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CRI Canine Rehab > Pelvic Limb > Flashcards

Pelvic Limb Flashcards

1
Q

What cause intrinsic/ passive stability of the lumbar spine?

A

Ligaments
Facets
Discs

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2
Q

What cause extrinsic/ active stability of the lumbar spine?

A

Core muscles

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3
Q

What is spinal arthritis and what can occur secondary to this?

A

Degenerative joint disease of articular facets

  • Cause bony and soft tissue proliferation
  • Can result in spinal cord compression and pain
  • ROM decreases
  • Can cause muscle spasms
  • Decreases performance in working dogs
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4
Q

What does spondylosis occur?

A
  • New bone is laid down when hypermobility occurs in a joint
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5
Q

What type of IVDD occurs with lumbosacral instability?

A

Type II

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6
Q

What is the pathway of force transfer from the hind limb to the lower back

A

Limb –> sacrum –> L7

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7
Q

What is the weight-bearing axis of the pelvis?

A

Acetabulum
Ilial body
SI joint
Sacrum

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8
Q

In what direction do sacroiliac luxations occur? When is surgical correction indicated?

A

Craniodorsal

When significant displacement or neuro deficits are noted

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9
Q

What is an uncommon sequelae to femur fractures in young dogs?

A

Quadriceps contracture

Occurs when blood supply to fracture increases, surrounding quadriceps mm becomes enveloped in callous and fibrous tissue

Usually occurs secondary to long-term coaptation or soft tissue trauma

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10
Q

What parts of the leg are affected by quadriceps contracture? Is this extended or flexed?

A

Rigid extension of stifle and tarsus

Leg cannot be flexed due to muscles becoming fibrotic and contracted

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11
Q

What surgical treatment options are used for quadriceps contracture?

A

Z-plasy - lengthens quadriceps tendon

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12
Q

What is the long-term prognosis with QC

A
  • Guarded

- Early intervention is best option for good prognosis

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13
Q

What is a muscle strain?

A

Contraction of the muscle when it is elongated

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14
Q

What is a grade 1 muscle strain

A

Few fibers are disrupted

- E.G hematoma

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15
Q

What is a grade 3 muscle strain?

A

Muscle is completely ruptured

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16
Q

Why do you not want scar tissue to form with muscle strains?

A
  • Predisposition to future injury (scar tissue is weak)

- Muscle strength decreases ~ 50 %

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17
Q

What is the difference between strain and sprain?

A
  • Strain occurs with muscles and tendons

- Sprains occur with ligaments

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18
Q

What soft tissue structures are most at risk of injury?

A
  • Those crossing multiple joints
  • Occurs at myotendinous junction
  • Most common are hip flexors, adductors, and hamstrings
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19
Q

What types of treatments/ rehab are needed for muscle injury?

A
  • Rest and immobilization for 3-5 days, include ice and NSAIDs
  • Controlled remobilization for 4-6 weeks
  • Reduce scar tissue with manual therapy
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20
Q

What is a common cause of iliopsoas strain?

A

Secondary to sporting injury

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21
Q

What muscles are involved with fibrotic myopathy?

A

Gracilis and semitendinous

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22
Q

What is the common presentation for fibrotic myopathy?

A
  • GSD/ Belgian Shepherds
  • ~5 YO
  • 80 % male
  • 25 % bilateral
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23
Q

What is the appearance of the gait with fibrotic myopathy?

A
  • Shortened stride
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24
Q

How is the hind limb positioned with fibrotic myopathy?

A
  • Rapid, elastic internal rotation of paw
  • Extenral rotation of tuber calcani
  • Internal rotation of stilfe during middle and late swing phase
  • Best visualized behind dog
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25
Q

What region of the muscle is painful on palpation with fibrotic myopathy?

A

Insertion

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26
Q

What are the stabilizers of the tarsus?

A

Joint congruity
Collateral ligaments
Plantar fibrocartilage

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27
Q

Where is osteochondrosis dissecans commonly seen in the hock?

A

Medial aspect of the talus

Palpates as firm swelling of the calcaneus

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28
Q

What muscles make up the Achilles tendon

A 
Gastrocnemius
Biceps femoris
Semitendinosis
Gracillis
Superficial digital flexor
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29
Q

What is the function of the common calcanean tendon

A

Tarsal extension and stifle flexion

Also used in cranial tibial thrust

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30
Q

What breeds are most commonly affected with gastroc avulsion?

A

Labs and dobermans

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31
Q

What PE findings are noted with partial Achilles ruptures?

A

Extended stifle
Flexed hock
Flexed digits (secondary to stretch of the superficial digital flexor tendons)

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32
Q

How are partial Achilles Tendon tears diagnosed? Treated

A

Dx: U/S

Tr: ESWT
- Coaptation

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33
Q

What PE findings are noted with complete tear of Achilles tendon?

A

Plantigrade stance

  • Needs to be surgically corrected
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34
Q

What is the role of rehab in the cancer patient

A
  • Complimentary to therapy

- Exercise helps with cancer fatigue and functional activity/ immune function in people

35
Q

What are some cancers of the nervous system?

A

Brachial plexus
Nerve root
Spinal tumours
Brain tumors

36
Q

What are the stabilizers of the coxofemoral joint?

A
  • Ligament of femoral head
  • Acetabular rim
  • Joint capsule
  • Gluteal muscle and pectineus mm
  • Rotators and flexors
37
Q

What is coxa-vara and what conditions are typically seen with this?

A
  • Bow-legged
  • Decreased transverse plane
  • Seen with medial patellar luxation
38
Q

What is coxa-valga and what conditions are typically seen with this?

A
  • Increased transverse plane

- Seen with hip dysplasia

39
Q

What is hip dysplasia?

A
  • Abnormal growth/ development of hip joint
  • Usually bilateral
  • Laxity leads to malformation of femoral head and acetabulum and eventually DJD
40
Q

What is the signalment for hip dysplasia

A
  • Castrated male dogs

- Typically bimodal

41
Q

What clinical signs are seen with hip dysplasia early in the disease? Later in the disease?

A
  • Early: 2-12 months: joint laxity

- Later: 1-4 YO DJD

42
Q

What is degenerative joint disease?

A
  • Degradation of articular cartilage adn subchondral bone

- Usually secondary to another underlying condition

43
Q

What clinical signs are noted with early stages of hip dysplasia?

A
  • Acute onset
  • Diminished activity
  • Sore hind quarters
  • Reluctance to rise
  • Bunny hopping gait
  • Small pelvic muscles
  • Positive Ortolani sign
44
Q

What clinical signs are noted with late stages of hip dysplasia?

A
  • Chronic onset
  • Waddling gait
  • Decreased ROM and crepitus
  • Slow to rise
  • Increased chest musculature, decreased pelvic muscle
  • Usually Ortolani negative
45
Q

What important factors can reduce the severity of hip dysplasia?

A
  • Slowing growth rate

- Weight control

46
Q

What other orthopedic condition can be mistaken for hip dysplasia?

A
  • Cranial cruciate ligament rupture
47
Q

What is the age cut-off for juvenile pubic synphysiodesis

A
  • Performed under 20 weeks old
  • Closes pubic growth plate –> leads to increased acetabular coverage of femoral heads
  • Good for mild-moderate laxity
48
Q

What structures are cut for a triple pelvic osterotomy?

A
  • Pubis, ischium, and ilium

- Appkly pre-bent plates to cuts

49
Q

What is the recommended age for a triple pelvic osterotomy?

A
  • 5-8 months

- Perform before DJD sets in

50
Q

What is the complication rate of total hip replacements?

A
  • 5-30%

- e.g infection, luxation, loosening, shaft fractures

51
Q

What must be removed for an FHO?

A

Must remove bone-on-bone contact –> removes pain

  • Must completely remove femoral head and neck
  • Needs rehab ASAP due to joint becoming muscular rather than bone
52
Q

What PE signs are noted with coxofemoral luxations?

A
  • Non-weight bearing
  • Hock and foot adducted
  • Stifle externally rotated
53
Q

When is a closed reduction of a coxofemoral luxation indicated?

A
  • No hip dysplasia
  • Occurred < 5 days ago
  • Keep in Ehmer sling for 10 days
54
Q

When is are surgical treatments of a coxofemoral luxation for a non-dysplastic hip? Dysplastic hip?

A

Non-dysplastic: open reduction + toggle pin or iliofemoral suture

Dysplastic: FHO or THR

55
Q

What is a common presentation of Legg-Calve-Perthes dz?

A
  • Small breed dogs, 5-8 months, chronic progressive lameness
56
Q

What clinical signs are noted with Legg-Calve-Perthes dz?

A
  • Decreased ROM
  • Crepitus
  • Muscle atrophy
57
Q

How do you diagnose and treat LCP dz?

A
  • Rads

- Treat with FHO or THR

58
Q

What are the active stabilizers of the stifle? Passive?

A

Active: Muscles

Passive: cruciate ligaments, joint capsule, collateral ligaments, menisci

59
Q

What condition can be seen with dogs with medial patellar luxation?

A
  • 40% have CrCL tears
60
Q

What PE findings are noted with dogs with MPL?

A
  • Occ hopping, skipping, reluctance to jump
61
Q

What condition can be seen concurrently with lateral patellar luxation?

A
  • Hip osteoarthritis
62
Q

What is the treatment recommendation for patellar luxations?

A
  • Grade I and II can be treated with rehab early on

- Grade III and IV should be surgically corrected

63
Q

What types of osteotomies can be used to treat patellar luxations?

A
  • Trochleoplasty (wedge, block recession)
  • Tibial tuberosity transposition
  • Distal femoral ostectomy
64
Q

What soft tissue surgeries can be performed for patellar luxations?

A
  • Lateral/ medial imbrications
  • Lateral/ medial release
  • Anti-rotational suture
65
Q

What are the functions of the Cr Cruc Lig?

A
  • Limit cranial drawer
  • Limit hyperextension
  • Limit internal rotation
66
Q

What are the two bands of the cranial cruciate ligament? When is tension/ tightness felt on these bands?

A
  • Craniomedial band (smaller): tight in flexion and extension
  • Caudolateral band (larger): loose in flexion, tight in extension
67
Q

What band are partial tears noted in? When can you notice this?

A
  • Craniomedial band

- Cranial drawer noted only in flexion and non-weight bearing

68
Q

What are the functions of the meniscus?

A

Load transmission and shock absorption

69
Q

What is a normal tibial plateau angle? Abnormal?

A

Normal: 25 degrees

Abnormal: >35 degrees
Larger angles associated with cranial cruciate tear

70
Q

What are the passive stabilizers of the stifle?

A
  • CrCL
  • Mensici
  • Collateral ligaments
71
Q

What are the active/ dynamic stabilizers of the stifle?

A
  • Hamstrings
  • Quadriceps
  • Gastroc
72
Q

What test can you perform to assess for stability of the cranial cruciate ligament?

A
  • Cranial drawer: test in flexion and extension - Tests for passive stabilizers (CCL)
  • Tibial thrust: test in normal standing angle - mimics the forces dogs will be and experiencing when standing and active stabilizers
  • Internal rotation
73
Q

What percentage of Cr CL is bilateral?

74
Q

What is the causes of cranial cruciate ligament rupture?

A

Unknown

  • Developmental/ genetic
  • Immune-mediated
  • Metabolic (fat metabolism vs nutrient deficiency)
  • Hormonal: early spay/ neuter, thyroid function,
  • Obesity
75
Q

What physical exam findings are noted with cruciate rupture?

A
  • During walking - weightbearing lameness, (
  • During standing eval: hip and stifle flexion, hock extension
  • On palpation: pain on extension, +/- meniscal click
76
Q

What clinical signs are eliminated with extra-capsular suture?

A
  • Eliminates cranial drawer, tibial thrust, internal rotation
77
Q

What clinical signs are reduced with osteotomies? What are still present?

A
  • Eliminates cranial tibial subluxation

- Cranial drawer still present

78
Q

Why do TPLO/ TTA work so quick?

A
  • Passive stability immediately improved

-

79
Q

What region of the meniscus is damaged during a cruciate ligament tear?

A

Caudal pole of medial meniscus

80
Q

What are pros and cons of meniscal release?

A
  • Pros: decreases subsequent injury,

- Cons: eliminates function (shock absorption), develops OA, does not eliminate future injury

81
Q

What are side-effects to stifle procedures?

A
  • Decreased weight-bearing secondary to quadriceps inhibition
  • Decreased ROM
  • Lumbar muscle and iliopsoas discomfort
  • Compensation to other limbs
82
Q

Where the cranial cruciate ligament originate and insert?

A

Originates at caudal aspect of lateral condyle

Inserts at cranial aspect of tibia

83
Q

Where does the medial mensicus attach? Lateral mensicus?

A
  • Medial attaches to proximal tibia - More likely to be crushed under femoral condyle
  • Lateral attaches to femur (meniscofemoral ligament)
  • Poor healing due to poor blood supply
84
Q

What are the landmarks for cranial drawer test

A

Proximal femur: patella with thumb on fabella

Distal hand: fibular head and tibial tuberosity

CRI Canine Rehab (7 decks)

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