Term
| What are the bones of the LA digit? |
|
Definition
-metacarpus/metatarsus
-phalanges 1-3
-sesamoid bones |
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Term
| What are the joints of the LA distal limb? What are their associated common names? |
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Definition
-Metacarpo/metatarsophalangeal joint: Fetlock
-Proximal interphalangeal joint: Pastern
-Distal interphalangeal joint: coffin |
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Term
| What are the tendons of the LA distal limb? |
|
Definition
-superficial digital flexor
-deep digital flexor
-common digital extensor |
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Term
| What are the layers of the horn in the LA distal limb? |
|
Definition
-perioplic
-lamellar
-solar |
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Term
| What are the layers of the corium/lamina in the LA distal limb? |
|
Definition
-perioplic
-parietal
-lamellar
-solar |
|
|
Term
| What are some of the other important structures in the LA distal limb? Seriously though just read this list a few times. |
|
Definition
-flexor process of P3
-navicular bursa
-digital cushion
-coronary band
-white line
-dorsal common digital vein
-abaxial sesamoid vv |
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Term
| What are the normal weigth bearing surfaces of the LA distal limb? |
|
Definition
-abaxial hoof wall
-heel
-toe |
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Term
| Which claw bears the majority of the weight in the LA front end? Back end? |
|
Definition
-front = medial
-rear = lateral |
|
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Term
| What are the components of the pedal bone support system? |
|
Definition
-laminae (corium)
-digital cushion |
|
|
Term
| What is the most common location for solar ulcers? |
|
Definition
| -deep to the flexor process of P3 |
|
|
Term
| What are the components of a LA lameness exam? |
|
Definition
-history
-distance xam with animal standing
-distance exam with anial walking
-hands on exam
-other diagnostics |
|
|
Term
| What are the important parts of taking a history for the lameness exam? |
|
Definition
-initial clinical signs
-changes in diet, housing
-duration
-progression
-response to treatment
-other animals affected |
|
|
Term
| What do we look at during our distance lameness exam? |
|
Definition
-natural environment if possible (ood footing)
-posture: back, limb posture
-Weight bearing
-limb abduction/adduction
-symmetry
-confirmation
-obvious swelling, injury, etc |
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Term
| What does an arched LA back suggest? |
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Definition
|
|
Term
| What do crossed legs suggest in a cow? |
|
Definition
|
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Term
| Why do we look at symmetry during a distance lameness exam? |
|
Definition
| -looking for muscle atrophy or coxofemoral luxaiton |
|
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Term
| What do we specifically look at during the walking portion of a distance lameness exam? |
|
Definition
-posture: back
-Limb movement: circumduction, joint movement, stride length, duration of each phase of stride
-Foot placement: abduction/adduction, toe touching, shifting weight from to toe or heel
-head carriage |
|
|
Term
| Approximately what percentage of LA lameness occurs in the foot? |
|
Definition
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|
Term
| What is the purpose of assigning a lameness score? |
|
Definition
-improves communication
-enables tacking of progression or response to treatment |
|
|
Term
| What are the different lameness scores and what do they mean? |
|
Definition
1 = normal
2 = slight abnormality (stiff, uneven gait)
3 = slight lameness ( moderate and consistent lameness)
4 = obvious lameness (still weight bearing)
5 = severe lameness (non-weight bearing) |
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Term
| What is the significance of a head bob during a LA lameness exam? |
|
Definition
| -head bobs down with the sound limb |
|
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Term
| What are different restraint methods that we use for a hands on lameness exam? |
|
Definition
-tilt chute or hoof trimming table
-ropes
-cast
-avoid sedation/local anesthesia if possible |
|
|
Term
| What is the purpose of a hoof tester? Where is it used? |
|
Definition
-to apply pointed pressure to different parts of the LA distal limb to look for sensitivity
-Apical toe, Abaxial wall to midsole, sole-heel junction, axial-abaxial wall, percussion |
|
|
Term
| What is the purpose behind hoof trimming? |
|
Definition
-helps locate the lesion
-allows exporation of cracks, crevices, and tract |
|
|
Term
| Why do we explore cracks, crevices, and tracts when we trim LA hoofs? |
|
Definition
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Term
| What is swelling on the coronary band highly indicative of? |
|
Definition
| -septic arthritis in the coffin joint |
|
|
Term
| What are the possible causes of upper limb swelling in LA? |
|
Definition
-joint effusion
-cellulitis
-hematoma
-fibrosis |
|
|
Term
| What motions do we test on the upper limb lameness exam of LA? |
|
Definition
-flexion
-extension
-abduction
-adduction |
|
|
Term
| What can crepitation mean on an upper limb LA lameness exam? |
|
Definition
-fracture
-ligament rupture
-gas producing infection: puncture wound, ruptured bulla in lung, abdominal surgery |
|
|
Term
| What are the components of the triangle we look at on LA? When is it optimal to palpate these landmarks? |
|
Definition
-tuber coxae, tuber ischii, greater trochanter
-while the animal is walking |
|
|
Term
| What is the most common issue seen with a messed up triangle in LA? |
|
Definition
|
|
Term
| What ancillary diagnostics are part of a LA lameness workup? |
|
Definition
-rads: equine >> FA
-US
-arthrocentesis
-regional anesthesia
-culture/sensitivity |
|
|
Term
| What issues do we see on rads that occur with LA lameness? |
|
Definition
-osteomyelitis: periosteal rxn with lysis
-septic arthritis: widened joint space
-ligament injury: joint laxity, instability
-fracture |
|
|
Term
| How long does it take to see radiographic evidence of infection in bone? |
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Definition
|
|
Term
| What is a cranially displaced tibial tuberosity indicative of? |
|
Definition
| -ruptured cranial cruciate ligament |
|
|
Term
| What are the uses of ultrasonography as an ancillary diagnostic for LA lameness cases? |
|
Definition
-Softtissue eval: cellulitis, edema
-Tendon/tendon sheath: fluid eval
-Joints: synovial fluid eval |
|
|
Term
| Which specific tendon is US good for? |
|
Definition
|
|
Term
| What does chronic inflammation look like on US? |
|
Definition
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|
Term
| What is the purpose of arthrocentesis for the purposes of a lameness case in LA? |
|
Definition
|
|
Term
| What arthrocentesis values are consistent with septic arthritis? |
|
Definition
| --NCC > 25,000 cells/ul, TP > 4.5g/dl |
|
|
Term
| What is the huge stipulation to performing arthrocentesis? |
|
Definition
| -MUST BE STERILE, thus if you cannot get to the joint through healthy tissue, don't bother doing it |
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Term
| What are the three major methods of regional anesthesia used as an ancillary diagnsotic for a LA lameness exam? What is the purpose? |
|
Definition
-perineural, regional IV (FA), intra-articular
-determines source of pain by reducing or eliminating pain response |
|
|
Term
| Describe a regional IV anesthetic administration in LA. |
|
Definition
-easily anesthetizes distal limb
-anesthetic injected IV distal to a tourniquet |
|
|
Term
| What do we use for digital anesthesia? Why? |
|
Definition
-20 mls 2% lidocaine into dorsal common digital v
-provides effective surgical aneshtesia distal to the tourniquet |
|
|
Term
| What would cause us to switch vv for digital anesthesia from the dorsal common digital v? |
|
Definition
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|
Term
| Why would we bother with culture/sensitivity testing as an ancillary diagnostic of LA lameness? What is the major drawback to this method of testing? |
|
Definition
-confirms sepsis and may guide antimicrobial therapy
-most bugs causing issues are in the synovial membrane, not the fluid, so a culturing a biopsy could be useful but just fluid wouldn't be
-will always grow Trueperella pyogenes regardless of who the primary culprit is |
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