06 Written Ortho Flashcards
1
Q
- Bone grafts are frequently used to promote bone healing in areas where deficits occur or where there is need to stimulate bone healing. Which statement below is correct regarding bone grafts?
a. The exact longevity of bone cells transferred to a graft site is not known, however it has been shown that more than 60% of cells collected and maintained in saline soaked sponges can survive for up to 30 minutes.
b. Experimentally, with the exception of BMP 4, allografts elicit osteoblastic activity.
c. The term creeping substitution stated for cortical grafts does not classically occur with autogenous cancellous grafts that undergo a proactive pattern of bone deposition and remodeling.
d. Cortical allograft contains BMP, but BMP and other bone derived growth factors cannot be preserved in normal processing and therefore do not contribute to osteoinduction.
e. Cortical bone sterilized by 12% ethylene oxide at 110 psi for 2 hours and packaged in paper is less antigenic and less dehydrated than bone processed at 84% ethylene oxide at room temperature and pressure for 12 hours and stored in a -70 freezer.
A
c. The term creeping substitution stated for cortical grafts does not classically occur with autogenous cancellous grafts that undergo a proactive pattern of bone deposition and remodeling.
2
Q
- Which of the following muscle contractures carry a guarded to poor prognosis?
a. Infraspinatus, Semitendinosus, Teres Minor
b. Supraspinatus, Gracilis and Teres Minor
c. Gracilis, Quadriceps and Triceps
d. Quadriceps, Semitendinosus and Gracilis
VCOT 2006
A
d. Quadriceps, Semitendinosus and Gracilis
3
Q
- Rupture of the cranial cruciate ligament is common in dogs. Surgical techniques have been developed to prevent tibial thrust. Which statement regarding the Tibial Tuberosity Advancement (TTA) technique is accurate?
a. The TTA utilizes an osteotomy performed in the transverse plane to move the patellar tendon cranially to lie perpendicular to the tibial plateau.
b. Measurements for corrections are taken from a lateral radiograph at a stifle joint angle of 135o with cranial translocation.
c. When adjustments were made to classification of major and minor complications in the study performed by Lafaver et al the major complication rate was 14.9% and the minor complication rate was 16.7%.
d. Implant failures can be associated with placement of the proximal aspect of the plate too caudal resulting in caudal displacement of the plate when the tibial tuberosity is advanced cranially.
e. Unlike what is reported with the tibial plateau leveling osteotomy, the Lafaver study showed that medial meniscal tear is rare after TTA and is not currently meniscal release is not recommended given the importance of this structure to the biomechanics of the stifle joint.
A
c. When adjustments were made to classification of major and minor complications in the study performed by Lafaver et al the major complication rate was 14.9% and the minor complication rate was 16.7%.
4
Q
- Sacroiliac fracture luxation is a common injury seen with other pelvic trauma associated with vehicular trauma. Which statement is accurate concerning the techniques used in stabilization of these injuries?
a. Fixation with a transilial pinning method where the pin lies over the articular facets of L7 is comparable to unilateral lag screw fixation in transmitting load to the opposite iliac wing.
b. Trans-iliosacral rods were associated with higher patient morbidity associated with urinary incontinence related to subsequent fracture of the sacral body when too large an implant was chosen.
c. Two screws correctly placed within the sacrum were determined to be as effective in preventing screw loosening and loss of reduction as was one cancellous screw engaging 50% or more of the sacrum.
d. Dogs are placed in sternal recumbency with their feet pointed cranially to facilitate reduction of the ilial wings and visualization of the sacral body during trans-iliosacral rod placement.
e. The most common complication seen with transilial pinning or trans-iliosacral rods is seroma formation associated with the rod or pins, and pin migration.
A
e. The most common complication seen with transilial pinning or trans-iliosacral rods is seroma formation associated with the rod or pins, and pin migration.
5
Q
- Which of the following limb spare technique cannot be recommended for the treatment of distal radial malignancies in dogs?
a. Transverse ulnar bone transport osteogenesis
b. In situ intraoperative radiation therapy
c. Placement of a stainless steel endoprosthesis
d. Ulnar transposition autograft
Vet Surg 2007
A
b. In situ intraoperative radiation therapy
6
Q
- Which of the following statements is the most correct regarding orthopedic infections?
a. Radiolabeling neutrophils with I131 is a sensitive and specific method of diagnosing chronic osteomyelitis
b. Hematogenous spread of bacteria cause 22.5% of osteomyelitis cases
c. Septic arthritis is characterized by acute pain and swelling, in multiple joints
d. Prophylactic antibiotics are effective when given 5-7 days post-operatively.
e. None of the above are correct
A
e. None of the above are correct
7
Q
- Why is it important to maintain the PaCO2 of animals with intracranial disease within normal range while they are under anesthesia?
a. The brain of these animals will not detect an increase in PaCO2, resulting in myocardial ischemia
b. Increasing PaCO2 would induce a vasodilation of the cerebral vessels, increasing the risk of brain herniation
c. Injury to the brain increases respiratory drive, causing PaCO2 to decrease, producing a vasoconstriction of the cerebral vessels
d. The vasoconstriction induced by rising PaCO2 would further decrease cerebral perfusion
Slatter 2003, pp1135
A
b. Increasing PaCO2 would induce a vasodilation of the cerebral vessels, increasing the risk of brain herniation
8
Q
- Juvenile pubic symphysiodesis (JPS) has been shown by several investigators to produce ventrolateral rotation of the acetabular rim. A recent study performed by Manley et al comparing the JPS and triple pelvic osteotomy (TPO) techniques revealed what findings?
a. The pre-surgical lameness score for dogs that were treated with JPS had improved at the 2 year postoperative lameness evaluation.
b. The preoperative lameness score for dogs that were treated with TPO was not significantly different from the 2 year postoperative lameness score.
c. Both the JPS and TPO procedures were successful in increasing the coverage of the femoral head as measured by DARA.
d. Neither procedure as evaluated in this study was shown to be successful in reducing subluxation of the hip joints or reducing the development and progression of DJD.
e. Dogs with any level of DJD were not included in this study and yet DJD was seen in all dogs regardless of where they received a TPO or JPS procedure.
A
d. Neither procedure as evaluated in this study was shown to be successful in reducing subluxation of the hip joints or reducing the development and progression of DJD.
9
Q
- Choose the correct answer regarding muscular pathology?
a. Scapular dislocation is due to serratus ventralis muscle rupture
b. Scapular dislocation is a grade V muscle strain
c. Surgical intervention is not needed for strains unless contracture occurs as a result
d. The most common site of muscle strain is mid belly where fibers are weakest.
e. All of the above
A
a. Scapular dislocation is due to serratus ventralis muscle rupture
10
Q
- Craniodorsal luxation as a complication in total hip replacement has been well documented. Recently, Nelson LL et al reported on the risk factors for ventral luxation in dogs with canine total hip replacement (THR). Which statement is accurate regarding the findings of this study?
a. Saint Bernard-type dogs were at greater risk of ventral luxation as compared with other breeds groups undergoing THR, although no significant specific risk factor related to implant position or size was found.
b. The use of cementless components was a significant risk factor in the development of ventral luxation and was thought to be related to femoral subsidence and retroversion.
c. The use of a short neck length was identified as a significant risk factor in that progression from a +0 neck to a +9 neck increased the risk for ventral luxation.
d. Increase angle of lateral opening was a significant risk factor especially in Saint Bernard-type dogs and was directly related to impinge of the femoral neck on the dorsal rim of the cup.
e. Ventral luxation is most commonly and effectively treated closed and the same was true for this study.
A
a. Saint Bernard-type dogs were at greater risk of ventral luxation as compared with other breeds groups undergoing THR, although no significant specific risk factor related to implant position or size was found.
11
Q
- Interlocking nail constructs with 2 screws per segment most effectively control:
a. Axial compression
b. Axial tension
c. Torsion
d. Bending forces
Slatter 2003, pp1807
A
d. Bending forces
12
Q
- Several approaches have been advocated for removing lesion of the thoracic and lumbar spine. Recently, Forterre et al described the thoracolumbar dorsolateral laminectomy to expose the spine cord for tumor or subarachnoid cyst removal. Which of the following statements is accurate regarding surgical approaches to the spine?
a. The Funkquist Type A procedure removes the articular processes to the level of a dorsal plane drawn through the middle of the spinal cord and is characteristically associated the greatest risk of constrictive fibrosis.
b. The Funkquist Type A procedure preserves the cranial articular process, but removes most of the caudal articular processes and the pedicles preventing constrictive fibrosis.
c. The thoracolumbar dorsolateral laminectomy is a modification of the Funkquist Type B procedure in that it preserves the articular facets on the side of the spinal cord ipsilateral to the lesion.
d. The dorsal spinous processes is removed when performing the Funkquist Type A and B and the thoracolumbar dorsolateral laminectomy.
e. The modified dorsal laminectomy removes the caudal articular facets while preserving the cranial facets and pedicles.
A
a. The Funkquist Type A procedure removes the articular processes to the level of a dorsal plane drawn through the middle of the spinal cord and is characteristically associated the greatest risk of constrictive fibrosis.
13
Q
- According to Ruddle et al (VCOT 2006), which of the following statements is true?
a. Hanson Type I Intervertebral Disk Disease is most likely to occur in the T13-L1 intervertebral space.
b. There are no regional difference (T3-L3 vs L4-S1) in prognosis for dogs with Hansen Type I disk extrusions.
c. As the dog’s age increases the severity of spinal cord injury is decreased in dogs with intervertebral disk disease.
d. Strong ambulation occurs faster after surgery in dogs with Hanson Type I disk extrusion in the T10-L2 region.
A
b. There are no regional difference (T3-L3 vs L4-S1) in prognosis for dogs with Hansen Type I disk extrusions.
14
Q
- Which is the tension surface of the humerus?
a. The craniomedial aspect
b. The craniolateral aspect
c. The caudmedial aspect
d. The caudolateral aspect
Slatter 2003, pp1788
A
b. The craniolateral aspect
15
Q
- The cause for forelimb lameness associated with the shoulder joint can be elusive and several tests have been developed to determine stability of the shoulder joint. The research performed by Devitt CM et al regarding the validity of those tests revealed?
a. The biceps test had a moderate effect on post-test probability of cranial compartment changes but was confounded by cervical intervertebral disk disease.
b. The possibility of lesions in any compartment of the shoulder joint could not be determined by the results of the craniocaudal instability test.
c. Hyperabduction as described by Cook JL. et al had a moderate effect on post-test probability of medial compartment changes.
d. The likelihood ratio indicates how much a given diagnostic test result will alter the post-test probability of a target disorder.
e. A craniomedial evaluation of the shoulder joint was performed using a outside-in technique to establish the portal.
A
b. The possibility of lesions in any compartment of the shoulder joint could not be determined by the results of the craniocaudal instability test.
