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Eq SX Musc Skel Exam > Stifle and Femur > Flashcards

Stifle and Femur Flashcards

1
Q

Landmarks of femur

A
  1. Lateral trochlear ridge
  2. Medial trochlear ridge
  3. Medial femoral condyle
  4. Lateral femoral condyle
  5. Intercondylar fossa
  6. Extensor fossa-cranial lateral
  7. Caudal lateral fossa
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2
Q

Patella

A

Parapatellar fibrocartilage-medial

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3
Q

Tibia

A
  1. Medial tibial plateau (condyle)
  2. Lateral tibial plateau (condyle)
  3. Intercondylar eminence of tibia
    - Medial intercndylar eminence of the tibia
  4. Tibial tuberosity
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4
Q

Joints

A
  1. femoropatellar
    - suprapatellar pouch
  2. Medial femorotibial
    - cranial compartment
    - caudal compartment
  3. Lateral femorotibial
    - cranial compartment
    - caudal compartment
    - -proximal
    - -distal
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5
Q

Soft tissues (cranial)

A
  1. Patellar ligaments
    - lateral
    - middle
    - medial
  2. Parapatellar fat pad
  3. Quadriceps femoris muscles
  4. Sartorius
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6
Q

Soft tissues (caudal)

A
  1. Popliteus muscle
  2. Semimembranosus
  3. Semitendiosus
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7
Q

Soft tissues (medial)

A
  1. Medial collateral ligament
  2. Medial femoropatellar ligament
  3. Sartorious
  4. Gracillus
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8
Q

Soft tissues (lateral)

A
  1. Lateral collateral ligament
  2. Lateral femoropatellar ligament
  3. Insertion of the long digital extensor and peroneus tertius
  4. Biceps femoris
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9
Q

Intra articular soft tissues

A
  1. Medial and lateral meniscus
  2. Cranial cruciate ligament
  3. Caudal cruciate ligament
  4. Medial and lateral cranial meniscotibial ligaments
  5. Medial and lateral caudal meniscotibial ligaments
  6. Meniscofemoral ligament (lateral)
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10
Q

Common OA sites

A
  1. Medial femorotibial joint
  2. Lateral femorotibial joint
  3. Femoropatellar joint
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11
Q

Common fx or fragment sites

A
  1. Patella
  2. Trochlear ridge
  3. Medial intercondylar eminence of the tibia
  4. Avulsion of insertion of LDE (or PT)
  5. Avulsion insertion of Cr cruciate
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12
Q

Common site luxation

A
  1. upward fixation of patella (not true luxation)

2. Lateral luxation of patella (rare)

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13
Q

Common soft tissue injuries

A
  1. Collateral ligament desmitis, tear/disruption (M > L)
  2. Patellar ligament desmitis/tear/disruption
  3. Cruciate ligament tear or disruption (Cr > Ca)
  4. Meniscal tears
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14
Q

Common OC/OCD sites

A
  1. LTR-most common
  2. Medial trochlear ridge
  3. Patella
  4. Osteonecrosis of femoral condyles in foals
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15
Q

Subchondral bone cysts

A
  1. Medial femoral condyle
  2. Proximal tibia
  3. Meniscal cysts
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16
Q

Stifle/hock lameness

A
  1. Often bilateral
  2. difficulting changing gait
  3. bunny hopping
  4. squared off toes from dragging foot
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17
Q

Most useful radiographic view for femorotibial OA

A

caudocrania projection

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18
Q

earliest radiographic sign of medial femorotibial OA

A

lipping of medial tibial plateau due to osteophyte formation

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19
Q

Other radiographic signs of medial femorotibial OA

A
  1. Osteophyte formation on femoral condyle
  2. flattening of condyle
  3. areas of sclerosis and/or lysis in subchondral bone of weight bearing regions
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20
Q

Joint space narrowing is a sign of

A

end stage joint disease

-also depends on very careful positioning to determine

21
Q

Best radiographic view for femoropatellar OA

A

lateral view

22
Q

Earliest/most obvious sign of femoropatellar OA

A

osteophyte formation of distal patella

23
Q

Etiology patellar fractures

A

Direct trauma

24
Q

CS patellar fx

A
  1. variable effusion, swelling, lameness

2. May hold limb partially flexed, capable of weight bearing

25
Q

Radiographic view if patellar fx

A

Standard 3 views + flexed lateral and patellar skyline

26
Q

Patellar fx tx conservative

A

stall rest 2-3 mos

-patellar base fx doesn’t require sx

27
Q

Patellar fx removal

A
  • Arthroscopy preferred (can also visualize trochlear ridges)
  • Can remove up to 1/3 of patella if medial saggital slab fracture
28
Q

Patellar fx fixation

A

Can use lag screws or small plates
Crit fixation
1. complete disruption quadriceps apparatus
2. fx gap > 5mm
3. Malalignment articular surface
4. Unstable fragments palpable through skin

29
Q

Patellar fx prog

A

Frag rem saggital fx-80-100% full athletic fxn

Disruption quad app-guarded for athlete

30
Q

Trochlear ridge fractures

A
  • Direct trauma
  • mod-severe lameness, effusion, swelling
  • crepitus/external wounds possible
  • possiblity for joint sepsis
  • tx arthroscopic rem frags
  • prog good, non-weight bearing
31
Q

Fx of medial intercondylar eminence of tibia

A
  • not usually avulsion fractures
  • best radiographic views for dx are caudocranial and flexed lateromedial
  • removal salal frags
  • prognosis good, more dependent on soft tissue injuries
32
Q

Avulsion fx of long digital extensor tendon or peroneus tertius

A
  • share common origin in extensor sulcus, lateral to distal aspect of lateral trochlear ridge of femur
  • most common foals and young horses
  • typically after forced hyperextension of the hindlimb
  • dx rads, tx rem frags and rest
  • prog-poor
33
Q

Avulsion fx cranial cruciate ligament

A

rare

34
Q

Lateral patellar lux

A

rare

35
Q

soft tissue injury

A

dx: MRI, likely underdiagnosed

36
Q

Collateral ligament injury

A
  • u/s common method diagnosis

- complete disruptions or concurrent meniscal/cranial cruciate injury has poor prog

37
Q

Patellar ligament injury

A
  • jumpers are overrepresented
  • partial or no response to block
  • u/s diagnostic method of choice
  • not sure of prognosis
38
Q

Cruciate ligament injury

A

uncommon

prognosis poor if joint instability

39
Q

Meniscal injury

A

Most common soft tissue injury of the stifle (medial meniscus)
-insidious onset

40
Q

CS meniscal injury grades

A

G1: longitudinal tear cranial horn and meniscotibial ligament with minimal separation
-63% return to work
G2: Same as grade 1 with greater tissue separation
-56% return to work
G3: Tears extend beneath femoral condyle and cannot be viewed in their entirety
-5% return to work

41
Q

Meniscal injury tx

A 
Arthroscopic debridement (partial menisectomy) 
Prolonged rest (6 months)
42
Q

Factors that decrease prognosis for meniscal injury

A
  1. Articular cartilage damage
  2. Concurrent soft tissue injuries
  3. Concurrent subchondral bone cyst
  4. Dystrophic mineralization of meniscus
43
Q

Osteonecrosis of medial femoral condyle

A

rare

only in foals

44
Q

Subchondral bone cysts

A

Common lesion of stifle, second to

-OC/OCD

45
Q

Etiology of subchondral bone cysts

A 
age 1-3
MFC most common site
Other sites
-proximal tibia
-LCF
-patella
46
Q

suchondral bone cysts CS

A

Asymptomatic-prepurchase rads
May be unilateral or bilateral
variable response to hind limb flexion
variable response to diagnostic anesthesia

47
Q

Subchondral bone cysts rads

A
  1. Caudocranial and flexed lateral most useful
    - also take caudolateral-craniomedial oblique
  2. ALWAYS take contralateral if lesion id’d
48
Q

Femur fx rads

A
  • Under general anesthesia

- Mediolateral and craniocaudal views

49
Q

Femur fx U/S

A
  • First line dx method adults
  • Can be done standing
  • Cannot assess configuration

Eq SX Musc Skel Exam (20 decks)

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