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1
Q

Type A synoviocytes?

A

Phagocytic

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2
Q

Type B synoviocytes?

A

Produce hyaluronan and lubricin

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3
Q

Hyaluronan?

A

large molecule responsible for VISCOSITY

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4
Q

Hyaline articular cartilage is 20% ECM, 60% of which is collagen, mostly Type ___?

A

TYPE II –> resists TENSILE forces

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5
Q

Hyaline articular cartilage is 20% ECM, including which Proteoglycans?

A

Aggrecan with chondroitin sulfate and keratin sulfate attached to
hyaluronan –> resists COMPRESSIVE forces

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6
Q

How do inflammatory mediators damage cartilage?

A

DAMAGE to joint if anabolism does not keep up with catabolism

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7
Q

3 types of Cartilage healing?

A

Partial thickness repair (intrinsic)

full thickness repair (extrinsic and matrix flow)

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8
Q

Partial Thickness repair?

A

Intrinsic- CHONDROCYTES repair poorly

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9
Q

Full thickness repair - extrinsic?

A

mesenchymal elements from subchondral bone produce

fibrocartilage, NOT TYPE II CARTILAGE

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10
Q

Full thickness repair - matrix flow?

A

Matrix flow- cartilage from periphery moves in, REALLY limits movement

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11
Q

Most common feature of OA?

A

pain and lameness

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12
Q

Rad appearance of OA?

A

No joint space = no cartilage there!

Decreased joint space, osteophyte/enthesophyte formation, subchondral bone sclerosis, soft tissue swelling

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13
Q

OA diagnosis?

A

imaging

Fluid evaluation/cytology is NOT very useful, but less viscous is BAD

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14
Q

OA treatment?

A

NSAIDs-Phenylbutazone, flunixinmeglumine, carprofen

Corticosteroids-INTRA-ARTICULAR

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15
Q

Slow-acting/disease-modifying drugs to treat OA, why?

A

Stimulates hyaluran production and Chondroprotective

Hyaluronan IA/IV, also anti-inflammatory and lubricating

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16
Q

3 Modes of Joint Infection

A
  1. Primary- Direct penetration of joint (older animals)
  2. Secondary- Extension from adjacent infection
  3. Tertiary- Infection from hematogenous spread SEPsis (young animals) -3types
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17
Q

3 types of tertiary joint infection?

A

S- Synovial, NO osteomyelitis, most association with joint space
E- Epiphyseal, subchondral/epiphyseal osteomyelitis, may extend into joint
P- Physeal, steomyelitis adjacent to physis (metaphyseal side) (growth plate)

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18
Q

Diagnosis of septic arthritis?

A

synovial fluid cytology

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19
Q

septic arthritis treatment?

A

Treat like it’s an EMERGENCY, even if you don’t know if it’s there! Goal is to ELIMINATE
the organism and REMOVE inflammatory products

JOINT LAVAGE WITH SEVERAL LITERS OF ISOTONIC FLUID

Arthroscopy

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20
Q

Most common sites for OC

A

tibiotarsal joint (hock), femoropatellar joint (stifle), metacarpo/metatarsophalangeal joint

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21
Q

Most common subchondral bone cyst location

A

medial femoral condyle

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22
Q

How to treat angular limb deformity with hoof manipulation?

A

trim lateral if valgus
trim medial is varus
(opposite if placing hoof extensions)

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23
Q

How to treat angular limb deformity with periosteal elevation?

A

physis must be active!

perform on concave/short side

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24
Q

How to treat angular limb deformity with growth retardation?

A

apply implant to convex (long) side

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25
Q

Juvenile arthritis most common in ?

A

tarsus

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26
Q

Juvenile arthritis treatment?

A

no treatment, only prevention

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27
Q

congenital contracture deformities most common in

A

carpus and fetlock

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28
Q

diagnosis of navicular syndrome?

A

MRI is gold standard

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29
Q

surgical treatment of navicular syndrome?

A

navicular bursoscopy

palmar digital neurectomy - considered salvage procedure - CANNOT FEEL FOOT SO MUCH MANAGE APPROPRIATELY

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30
Q

How common are second phalanx fractures?

A

Relatively rare except for quarterhorses

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31
Q

Most common long bone fracture in athletic horses (racehorses)?

A

Fracture of MC3/MT3

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32
Q

What are splint bone fractures?

A

MC2/MC4 and MT2/MT4

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33
Q

____ should always be evaluated before a splint ostectomy

A

Suspensory

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34
Q

Most common cause of lameness in hindlimb

A

OA

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35
Q

Hunting dog with cranially extended limb (hyperextension of limb)- adducted elbow and abducted paw. what is it?

A

infraspinatus contracture

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36
Q

infraspinatus contracture treatment?

A

Infraspinatus tenotomy- cut the tendon= CURATIVE

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37
Q

____ scapulohumeral luxation- acute, non-weight bearing lameness congenital in toy breeds

A

MEDIAL

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38
Q

Medial scapulohumeral luxation treatment?

A

Open reduction is successful if anatomy is still viable

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39
Q

Lateral scapulohumeral luxation treatment?

A

quick, closed reduction and SPICA SPLINT

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40
Q

Bicipital Tenosynovitis is overdiagnosed, best diagnostic tool?

A

ultrasound

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41
Q

Bicipital Tenosynoviti treatment

A

try 1 dose of steroids (IA), NO NSAIDs, if unsuccessful- cut tendon at its origin (bicipital tendon transposition)

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42
Q

Traumatic Elbow Luxation - _______ is very painful

A

LATERAL

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43
Q

Traumatic Elbow Luxation - how should you take rads?

A

orthogonal

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44
Q

Traumatic Elbow Luxation treatment?

A

REDUCE immediately! (

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45
Q

3 things you must do when reducing a Traumatic Elbow Luxation

A
  1. work it back and forth to get the inside junk/hemorrhage out
  2. TEST IT- if it falls out, it’ll fall out in vivo
  3. Re-Radiograph to make sure it’s reduced
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46
Q

Congenital elbow luxation most common?

A

bulls dogs and small breeds - LATERAL luxation

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47
Q

Congenital elbow luxation requires _____

A

early diagnosis and early surgery (<2-3 months)

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48
Q

Compression angular limb deformity?

A

Traumatic disturbance to Distal Ulnar Physis- Salter Harris V

49
Q

What must you tell owner when dealing with an angular limb deformity caused by trauma

A

MUST inform owner of forelimb growth disturbance risks following any trauma involving appendicular skeleton in immature animal

50
Q

Carpal hyperextension injury - treatment?

A

Coaptation won’t work- requires partial or pancarpal arthrodesis (95% of the time in dogs)

51
Q

EXACT differential diagnosis for a skeletally immature large breed dog with a forelimb lameness

A

Options:

a. Humeral head Osteochondritis
b. Humeral panosteitis
c. Ununited anconeal process (UAP)
d. Fragmented coronoid process (FCP)
e. Ostechondritis of the humeral condyle
f. Radial/ulnar panosteitis
g. Retained cartilage core

52
Q

Osteochondrosis?

A

Ossification defect- Bone cannot form, so cartilage gets thicker and thicker

53
Q

Osteochondrosis most common location?

A

CAUDAL ASPECT OF HUMERAL HEAD (shoulder)- almost ALWAYS

54
Q

Osteochondrosis can progress to ____

A

OCD - Lameness is almost always shoulder or elbow

55
Q

Osteochondrosis treatment?

A

remove the flap - Osteotomy or macroscopically, great prognosis

56
Q

Presentation for elbow dysplasia

A

Rottweiler at 5-8 months = classic example of an elbow dysplasia dog

57
Q

UAP rads

A

Need extended AND flexed (most apparent) lateral views

58
Q

OC/OCD of the humeral condyle most common ____

A

medial humeral condyle (medial trochlea)

59
Q

OC/OCD of the humeral condyle - rads?

A

Seen on Craniolateral-caudomedial OBLIQUE radiographs

60
Q

3 Conditions of Elbow Dysplasia

A

a. Ununited anconeal process
b. OC/OCD of humeral condyle
c. Fragmented coronoid process

61
Q

Most common elbow dysplasia?

A

FCP - Chronic, excessive load on the MEDIAL portion “medial coronoid disease”

62
Q

Panosteitis?

A

Associated with SYSTEMIC disease

63
Q

Predilection for hip dysplasia

A

Young, Large-breed dogs (breed-specific), highly associated with a bad diet

64
Q

Pathophysiology of hip dysplasia?

A

Young dog necropsy-will see ROUND LIGAMENT fraying in

65
Q

Hip dysplasia clinical signs?

A

laxity - ortolani sign

66
Q

How to verify hip dysplasia diagnosis?

A

rads - CHECK THE CRANIAL ACETABULAR MARGIN

67
Q

Treatment options for young animals with hip dysplasia

A

Most require medical management, NOT surgery

If surgery, Goal: eliminate subluxation to PREVENT DJD
For young dogs - Triple Pelvic Osteotomy of Ilium, Ischium and Pubis if <10 months old
Old dogs - FHO or Total Hip Replacement

68
Q

3 Major forms of stabilization to the hip joint

A

i. Round Ligament
ii. Joint capsule
iii. Dorsal acetabular rim
iv. (Minor :acetabular labrum and pelvic muscles)

69
Q

Most common hip luxation?

A

cranio-dorsal

70
Q

Open reduction of hip luxations? (When there are complications/chronicity)

A
  1. Toggle Pin- reconstruct the ROUND ligament with a toggle pin
  2. Capsulorraphy- NEED in-tact capsule, suture it back after reduction
  3. Extra-capsular prosthesis- prevents external rotation (done with crappy capsule) -CANNOT perform with a dysplastic joint
71
Q

Gradual degeneration of the CCL pathophysiology?

A

i. Loss of fibroblasts and condroid metaplasia
ii. Degeneration from the CORE
iii. Transformational change
iv. Improper regeneration due to cyclic loading- excessive use

72
Q

3 CCL rupture syndromes

A
  1. acute - traumatic
  2. early degenerative (bilateral)
  3. chronic degenerative (30-40% bilateral)
73
Q

most common CCL rupture

A

early degenerative

74
Q

location affected in acute-traumatic CCL rupture

A

Medial Collateral Ligament and Caudal Cruciate Ligament affected

75
Q

chronic degenerative CCL rupture (CCLR) can lead to

A

medial meniscus injury (50-90%) - Caudal pole ends up getting CRUSHED between femur and tibia -Known as the “wedge phenomenon”

76
Q

main clinical feature of drawer test?

A

stability

77
Q

CCLR most common repair and technique

A

Extra-articular- Most Common!

Lateral Imbrication technique- Suture around fabella and through tibial tunnel from LATERAL to MEDIAL

78
Q

Tibeal plateau leveling osteotomy?

A

repair of CCLR

circular cut caudal to the tibial crest to alter the angle

79
Q

Patellar luxation location?

A

smaller dog= more likely the luxation will be MEDIAL

80
Q

Patellar luxation clinical signs?

A

Intermittent, non-weight-bearing lameness (walks and then hops)

81
Q

Patellar luxation grading system?

A
  1. IN/IN- stays in, can be pushed out if you want it to
  2. IN/OUT- Mostly in, can luxate on its own or you can make it
  3. OUT/IN- Mostly out, can reduce on its own or you can make it
  4. OUT/OUT- stays out, can’t be reduced
82
Q

OCD pathophysiology?

A

Osteochondrosis(OC) progresses to OCD, resulting in a cartilage flap

Common in immature large breed dogs

83
Q

OCD 3 most common sites

A

i. Forelimb- humeral head
ii. Stifle- lateral femoral condyle
iii. Hock-
Medial trochlear ridge Surgery is least successful

84
Q

Require a ____ change before appearing on rads

A

40%

85
Q

Best method of imaging?

A

MRI but can only image distal extremities and rostral head and super $$$

86
Q

When to use thermography?

A

great for butt and back

87
Q

Treadmill gait analysis system?

A

angle of the fetlock - Fetlock in lame limb will not drop as low as normal limb

88
Q

LA medical therapy - NSAIDS

A

want COX II
Cannot use extended time because toxicity to large colon, renal blood flow, and gastric acid production
IL1RA blocks IL1 inflammatory action

89
Q

LA external coaptation

A

Kimsley Leg Saver and Robert Jones Bandage­ takes the load off the legs

90
Q

Most common use of athroscopy

A

remove fragments

91
Q

short, long-bone fracture in a horse are mechanically induced. acute, simple –> complex fracture of ___

A

Pastern bone

92
Q

most common intra-articular fractures?

A

fetlock!!

also sesamoids, especially apical

93
Q

Dyaphyseal injuries?

A

Metacarpal fractures‐ stress fractures and multiple fractures in Athletic horses that train too hard too fast

94
Q

Metacarpal stress injuries?

A

Bucked Shin‐ microfractures

95
Q

Bucked Shin‐ microfractures treatment?

A

rest

osteostixis

96
Q

surgical removal of splint bone fragment requires ____

A

good hemostasis

97
Q

sequestrum

A

common in horses, MUST HAVE BACTERIA FROM SEPSIS OR INFECTION

98
Q

3 common causes of tendon bowing injury

A

i. Improper shoeing
ii. Improper bandaging
iii. Inadequate conditioning

99
Q

Tendon injury scars?

A

will try to heal but will not be as functional

100
Q

tendon injury diagnosis and treatment?

A

ultrasound

101
Q

What are you looking for in muscle palpation during PE ?

A
  1. Consistency
  2. Withdrawal
  3. Twitching
102
Q

Most important part to check during physical exam?

A

Carpal bone

103
Q

Flexion test?

A

quick flexion will induce withdrawal if painful

104
Q

Churchill’s Hock Test

A

identifies tarsal pain

  1. Pull the median splint bone into canon bone
  2. Positive if horse elevates leg
105
Q

AAEP Lameness grading scale

A

0-­ None
1-­ Difficult to observe lameness
2-­ Some circumstances causes awareness of lameness
3-­ Lameness consistent at a trot under all circumstances
4-­ Lameness obvious on a walk
5-­ Non­weight­bearing

106
Q

Palmar digital block

A

mid pastern or pastern ring (distal foot)

107
Q

Abaxial block

A

most common!

above the sesamoids (whole foot and most of pastern)

108
Q

Carpal block

A

Dorsum over joint, laterally with 1-­1.5 in needle, MUST avoid connective tissue

109
Q

Coffin bone fractures (Distal phalanx)

A

Very crippling, painful and scary fractures

110
Q

Coffin bone fractures treatment

A
  1. Shoeing with full bar shoe
  2. Internal fixation if transverse fracture­ probably won’t be
  3. Neurectomy to reduce pain
111
Q

Navicular syndrome classic presentation

A

pointed front limbs (rarely rear) with short/choppy strides

112
Q

Navicular syndrome affects

A

coffin and distal phalanx articulate

113
Q

Navicular syndrome treatment?

A

Drugs
Neurectomy if other methods fail - guillotine technique
Can also do Proximal Navicular suspensory Desmotomy­ splitting ligament to allow drainage

114
Q

What should you not do with abscesses caused by a nail?

A

Do not remove a nail until you have radiographed the hoof

115
Q

septic condition - treatment

A
  1. Establish drainage
  2. Soak foot in magnesium sulfate <12 hours
  3. Bacteriocidal bandaging
116
Q

Laminitis treatment?

A

ALWAYS AN EMERGENCY

117
Q

Laminitis pathophysiology?

A

Systemic Illness –> SEROTONIN causes vasoconstriction –> capillary beds engorge and leak –> edema cause
opening of arterial­venous shunts –> blood shunted away from capillaries –> ischemia of lamina

118
Q

Chronic laminitis diagnosis?

A

Radiograph of hoof NECESSARY

1st see widening of space between hoof wall and coffin bone, sinking coronary band

119
Q

Laminitis treatment?

A

a. Heparin­ - prevent capillary bed coagulation
b. Vasodilatory agents­ -
Acepromazine (phenoxybenazmine­ not safe, hypotension)
c. Foot therapy­ - stand the horse in sand or packing with 3M cast material, trim hoof to
decrease angle (but not severely)
i. Reverse shoeing with caudal hoof packing
d. Deep digital tenotomy­ - relieve pull on navicular bone
e. Hoof wall resection­ - Separate hoof to lamina to expose necrotic bone, done when GAS is
found
f. Egg bar shoe applied­ - heart­bar is too difficult to apply

Ortho (3 decks)

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