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CRI Canine Rehab > Thoracic Limb > Flashcards

Thoracic Limb Flashcards

1
Q

What is the function of the rotator cuff in dogs

A

Prevents subluxation

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2
Q

What are the active/ dynamic stabilizers of the shoulder

A
  • Subscapularis m
  • Biceps tendon
  • Suprapinatus
  • Infraspinatus
  • Teres minor
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3
Q

What are passive stabilizers of the shoulder?

A
  • Joint capsule
  • Medial glenohumeral ligament
  • Lateral glenohumeral ligament
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4
Q

What are the primary stabilizers of the shoulder joint

A
  • Glenohumeral ligaments
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5
Q

What direction does the biceps tendon provide stability during joint extension

A
  • Medial stability
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6
Q

What is another function found in the medial GH ligament

A
  • Has lots of mechanoreceptors for propioception
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7
Q

What is osteochondritis dissecans (OCD)

A
  • A devitalized portion of articular cartilage on the head of the humerus. Should be surgically removed
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8
Q

What are examples of shoulder disease

A
  • Glenoid fragmentation
  • Luxation or dysplasia
  • OA
  • Trauma
  • Neoplasia (bone, synovial, nerve root) - want to rule this out
  • Neuro dz - neck disease can mimic forelimb disease
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9
Q

A dog walks in with a flexed and caudally deviated elbow. what is your primary differential?

A

Infraspinatus contracture

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10
Q

What should you look for on a standing forelimb palpation?

A
  • Cervical spine and muscles
  • Muscle symmetry
  • Trigger points and tightness
  • Elbow thickening
  • Conscious propioception
  • Biceps stretch test (flex shoulder and extend elbow, followed by palpating tendon)
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11
Q

What would a biceps tendon rupture present?

A

Elbow can be completely extended

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12
Q

What are examples of medial shoulder instability?

A
  • Rotator cuff injury

- Damage to subscapularis tendon or medial GH ligament

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13
Q

What are causes of medial shoulder instability?

A
  • Overuse/ repetitive injury
  • Jumping, slipping, landing in ABduction
  • Rarely traumatic
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14
Q

How do medial shoulder instabilities present themselves?

A
  • Refuse tight turns

- Show weight-bearing lameness – short stride, worse after exercise, minimal response to rest + NSAID

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15
Q

How do you diagnose medial shoulder instability?

A
  • Shoulder palpation
  • Pectoral m spasm
  • supra/ infraspinatus muscle atrophy
  • Decreased range of motion on extension
  • +/- Discomfort on abduction
  • Abduction angle > 50 when in lateral recumbency
  • Can refer for arthroscopy
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16
Q

What is a normal shoulder joint abduction angle?

A
  • = 35 degrees
    • not accurate in dogs < 15 kg
  • Usually unilateral
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17
Q

What is a abnormal shoulder joint abduction angle?

A
  • > /= 50 degrees

** not accurate in dogs < 15 kg

18
Q

What is the preferred diagnostic for medial shoulder instability

A

Arthoscopy

19
Q

How is mild medial shoulder insatbility defined and treated?

A
  • Inflammation without fraying, diruption, laxity
  • Slings or hobbles (keep them in for 4-6 weeks, only take off when in rehab)
  • Can use laser too
  • Timeframe 2-4 months
20
Q

How is moderate medial shoulder insatbility defined and treated?

A
  • Disruption and fraying of subscapularis tendon +/- medial GH ligament joint capsule
  • Treat with radiofrequency (heats tissue, becomes stronger as it cools down) or imbrication
  • Treat with hobbles for 3-4 months
  • 4-6 months of intense rehab
21
Q

How is moderate severe shoulder instability defined and treated?

A
  • 65 - 90 degree abduction with complete rupture of medial support tissue
  • Needs to be reconstructed
  • NWB in sling for 2 weeks
  • Hobbles for 3 months after
  • Rehab for 6 months
22
Q

What is the most common population for biceps tendinopathy?

A
  • Medium-large breed adult active dogs
23
Q

What is the presentation for biceps tendinopathy?

A
  • Chronic intermittent lameness
  • Worse after exercise
  • Non-responsive to NSAIDS
  • Associated with elbow disease
  • Can also occur secondary to supraspinatus tendon
  • More likely to be injured because it crosses two joints
24
Q

How do you treat biceps tendinopathy?

A
  • Surgery (can help but adhesions form long-term)

-

25
Q

What therapies should be addressed for shoulder tendinopathies?

A
  • Pain relief
  • Stimulate tissue healing (takes long time, > 6 months)
  • Collage fiber reallignment (eccentric)
  • Controlled return to function
26
Q

What is the presentation for Supraspinatus tendinopathy?

A
  • Active medium-large breed dogs
  • Repeat stress on tendon (eccentric loading on stretched muscle)
  • Presents as chronic weight-bearing lameness
  • Non-responsive to NSAIDS
  • Worse after exercise
27
Q

What are findings on PE that indicate Supraspinatus tendinopathy?

A
  • Function is to extend shoulder. Flexing elbow allows differentiation between biceps and SS dz
  • Supraspinatus atrophy
  • Pain on shoulder flexion especially with pressure on insertion point
  • Decreased muscle girth
  • Decreased ROM
  • On rads, mineralization is noted on supraspinatus
28
Q

What are surgical therapies for supraspinatus tendinopathy?

A
  • Removal of mineralized regions
  • Longitudinal incision
  • Tenectomy of SS
29
Q

What are non-surgical therapies for supraspinatus tendinopathy?

A
  • Shockwave
  • Stem cell
  • Rehab (eccentric training, neuromuscular training - prevents further injury)
  • Activity avoidance that may predispose dogs to this condition (jumping off things, etc)
30
Q

What dog is the poster child for elbow dysplasia?

A

Bernese Mountain Dogs

31
Q

What is a common presentation for fragmented coronoid process

A
  • Acute jump-down procedure
32
Q

What is BURP

A
  • Biceps ulnar release procedure

- Releases biceps tendon attachment to coronoid process

33
Q

What are treatment options of elbow medial compartment disease?

A
  • Surgery (arthroscopy
  • Multimodal OA management
  • Rehab
  • Regenerative medicine
  • Remember shoulder and compensation in rest of the body (biceps and long head of triceps connect elbow to shoulder)
34
Q

What are clinical signs noted with elbow osteoarthritis?

A
  • Cartilage erosion, periarticular fibrosis, decreased ROM, pain
35
Q

What are treatment options for elbow osteoarthritis?

A
  • Weight loss
  • Laser
  • ESWT
  • UWT
  • Massage
  • NSAIDs
  • Omega 3s
  • Acupuncture
36
Q

What is the common presentation for carpal hyperextension injury?

A

Large sporting dogs

- Usually secondary to a fall

37
Q

What anatomic damage causes signs of carpal hyperextension?

A
  • Tear in palmar fibrocartilage and short ligaments

- Avulsion and chip fractures also common

38
Q

How can you diagnose carpal hyperextension?

A
  • Palpate carpus

- Stress radiographs

39
Q

How can you treat mild carpal hyperextension?

A
  • Support and rehab
40
Q

How can you treat severe carpal hyperextension?

A
  • Arthrodesis and external coaptation
41
Q

What is a common presentation of a superficial digital flexor rupture?

A
  • Toes appear dropped

- This is due to tendon inserting on P2

42
Q

What is a common presentation of a deep digital flexor rupture?

A
  • Toes appear pulled up

- This is due to tendon inserting on P3

CRI Canine Rehab (7 decks)

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