SA Ortho Exam

Question 1

Components of ortho exam

Answer 1

History, physical exam, ortho exam, gait exam, standing exam
Long bone palpation, joint palpation, muscular palpation

Question 2

Orthopedic exam

Answer 2

Gait exam, standing palpation, recumbent exam, specific exam tests - drawer & thrust
Supportive exams - sedated exams / imaging
Neurological exams

Question 3

Gait exams

Answer 3

Observe conformation
Hyper/hypoflexion of joints
Observe posture - symmetry, atrophy
Good traction
Observe from front & side

Question 4

Signs of forelimb lameness

Answer 4

Head bob - down on sound
Abduction, adduction or circumduction of limb
Changes in stride length/duration

Question 5

Hind limb lameness

Answer 5

Hip hike on affected leg
Abduction, adduction or circumduction of limb
Shorter stride on affected leg
Faster stride on sound leg
Bunny hopping

Question 6

SA lameness grade

Answer 6

0 - sound
1 - mild weight bearing lameness
2 - moderate weight bearing lameness
3 - severe weight bearing to toe touching lameness
4 - non weight bearing at all times

Question 7

Standing exam features

Answer 7

Symmetry
Equal weight distribution
Joint effusion

Question 8

Things to check in head/axial skeleton

Answer 8

Head
Cervical spine - palpation, ROM
Thoracolumbar spine - direct palp of DSP
Lumbosacral junction - direct palp, tail manip, rectal palp

Question 9

Phalangeal joints

Answer 9

Nails, interdigital spaces, Joint ROM, pain, thickening

Question 10

Carpus

Answer 10

Palp of effusion - joint space on either side
ROM - 20-30 * flexion, 180-190 degree extension
Instability - palmar & medial, lateral
Hyperextension injury
Palp of sesamoids - 2 & 7 are usually hurt

Question 11

Elbow

Answer 11

Effusion - caudal in joint, either side of olecranon
ROM - extension 160, flexion 40-50

Question 12

Shoulder

Answer 12

normal ROM - Superman, keep elbow in flexion when flexing shoulder
Medial instability - limb in extension, sedated or anesthetized, abduction > 50 degrees is supportive

Question 13

Shoulder - biceps & muscle palp

Answer 13

Biceps tenosynovitis - palp of biceps tendon of O&I
Muscle palp - supraspinatus infraspinatus

Question 14

Tarsus

Answer 14

Effusion, ROM 40-45
Medial & lateral instability - need palpate in flex & extend
Long & short collaterals
Superficial digital flexor tendon
Calcaneal tendon - partial vs complete, plantigrade stance

Question 15

stifle land marks

Answer 15

Tibial crest
Fibular head
Lateral fabella
Patella
Patellar tendon

Question 16

Stifle

Answer 16

Effusion - bilateral
ROM - hock touch ischial tuberosity in flex, 180 in ext
Sit test - knee ROM

Question 17

Common stifle injury

Answer 17

Cranial cruciate ligament injury
Cranial drawer
Tibial thrust
Stifle effusion
Pain on hyperextension
Medial buttress

Question 18

Cranial drawer

Answer 18

Proximal hand
Index on pat, thumb on lat fib - stabilize
Distal hand - intend on tib tub, thumb on fib head, push tibia cranially
Test in flex and ext

Question 19

Signs of partial tear in cranial drawer

Answer 19

Drawer only in flexion

Question 20

Full tear on cranial drawer

Answer 20

Drawer in flexion and extension

Question 21

Cranial tibial thrust

Answer 21

Proximal hand wrap distal femur, index over pat lig, ending on tib tub
Distal hand holds foot - WB flex tib and tars

Question 22

Normal results cranial tibial thrust

Answer 22

No tibial advancement

Question 23

Complete CCL rupture

Answer 23

Thrust >1cm

Question 24

Patellar lux - med and lat

Answer 24

Medial lux - internal rotation of tib - push pat med
Lateral lux - external rotation of tib - push pat lat

Question 25

Hip

Answer 25

Rom, difficult to palpate effusions

Question 26

Otrolani

Answer 26

On hips
= hip lax or dysplasia common in young dogs
Check in lat recumbency - upper hand stabilizes patient at pelvis, grasp stifle w lower hand
Press down on greater trochanter to reduce

Question 27

Palpating hip for luxation /dislocation

Answer 27

Thumb test - caudal to greater trochanter
Triangle test - GT, dorsal Ilial wing, ischial tub
Rectal exam - caudoventral lux, femoral head gets stuck in the obturator foramen