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Large Animal Surgery > Tendon Laceration and Therapy of Joint Dz > Flashcards

Tendon Laceration and Therapy of Joint Dz Flashcards

1
Q

What 3 things can cause tendon disruption?

A

Trauma
Activity
Sepsis

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2
Q

What 3 modalities can you use to diagnose a tendon laceration?

A

Physical exam (joint angle sometimes is just not normal)
Ultrasound
Tenoscopy

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3
Q

What does the fetlock joint look like if just the SDF tendon is lacerated?

A

Dropped fetlock

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4
Q

What does the fetlock joint look like if the SDF and DDF tendons are lacerated?

A

Dropped fetlock and toe up

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5
Q

What does the fetlock joint look like if the SDF and DDF tendons and the suspensory ligament are lacerated?

A

Fetlock is on the ground

NOTE: Only real chance for this horse is a fetlock arthrodesis.

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6
Q

If you have a complete rupture of the common calcanean tendon and gastrocnemius muscle, what 2 things will you see clinically?

A

Non-weight bearing

Hock can be flexed without flexing the stifle

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7
Q

How can you rest for rupture of the common calcanean tendon?

A

Try flexing the hock without flexing the stifle

NOTE: This is often a cause of euthanasia

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8
Q

What is the treatment for common and long digital extensor tendon lacerations?

A

Cast for 3-6 weeks and stall rest for another 6 weeks

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9
Q

What are 3 differentials for excessive fluid in the tendon sheath (seen on ultrasound)?

A

Septic arthritis
Septic tenosynovitis
Abscess

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10
Q

Describe a tendon sheath and its purpose.

A

Fibrous outside, synovial membrane inside.

Lubricates and protects.

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11
Q

What is the concern if a laceration goes into a tendon sheath?

A

Infection can spread more, need to be sure to use a sterile probe to investigate, and then flush wound VERY thoroughly.

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12
Q

What are the 5 steps of treating septic tenosynovitis?

A 
Aspirate for bacterial culture
Lavage
Tourniquet (regionnal IV anesthesia)
Systemic abx
Pain meds
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13
Q

What are 5 steps of management of a tendon laceration?

A 
Debridement
Culture
Lavage
Reapposition
Drainage
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14
Q

What 3 medical treatments would you provide for a tendon laceration?

A

Abx
Anti-inflammatories
Sodium hyaluronate

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15
Q

What type of suture material would you use for reapposition of a ruptured tendon?

A

Nylon or PDS

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16
Q

What suture pattern would you use to reappose a ruptured tendon?

A

3-loop pulley

17
Q

In what species does tenorrhaphy lack sufficient strength to withstand weightbearing forces?

A

The horse of course.

18
Q

What else is required in the equine patient after tenorrhpahy?

A

External coaptation

19
Q

What are 5 different types of support that you can provide following a tenorrhaphy?

A 
Cast
Kimsey leg saver
Bandages
Splints
Shoeing
20
Q

Why do tendon lacerations heal so slowly?

A

Poor blood supply

21
Q

In cattle, what is the difference between tenorrhaphy and casting vs. just casting?

A

No difference.

22
Q

How should you manage a horse with transected flexor tendons?

A

4-12 weeks of external coaptation
Stall confinement
Hand walking
Ultrasound

23
Q

What is the prognosis for a tendon laceration in a cow?

A

Good for life and productivity

24
Q

What 2 concerns might you have for a cow with a tendon laceration?

A

Prolonged convalescence

Persistent lameness

25
Q

What is the prognosis for equines with a digital flexor tendon laceration?

A

54% return to soundness

NOTE: partial disruption have a better prognosis.

26
Q

What are 5 things that can attribute to long-term failure?

A 
Extensive adhesion
Pain
Tendon contracture
Annular lig. constrictuon
Breakdown and recumbency
27
Q

What are 4 ways that tendon injuries can occur?

A

Direct trauma
Fatigue/lack of conditioning
Improper surface
Improper shoeing

28
Q

What are 4 types of tendon injury?

A

Strain
Tear
Rupture
Avulsion/fx

29
Q

What are 3 mechanical properties of tendons?

A

Great tensile strength
Transmit muscle contraction to bone
Store and transfer elastic energy

30
Q

What tendons are most frequently injured in the equine athlete?

A

SDF

DDF (inferior check, suspensory lig, distal sesamoidean lig)

31
Q

What do long sloping pasterns predispose a horse to?

A

Bowed tendons

32
Q

How do tendons heal?

A

Inflammatory phase
Fibroplasia
Collagen
Intrinsic/extrinsic

Large Animal Surgery (30 decks)

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