question 19

What type of views are a necessity?

Answer 19

Orthogonal views

Question 20

What are 3 special RAD techniques that may be helpful?

Answer 20

Oblique
Stress
Skyline (more in large animal)

Question 21

What are 4 conditions that RADs are not always diagnostic for?

Answer 21

Musculotenonous disorders
Arthropaties
Patellar luxations
Cruciate ligament rupture

Question 22

How do you evaluate an arthrocentesis?

Answer 22

Grossly (should be viscous, clear to VERY light straw colour)
Microscopically
+/- Culture

Question 23

How does nuclear imaging work in the skeleton?

Answer 23

Will accumulate in vascularized tissues aka areas of inflammation

NOTE: Findings are non-specific

Question 24

What has replaced nuclear imaging?

Answer 24

CT

Question 25

What is an arthrogram?

Answer 25

RAD of a joint following intraarticular injection of iodinated contrast

Question 26

What has replaced arthrograms?

Answer 26

MRI

Question 27

What 3 types of lesion might US be useful for?

Answer 27

Tendons
Ligaments
Muscles

Question 28

What is arthroscopy?

Answer 28

Direct visualization into a joint with a rigid endoscope

Question 29

What are 4 diagnostic uses of an arthroscopy?

Answer 29

OCD and FMCP (Fragmented Medial Coronoid Process)
Cruciate ligament disease and meniscal tears
Shoulder abnormalities
Intra-articular samples from histopathology