Veterinary Orthopaedic and diagnostic assessment Flashcards

1
Q

Describe a hands off assessment

A

History

Static evaluation

Dynamic assessment

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2
Q

What kind of questions might you ask (general)?

A

Age, breed & sex

Behaviour

General medical history

Vaccinations

Is the animal on any medications?

Allergies

Insurance status

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3
Q

What kind of questions might you ask (orthopaedic focused)?

A

Acute or chronic?

Has it happened before? Intermittent/continuous

If intermittent, how long does each ‘attack’ last? Does anything seem to trigger it?

History of injury/wounds in the area?

When was the horse last shod?

When was it noticed?

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4
Q

Describe a hands on assessment

A

Palpation and manipulation

Flexion tests

Regional anaesthesia +/- ancillary tests

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5
Q

What should you consider regarding the posture?

A

Are they evenly weightbearing?

Is one leg being carried?

Are they shifting weight?

What is their head position?

Is there hyperflexion or hyperextension of joints?

Are there any angular limb deformities?

What is their spinal posture?

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6
Q

How may symmetry be beneficial during an examination?

A

Muscle atrophy

Muscle hypertrophy

Swellings

Angular limb deformity

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7
Q

What environmental considerations should you make when carrying out an examination?

A

Enclosed

Sufficient light

Sufficient space

Distractions

Guideline

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8
Q

What assessments can you carry out to aid the examination?

A

Walk vs trot

Variety of directions - straight line & circle (both directions)

Variety of surfaces - hard & soft

Ridden assessments can be useful

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9
Q

Describe the UK lameness scoring system

A

0 - Sound

2 - Lameness hard to detect at walk or trot

4 - Lameness barely detectable at walk, easy to see at trot

6 - Lameness easily detectable at walk

8 - Hobbling at walk, unable/unwilling to trot

10 - Non-weight bearing

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10
Q

Describe the AAEP lameness scoring system

A

0 - Lameness not perceivable under any circumstances

1 - Lameness difficult to observe and not consistently present

2 - Lameness is difficult to observe at walk or trot in a straight line but can be consistently apparent under certain circumstances (ridden, circling etc)

3 - Lameness consistently observable at trot under all circumstances

4 - Lameness is obvious at walk

5 - Minimal weight bearing in motion or at rest or complete inability to move.

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11
Q

Describe other signs you may see if the animal has forelimb lameness

A

Head nod - nod on the sound leg

Ear bounce - as ears bounce up, that’s the lame leg

Head position - if lunging horse, if lame leg is on the inside, head will aim outwards

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12
Q

Describe other signs you may see if the animal has hindlimb lameness

A

Pelvic rise - lame limb may show greater amount of movement

Foot placement - hind limb should hit where forelimb was placed when walking. If falls short, may be lame

Toe dragging

Degree of joint flexion

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13
Q

Describe non-specific limb signs of lameness

A

Foot fall - can you hear the difference

Stride length and character

Tail position

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14
Q

What is referred lameness?

A

‘False lameness’

The animal tries to compensate by taking weight off of lame foot, which can make a different foot look lame instead

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15
Q

Describe secondary lameness

A

‘True’ lameness

Due to prolonged overloading

Referred -> secondary

Multiple limbs makes it difficult

Use ancillary tests!

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16
Q

What should you palpate?

A

Sequence to ensure no omissions

Relevant anatomy

  • Ligaments
  • Tendons
  • Joints
  • Bony prominence’s

Swellings

Pain

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17
Q

What are the two types of reduced ROM?

A

Mechanical

Painful

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18
Q

Describe a flexion test

A

Exacerbate lameness

Limb held in tight flexion (approx. 1 minute)

Horse is immediately trotted 12-15m

A positive result is a more pronounced lameness compared to before the test

Not very specific as cannot confirm exactly what joint as will be flexing more than one joint at a time

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19
Q

Describe diagnostic regional anasthesia

A

‘Nerve blocks’

Detect region of limb affected

Local anaesthetic used to desensitise certain areas

At least 80% improvement

Start low and work up – anaesthesia will work its way down so will numb everything below

20
Q

What does the palmar/plantar digital nerve block affect?

A

Desensitises entire foot EXCEPT:

Dorsal aspect of coronary band

Laminae of the dorsal wall of the toe

21
Q

What does the abaxiol sesamoid nerve block affect?

A

Desensitises:

Entire foot

Distal interphalangeal joint

Distal sesmoidean ligament

Flexor tendons distal to site

Proximal interphalangeal joint

22
Q

What does the low 4 point nerve block affect (forelimb)?

A

Desensitises limb distal to injection sites

23
Q

What does the low 6 point nerve block affect (hindlimb)?

A

Similar to low 4 point but in the hindlimb

Additional injection site

Tested by skin sensation distal to the sites

Desensitises limb distal to injection sites

24
Q

What does the high 4 point nerve block affect (forelimb)?

A

Palmar nerves just distal to carpus

Tested by squeezing of the suspensory ligament

Desensitises limb distal to injection site

25
Q

What does the high 6 point nerve block affect (hindlimb)?

A

Similar to high 4 point but in the hind limb

additional injection site

Tested by squeezing the suspensory ligament

Desensitises limb distal to injection site

26
Q

Name two additional nerve blocks in the forelimb

A

Median nerve block

Ulnar nerve block

27
Q

Name two additional nerve blocks in the hindlimb

A

Tibial nerve block

Peroneal nerve block

28
Q

Describe joint blocks

A

Local anaesthetic injected into joint spaces

Positive result would be >80% improvement in lameness seen

Aseptic conditions

29
Q

List methods of diagnostic imaging

A

X-rays

Ultrasound

Computed Tomography

Magnetic Resonance Imaging

Thermography

Scintigraphy

Arthroscopy

30
Q

What are the different types of x-ray machines?

A

Fixed machines

Portable machines

31
Q

What are some health and safety concerns regarding x-rays?

A

Change atom or molecule

Inappropriate chemical reactions

32
Q

What safety measures can you put in place with x-rays to reduce H&S concerns?

A

Radiation monitors/badges

Lead lined aprons, thyroid protectors and gloves

Grids

33
Q

Safety measures surrounding x-rays will differ between small animal and equine. How?

A

SA - min 2 metres from primary beam

Equine - Individuals in equine with portable must hold machine and plate

34
Q

Describe contrast media

A

Highlights area of interest

Positive  Liquid contrast medium

Negative  Air/carbon dioxide

35
Q

Describe ultrasound

A

Electric current applied to piezoelectric crystals

Change shape and vibrate

Produce high frequency sound waves

Amount reflected back at transducer is what produces the image

36
Q

Describe computer tomography

A

Ring-shaped machine

X-ray tube at one side and detector on the other

Rotates back and forth as patient moves through.

Cross-sectional images

Great differentiation of tissues with greyscale

Hounsfield scale

37
Q

Is computed tomography used in equine or small animal?

A

Heavily utilised in small animal

They can fit through the machine!

Use is limited in horses…. at the moment

Head

Neck

Distal limb

38
Q

Describe thermography

A

Infrared radiation emitted from the skin

Detects heat patterns and changes in blood flow

Highlights area of inflammation

39
Q

Describe scintigraphy

A

‘Nuclear’ imaging

Nucleotides attached to pharmaceuticals  target body part

Accumulate in areas of increase physiological function

Healing (fractures)

Increased cell turnover (neoplasia)

Increased blood supply (inflammation)

Nucleotides emit gamma radiation

Detected using a gamma camera as ‘hot spots’

Radioactive therefore heavily governed by H&S

40
Q

Describe arthroscopy

A

Endoscopy

Diagnostic and therapeutic

Full GA and ASEPTIC TECHNIQUE

41
Q

Name two laboratory techniques utilised in orthopaedics

A

Arthrocentesis

Synovial membrane biopsy

42
Q

Describe arthrocentesis

A

‘Joint taps’

Puncture joint capsule and aspirate synovial fluid

Aseptic technique

Iatrogenic joint sepsis

43
Q

What can an arthrocentesis analyse?

A

Gross appearance

Cytology

Bacteria

Antibodies (Lyme’s disease)

Protein

Indicates inflammation, septic joints, Lyme’s disease etc

44
Q

What can be put into the joint to assess joint involved with wounds?

A

Sterile saline

45
Q

What are ultrasounds good for viewing?

A

Tendons

Ligaments

Muscles

(Soft tissues)