Orthopedic Exam & Diagnostic Tools (1) Flashcards
Dr. Gilley
What is abnormal proprioception?
patient does not know where limb is placed
What occurs during a gait analysis?
evaluate all limbs during observation
perform gait analysis on floor with traction
What is the most important gait to evaluate lameness?
trot
What is a trot?
body is supported by 2 legs on opposite sides
What should you look on a gait analysis for forelimb lameness?
look for a head bob
What signs do you see with forelimb lameness?
- head lifts when lame leg bears weight
- head drops when weight bearing on normal limb
> “down on the sound”
What should you look on a gait analysis for hindlimb lameness?
- stride length shortened on lame leg
- normal limb reaches forward faster than lame leg
- oscillating motion during locomotion
- hip hike on lame leg - different depending where lameness is
What are the degrees of lameness?
0: no lameness
4: non-weight bearing lameness
What is favoring in regards to lameness?
trying to get off lame leg
use it less
How do you assess bilateral lameness?
- weight shifting while standing
- shortened stride
- bilateral muscle atrophy
- bilateral compensatory hypertrophy of unaffected limbs - like beefy shoulders
How should you visually inspect legs for lameness?
- observe patient in standing position
- know breed differences
- abnormal body conformation
- examine posture
- look for hyper flexion or hyperextension of joints
- muscle atrophy?
- angular limb deformities
What does general palpating assess with lameness?
general body palpation with animal standing - check for muscle atrophy and asymmetry
How should yo palpate the neck for lameness?
deep palpation
ventral and lateral flexion
extend neck
How should you palpate the back?
apply pressure to spinous processes down the entire length of the spine
How do you check for lumbosacral pain?
directly palpate lumbosacral region
apply pressure dorsally to lumbosacral joint
When palpating for a dog experiencing lameness, what on the hind leg should you check specifically?
“medial buttress” - found on medial aspect of stifle
indicator of cranial cruciate ligament rupture (CCLR)
What are the characteristics for localization in a physical exam for lameness?
without sedation
performed at the end of evaluation!!
neurologic exam
How is localization performed in a physical exam for lameness?
lateral recumbency - start at m most distal part of the leg
move through each joint through full range of motion
apply stress to joint medially and laterally
What is this, and what does it assess?
goniometry - joint angles
During localization, what do you do to each joint? To assess what?
palpate
pain, heat, swelling, instability
What is the Ortolani sign?
check for hip dysplasia
grasp flexed stifle and apply dorsally - apply counter pressure with other hand dorsal to pelvis
What is a positive Ortolani sign?
movement felt as femoral head reduces back into acetabulum
may be able to subluxate
reduction: greater trochanter will drop
How do you do the Ortolani maneuver in dorsal recumbency?
positioned in dorsal recumbency - place hands over stifles, hold femurs parallel
subluxate femoral head
What is the cranial drawer test?
one hand on tibia, one on finger
move tibia cranially with respect to femur
With the cranial drawer test, one hand is on the femur. Where do you place your fingers?
thumb: lateral fabella
index finger: patella
thumb: fibular head
index finger: tibial tuberosity
What is a positive cranial drawer test?
> 1-2 mm of movement
What is the tibial compression test?
- tarsus flexed with force
- tibia translates cranially with cranial cruciate ligament rupture
tibial thrust
What are these?
luxating patella manually
- stifle extended - medial
- stifle slightly flexed - lateral
