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Large Animal Surgery > Tendonitis > Flashcards

Tendonitis Flashcards

1
Q

What is the proximal/accessory ligament to the SDF?

A

Superior check ligament

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2
Q

What is the distal/accessory ligament of the DDF?

A

Inferior check ligament

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3
Q

From cranial to caudal, what structures do you encounter?

A

Third metacarpal bone > Suspensory ligament > DDF tendon > SDF tendon

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4
Q

What is the make-up of a tendon?

A

70% water, 30% dry matter

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5
Q

What 2 things make up the non-collagenous matrix of a tendon?

A

Tenocytes

Glycoproteins

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6
Q

What is important to remember about a relaxed tendon fascicle?

A

There is a crimp to allow for stretching.

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7
Q

What is the endotenon?

A

Blood supply, nerves and growth factors

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8
Q

What is the epitenon?

A

Contiguous with the endotenon, surrounds the tendon.

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9
Q

What is the paratenon?

A

Surrounds tendons NOT in a sheath

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10
Q

What is an example of a tendon that is not in a sheath?

A

Digital tendon flexor sheath

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11
Q

What is the purpose of the crimp pattern in tendons?

A

Allows for stretching

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12
Q

Where is the crimp in a tendon lost first?

A

Center

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13
Q

What is the “toe” region?

A

The point where a load is applied to the tendon and the crimp is lost.

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14
Q

How much can a tendon extend before it ruptures?

A

12-20%

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15
Q

How much does a tendon extend at the toe region?

A

1-3%

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16
Q

How much does a tendon extend at a walk?

A

3-8%

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17
Q

How much does a tendon extend at a trot?

A

7-10%

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18
Q

How much does a tendon extend at a gallop?

A

12-16%

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19
Q

How does a tendon heal?

A

Scar tissue (type III collagen) forms a less elastic tendon

**NOTE: risk of re-injury

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20
Q

What tendons are less efficient at healing?

A

Those in a tendon sheath.

21
Q

What is tendonitis?

A

Inflammation of a tendon.

22
Q

What are 3 causes of tendonitis?

A

Overuse
Infection
Traumatic injury

23
Q

What is one of the most common sites of tendonitis?

A

SDF tendon

24
Q

What are 2 mechanisms of an overstrain tendon injury?

A

Sudden overload

Strain induced

25
Q

What is the most common mechanism of an overstrain tendon injury?

A

Strain induced

26
Q

What is strain induced overstrain?

A

Repetitive microtrauma

27
Q

What are 3 causes of percutaneous tendon trauma?

A

Over-reaching (kicking back of front foot with the toe of the back foot)
Wire
Kicking

NOTE: Usually while tendon is under load, except with wire cuts.

28
Q

What type of tendon lacerations rarely have long term consequences?

A

Extensor tendon lacerations

29
Q

How much of the tendon have be lacerated and still provide full function at a walk?

A

50%

30
Q

What two tendons are most prone to injury?

A

SDF tendon
Suspensory ligament

NOTE: This is because they have the most load during a heel strike.

31
Q

What are the most common front and hind limb tendon tears within synovial cavities?

A 
DDFT (forelimb)
Manica flexoria (hindlimb)
32
Q

What is a predisposing factor to tendonitis?

A

Increased stress on the tendon

33
Q

What are 3 common histories in a case with tendonitis?

A

Percutaneous injury
Acute athletic event
Poor performance

34
Q

What are the 4 cardinal signs of inflammation?

A

Pain
Swelling
Heat
Lameness

35
Q

What is the best tool for diagnosing tendonitis?

A

Ultrasound of course!

36
Q

When is the best time to ultrasound an injury?

A

One week post-injury to give swelling and hematoma time to resolve. Also, a wound can take several days to declare itself.

37
Q

Why should you always evaluate both limbs?

A

To find normal (or could be bilateral).

38
Q

If looking at an ultrasound of a limb, what structure would you see from superficial to deep?

A

SDF
DDF
Check ligament
Suspensory ligament

39
Q

What would you expect to see acutely in a tendonitis case (3 things)?

A

Enlargement
Hypoechogenicity
Reduced striated pattern

40
Q

What two things would you expect to see in a chronic tendonitis case?

A

Variable enlargement and echogenicity

Fibrosis

41
Q

What 2 things do all treatment plans include for a tendonitis case?

A

Rest

Controlled exercise program

42
Q

What 3 things are integral parts of management of a tendonitis case?

A

Cooling
Support
Rest

43
Q

What is the goal of treating tendonitis?

A

To restore tensile strength.

44
Q

What type of tendonitis is a medical emergency?

A

Acute because we need to reduce the inflammation.

45
Q

What are 4 goals of treating acute tendonitis?

A

Reduce inflammation
Speed healing
Increase tensile strength
Decrease risk of re-injury

46
Q

What are 5 forms of non-surgical tendonitis treatment?

A 
Cold therapy (20 minutes)
Compression and coaptation
NSAIDs
Intralesional injections
ESWT (shockwave therapy)
47
Q

What are 3 different substances used in an intralesional injection?

A

Platelet rich plasma (PRP)
Stem cells
Bone marrow

48
Q

What is the best type of intralesional injection?

A

Stem cells mixed with PRP.

NOTE: This is costly.

49
Q

What are the 2 common surgical interventions for treating tendonitis?

A

Tendon splitting

Desmotomy

Large Animal Surgery (30 decks)

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