SA Musculoskeletal Exam Flashcards
What are the clinical grades of lameness?
Grade I- IV
Grade I- barely perceptible
Grade II- noticeable but weight bearing
Grade III- bears weight occasionally for balance
Grade IV- Completely non weight bearing
What may be the cause for an abnormal gait?
neurological or musculoskeletal?
May be due to a neurological problem rather than a primary musculoskeletal abnormality.
How do you examine the vertebrae, ribs, and sternum?
palpate the neck and carefully flex, extend, and turn the head to each side to check for pain response.
apply downward pressure over the vertebrae, while supporting the animal from below to detect pain.
Palpate the ribs and sternum for fractures, pain, swelling…
elevate the tail dorsally and side to side to look for lumbosacral pain
Name all the joints and major bones of the forelimb as you palpate each limb, beginning at the digits & moving proximally.
-digits: distal phalange, middle phalange, proximal phalange.
-metacarpal bones
-accessory carpal
-radius and ulna
-Olecranon (on ulna) -> ELBOW
-lateral epicondyle & medial epicondyle (which lay at the distal end of the humerus, and articulates the radius and ulna)
-greater tubercle of the humerus
SHOULDER JOINT (humeral head articulating with the glenoid cavity)
-ventral border of the scapula
-acromion
-spine of scapula
Name all the joints and major bones of the hindlimb as you palpate each limb, beginning at the digits & moving proximally.
-digits: distal phalange, middle phalange, proximal phalange.
-metatarsal bone
-tarsal bones— TARSAL JOINT
-Common calcanea tendon
-tibia and fibula
-tibial tuberosity
-patella and patellar ligament
STIFLE JOINT
-Femur, lateral epicondyle and medial epicondyle
-body of femur
-greater trochanter of the femur
-HIP JOINT (head of femur + acetabulum of pelvis)
-ischiatic tuberosity
-iliac crest
How do you examine the patella joints ?
examine the joint as a whole.
Positioned behind the standing animal, locate the tibial tuberosity, follow the patellar ligament proximally from it and determine the position and stability of the patella.
While applying gentle pressure, note where it can be shifted medially or laterally (indicating patella luxation)
Some mediolateral motion is normal.
REPEAT while flexing the limb.
How do you check the integrity of the cranial cruciate ligaments?
The crucial ligaments are evaluated by the cranial drawer technique
cranial drawer sign = cranial cruciate abnormality
-increased cranial movement of tibia relative to the femur is the cranial drawer sign
How do you evaluate cranial drawer signs
1.place animal in lateral recumbency
2. place 1 hand around the distal femur, so that your index finger rests on the PATELLA while your thumb is caudal to the femoral condyle in the area of the FABELLA.
Wrap the other hand in a similar fashion on the proximal tibia, with your thumb caudally on the FIBULAR HEAD and index finger on the TIBIAL TUBEROSITY
3. flex the joint to about 35 degrees
4. while holding the femur steady, move the tibia in a cranial caudal direction.
5. repeat this at 10 degree intervals up to 90 degrees flexion.
what is the cranial drawer sign?
increased cranial movement of tibia relative to the femur is the cranial drawer sign
what is an alternative technique to evaluate for cranial drawer, besides the cranial drawer test?
tibial compression test.
how do you do the tibial compression test?
-can better overcome muscle tone in larger or tense animals and may be easier for those with smaller hands.
-place the stifle at a 90 degree angulation, support the leg with one hand and place that index finger along the patellar ligament, with the fingertip sitting on the tibial tuberosity.
-with your other hand around the pes, firmly flex the tarsus.
As the hock flexes, feel for anterior displacement and medial rotation of the proximal tibia.
As the hock is forced into flexion, a normal cranial cruciate ligament prevents medial rotation and anterior displacement of the proximal tibia.
if increased motion is noted, then the cranial cruciate ligament is not intact
what is the atlas?
C1 has atlas wings. is a palpable landmark on dogs & cats
what is the axis?
C2. is palpable
are you able to palpate the medial collateral ligament?
It is firmly attached to the capsule and is often difficult to palpate.
are you able to palpate the lateral collateral ligament?
it is easy to palpate as a band of tissue running dorsally from the fibular head to the lateral femoral condyle.
what do the collateral ligaments prevent?
collateral ligaments are derived from and located within the fibrous parts of the joint capsule.
They prevent medial-lateral hinge motion at the joint and prevent medial-lateral rotation of the tibia on flexion.
they restrict craniocaudal motion of the tibia, hyperextension of the stifle and medial rotation of the tibia on flexion.
what may a damaged cranial cruciate ligament result in?
increased cranial motion of the tibia and increased medial rotation of the tibia in flexion.
How do you palpate the coxofemoral joints?
first observe in standing position for symmetry of the greater trochanter.
next place them in lateral recumbency.
flex and extend the coxofemoral joint, rotate the femur medially and laterally, and abduct and adduct the femur to fully evaluate the ball and socket joint.
what would be the finding when palpation for a luxation of the coxofemoral joint?
will result in asymmetry of the greater trochanters in the standing animal.
place in lateral recumbency.
place your thumb in the depression just caudal to the greater trochanter and cranial to the ischiatic tuberosity.
use your other hand to laterally rotate the femur.
as you rotate the femur in a normal animal, your thunk will be bumped out of the depression.
if the femoral head is luxated, then your finger will stay where it is.
How do you check for instability of the coxofemoral joint?
Ortolani sign
what is the ortolani sign? what is it detecting?
Instability of the coxofemoral joint can be detected by checking for a positive ortolani sign
two motions are required to perform this manuever:
1. in a lateral recumbency, attempt to dorsally subluxate the hip (One hand stabilizes pelvis, while the other pushes the femur dorsally while simultaneously adducting the stifle)
2. with pressure maintained dorsally, the stifle is abducted while using the thumb of your other hand to push on the greater trochanter. A positive ortolani sign is an audible click or a palpable thunk as the femoral head reenters the acetabulum.
what may a positive ortolani sign mean?
may suggest hip dysplasia or other coxofemoral joint instability.
What are the postural reactions?
paw replacement and hoppingg
How do you perform paw replacement test and what is it?
it is a postural reaction test.
start with your patient standing on all four limbs. pick up one paw at a time and place it sot hat dorsal surface of the paw bears weight.
a normal animal will immediately return the paw to its normal position.
successful paw replacement test requires several peripheral and CNS components, so it is a neurological function evaluation
