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Small Animal Surgery > Shoulder > Flashcards

Shoulder Flashcards

1
Q

What is the typical signalment of shoulder OCD?

A
  • biphasic age distribution: young (cartilage injury), mature (DJD)
  • male
  • large to giant breeds
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2
Q

Describe the physical exam findings of a dog with shoulder OCD

A
  • forelimb lameness (head bob, muscle atrophy)

- pain on hyperextension and flexion of shoulder joint

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3
Q

What are the indications for conservative management of should OCD?

A
  • small defect
  • minimal to no lameness
  • young dogs
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4
Q

How can shoulder OCD be managed conservatively?

A
  • rest
  • diet: control energy, vitamin D, and Ca intake
  • NSAIDs
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5
Q

Describe the typical surgical procedure done for shoulder OCD

A
  • flap removal and lavage
  • debridement of bone
  • defect heals with fibrocartilage
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6
Q

What is the prognosis for a dog with shoulder OCD?

A
  • good to excellent with surgery (fair to good for working dogs)
  • DJD expected (mild with surgery)
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7
Q

Describe the pathogenesis of biceps brachii tendinopathy

A
  • repetitive strain microtrauma
  • tendon fiber disruption
  • acute to chronic inflammation of tendon and associated synovial tissue
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8
Q

Describe the anatomy of the biceps brachii tendon

A
  • origin: supraglenoid tubercle
  • travels through intertubercular groove
  • contained by transverse retinaculum
  • insertion: proximal-medial radius
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9
Q

What is the typical signalment/presentation for biceps brachii tendinopathy?

A
  • adult, median to large breeds
  • weight bearing lameness
  • chronic, intermittent
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10
Q

Describe how you would assess pain in a patient with biceps brachii tendinopathy

A 
maximally flex shoulder and extend elbow
- deep palpation over intertubercular groove
- apply tension to biceps insertion
standing exam
- palpate insertion of tendon
- pressure applies tension to  biceps
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11
Q

How is acute biceps brachii tendinopathy treated?

A
  • confinement
  • NSAIDs
  • physical therapy
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12
Q

How is recurrent/persistent biceps brachii tendinopathy treated?

A
  • intra-articular corticosteroid injections
  • strict confinement
  • physical therapy
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13
Q

What are the indications to surgically treat biceps brachii tendinopathy?

A
  • refractory to medical treatment
  • radiographic changes
  • mechanical deficits
  • moderate to severe lameness
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14
Q

What surgical procedures are used to treat biceps brachii tendinopathy?

A
  • tenotomy of biceps tendon

- tenodesis of bicipital tendon

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15
Q

Describe the pathophysiology of shoulder intability

A
  • abnormally increased range of motion
  • laxity in support structures of the shoulder
  • repetitive microtrauma
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16
Q

What are the physical exam findings of a dog with shoulder instability?

A
  • muscle atrophy
  • pain on joint manipulation
  • medial: increased abduction angle (50 degrees)
17
Q

What is the treatment for moderate shoulder instability?

A
  • arthroscopic thermal capsulorrhaphy

- rest, PT, hobbles

18
Q

What is the treatment for severe shoulder instability?

A
  • medial glenohumeral ligament reconstruction

- velpeau sling

19
Q

Define contracture

A

muscle shortening not caused by active contraction

20
Q

Describe the pathogenesis of infraspinatus contracture

A
  • acute, traumatic disruption of muscle fibers
  • fibrosis and contracture secondary to necrosis
  • non-painful, non-weight bearing lameness
  • acute lameness subsides, then chronic lameness appears
21
Q

What is found on physical exam of a dog with infraspinatus contracture?

A
  • elbow adducted, antebrachium abducted
  • scapula elevates when shoulder is rotated
  • limited range of motion
  • usually no pain on manipulation
22
Q

How is infraspinatus contracture treated?

A
  • tenectomy of infraspinatus tendon
  • release of other capsular adhesions
  • physical therapy
23
Q

What is found on physical exam of a dog with traumatic shoulder luxation?

A
  • non-weight bearing lameness
  • pain on shoulder palpation
  • malpositioning of greater tubercle
  • M luxation: limb abducted
  • L luxation: limb adducted
24
Q

How is traumatic shoulder luxation treated?

A
  • closed reduction (recent injury, no fractures)

- open reduction + ligament repair

25
Q

What is the typical signalment for congenital shoulder luxation?

A
  • small, toy breeds

- 3-10 months of age

26
Q

How is congenital luxation treated?

A
  • open reduction/capsulorrhaphy
  • glenohumeral ligament reconstruction
  • if glenoid dysplasia - salvage procedures

Small Animal Surgery (26 decks)

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