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2. Anatomy > Equine forelimb > Flashcards

Equine forelimb Flashcards

1
Q

What are the 6 joints of the forelimb?

A
  1. Shoulder
  2. Elbow
  3. Carpus
  4. Fetlock
  5. Pastern
  6. Coffin
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2
Q

Shoulder joint

A

Articulation between the scapula and humerus

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3
Q

Elbow joint

A

Articulation between the humerus and the radius and ulna

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4
Q

What are the 3 distinct joints of the carpus joint?

A
  1. Radio-carpal joint
  2. Inter-carpal joint
  3. Carpo-metacarpal joint
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5
Q

Radio-carpal joint

A

Btwn distal end of the radius and the first row of carpal bones (accessory, ulnar, intermediate and radial –> lateral to medial)

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6
Q

Inter-carpal joint

A

Btwn the first row of carpal bones and second row of carpal bones (4th, 3rd, 2nd –> lat to medial)

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7
Q

Carpo-metacarpal Joint

A

Btwn second row of carpal bones and second metacarpal bone (medial splint bone), third metacarpal bone (cannon bone) and fourth metacarpal bone (lateral splint bone)

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8
Q

Fetlock Joint

A

Btwn distal end of the 3rd metacarpal, proximal sesamoid bones and the first phalanx

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9
Q

Pasten Joint

A

Btwn first and second phalanx

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10
Q

Coffin joint

A

Btwn second phalanx, distal sesamoid bone/ navicular bone and third phalanx (coffin bone)

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11
Q

What is located @ the olecranon?

A

Olecranon bursa to reduce friction
CS: capped elbow/ shoe boil –> inflammation and calcification of this bursa (drain)

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12
Q

What important muscles are on the lateral side of the scapula?

A

Supraspinatus and infraspinatus and btwn them is the suprascapular nerve

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13
Q

CS of the suprascapular nerve?

A

Located directly under the skin –> trauma –> Sweeny –> lameness, scapular muscle atropy and prominent scapular spine

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14
Q

What important muscle is on the medial side?

A

Subscapularis

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15
Q

What are the muscles of the humerus?

A

Biceps and triceps muscles

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16
Q

Bicipital Bursa

A

Between the tendon of the origin of the biceps muscle and the head of the humerus
Insert needle between the biceps and humerus slightly above the level of the deltoid tuberosity

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17
Q

Passive Stay apparatus

A

Enables the horse to rest while standing and use a minimal amount of muscular energy
2 overflexions and 2 overextensions

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18
Q

What is the first structure under PSA that prevents overflexion of the shoulder join?

A

Tendon of the biceps

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19
Q

Under PSA, what prevents overflexion of the elbow?

A

Collateral ligaments and fibrous components of digit and carpus
They take over the weight because they fatigue slower than muscles

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20
Q

Under PSA, what prevents carpus overextension?

A

Flat dorsal part of the midcarpal joint, radiocarpal joint, carpal ligaments and pull of the ECR by the laceratus fibrosis

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21
Q

Under PSA, what prevents fetlock overextension?

A

Proximal sesamoid bone and ligaments
Suspensory ligament

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22
Q

What muscles are on the lateral surface of the radius?

A

ECR
ECO
CDE
LDE
UL

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23
Q

What muscles are on the latero-caudal surface of the radius?

A

Lacertus fibrosus (LF)
FCR
FCU
DDF
SDF

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24
Q

What is significant about the medial surface of the radius?

A

Contains no muscles, only periosteum
Periosteal stripping performed here

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25
Q

Periosteal stripping

A

Treats the angular limb deformities (one side of the bone grows faster than the other)
Done medially only!
Created a inverted T shape incision in the periosteum to promote growth

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26
Q

Valgus

A

Angular deformity where the medial side grows faster than the lateral side (toes out)

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27
Q

Varus

A

Angular deformity where the lateral side of the bone grows faster than the medial side (toes in)

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28
Q

Transphyseal Bridging

A

Slows growth (laterally done)
Two 5.5 mm screws adjacent to the growthplate of the carpus, connected by a wire

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29
Q

What is the function of the triceps and UL?

A

Extend the elbow

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30
Q

What is the function of the ECR, LDE, ECO, and CDE?

A

Extends the carpus

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31
Q

What is the function of the biceps and FCR?

A

Flexes the elbow

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32
Q

What is the function of the SDF and DDF?

A

Flexes the carpus and digit

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33
Q

Which tendons pass over the carpus dorsally?

A

Tendons of the ECR and CDE

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34
Q

What is significant of the tendon of the ECR?

A

Inserts on carpometacarpal joint capsule
Important landmark to access carpus joint
Needle inserted on either side of the ECR tendon

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35
Q

CS of the ECR and CDE

A

Hyperflexion
OCD/ chip fractures/ slab fractures
Bone cysts
Carpitis

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36
Q

CS of the tendon of the CDE

A

The only tendon that reaches the distal end of the forelimb dorsally
Inserts on the extensor process of the P3
Hyperflexion

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37
Q

What is extensor process of P3 a landmark for?

A

Landmark for accessing the coffin joint
Needle inserted on either side of process for arthrocentesis, joint anesthesia, and block injections

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38
Q

CS of the extensor process of P3

A
  1. Bony deposits and calcification causing pyramid disease
  2. Racehorse fractures
  3. Arthrocentesis
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39
Q

What does the musculocutaneous nerve innervate?

A

Biceps (flexors of the elbow)

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40
Q

What does the a axillary nerve innervate?

A

Flexors of the shoulder

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41
Q

What does the radial nerve innervate and what’s the CS?

A

Extensors of the elbow, carpus and digits
CS: Hyperflexion, radial nerve paralysis, dropped elbow

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42
Q

What does the ulnar/ median nerve innervate and what’s the CS?

A

Flexors of the carpus and digits
CS: hyperextention

43
Q

CS of the brachial plexus

A

Atrophy (no nerve supply)
Touch toe lameness (can’t bear weight)
Brachial plexus paralysis

44
Q

Where does the SDF and DDF insert?

A

The palmar surface of P1 P2 for SDF
P3 for DDF both on palmar surface (ONLY)

45
Q

What is the continuous contraction of the SDF and DDF?

A

Contracted tendons/ clubfoot (foals)
Treated by severing one or two of the check ligaments (distal or proximal check ligament)

46
Q

Which two carpal joints can be used to arthocentesis or arthroscopy?

A

Radio-capral and inter-carpal because they have a spacious joint that’s easily accessed

47
Q

The carpo-metacarpal joint can be accessed by injecting the _______________

A

inter-carpal joint

48
Q

What is the metacarpal region made up of?

A

Second metacarpal bone (medial splint)
Third metacarpal bone (cannon bone)
Fourth metacarpal bone (lateral splint)
landmarks for metacarpal nerve blocks

49
Q

What covers the metacapus?

A

Tendon of CDE dorsally (cranial/ front)
SDF, DDF, and suspensory lig cover ventral (caudal/ back)

50
Q

Orientation of the suspensory ligament on the metacarpus

A

Divides into medial and lateral branches @ fetlock
Changes from ventral/caudal surface of M3 to dorsal surface of P1 and united with the tendon of the CDE on dorsal surface of the digit

51
Q

Suspensory injuries

A

Overextension of the fetlock

52
Q

What are the CS of the metacarpal?

A

Tendonitis (bowed tendon of SDF)
Periostitis/ bucked shins/ osteomyelitis
Inflammation of the periosteum that covers M3
Splint fractures and cannon bones
Ruptured and contracted tendons (club foot)

53
Q

What is the best diagnostic technique for tendon injuries?

A

Ultrasound

54
Q

Bowed tendon

A

Tendonitis of the SDF
Tears, then when it heals, it doesn’t heal straight giving it the bow shape

55
Q

How do you treat metacarpal injuries?

A

Check ligament desmotomies of the DDF and/ or SDF

56
Q

What are the 3 joints of the digit?

A

Fetlock, pastern and coffin

57
Q

What is the landmark to access the fetlock for athrocentesis/ arthroscopy?

A

Between M3 and distal end of M4 and lateral branch of the suspensory ligament
Standing horse or flexed joint

58
Q

What are the CS of the fetlock joint?

A

Sesamoiditis
OCD of the fetlock

59
Q

What BVs are seen on along the digit

A

Medial and lateral palmar digital nerves + dorsal branches in cordlike bundle
With vein (most superficial), artery and nerve (under skin, most embedded)

60
Q

What are the CS of the pastern joint?

A

High and low ringbone
Bone exostoses (irregular bone growth) of P2

61
Q

Alar cartilages

A

Extensions from the medal and lateral aspects of the third phalanx (2)
Protects P3 from both sides
Digital cushion between

62
Q

CS of the alar cartilages

A

Becomes calcified leading to side bone
Infection/ necrosis leading to quittor

63
Q

What structures cover P3 from the palmar/ plantar aspect?

A

Navicular bone
DDF
Digital cushion (chronological)

64
Q

How are the navicular bone and P3 connected?

A

Through Impar ligament (Sharpy’s fibers)

65
Q

Navicular Bursa

A

Sits between the navicular bone and DDF tendon
Inflammation: Navicular bursitis

66
Q

How do you inject the navicular bursa?

A

Place needle between alar cartilages through digital cushion (and DDF tendon) in a 45 degree angle on the palmar/ plantar midline

67
Q

Avulsion of the Sharpey’s Fibers (Impar ligament)

A

Rupture
Non-weight bearing lameness
Acute case or occurs gradually with age

68
Q

Development of Vascular Channels in navicular bone

A

With age fibers will start to rupture/ damage one by one –> necrotic
Osteoclasts eat the necrotic bone (clean)
Causes vascular channels and navicular disease

69
Q

How do you diagnose navicular disease?

A

Hoof testing
Nuclear scintigraphy (avulsion if one, disease if both)

70
Q

How do you fix navicular disease?

A

Palmar digital neurectomy (de-innervate the navicular bone)- pain killer, not treatment

71
Q

Hoof

A

Keratinized epidermis that covered P3
3 parts: wall, sole, frog

72
Q

Wall of the hoof

A

3 regions: toe, quarter, heel
CS: seedy toe (wall cracks), canker (wall leaks horn that becomes infected), thrush (infected wall angle)

73
Q

Sole abscess

A

Most common problem
Caused by foreign bodies (nail) causing an injury creating an opening in the sole that bacteria can get into

74
Q

How do you treat sole abscess?

A

Aggressive cleaning of the sole with hoof knife + epson salt
Street-nail procedure by making an opening in the frog to relieve pain and infection (exposing DDF tendon)

75
Q

The lamina of the hoof wall

A

Inner layer of the hoof wall: internal lamina of the epidermis
Interdigitates with the external lamina of the dermis that covers P3 (no separation normally)

76
Q

What is between the inter-digitation?

A

Blood supply for P3 (highly vascular)

77
Q

Blood supply of the lamina

A

Axial artery, a branch of the parietal artery (originates from the medial and lateral palmar digital arteries), and vein
Compromise= compromise to the inter-digitation

78
Q

What conditions cause compromise to the inter-digitation?

A

Endotoxemia (bacterial toxin circulates in the blood stream)
Trauma or grain overload followed by parturition –> leads to separation of epidermis and dermis leading to laminitis

79
Q

What is the initial stage of laminitis?

A

Founder with heat in area, pounding pulse in digital vessels above the bulbs of the heels, severe pain/ lameness

80
Q

What is the end stage of laminitis?

A

Rotation/ sinking P3
Loss of parallel relationship between the wall of the hoof and P3
P3 is pulled backward and downward by the DDF tendon

81
Q

Lameness examination

A
  1. History/ Physical exam- hoof cleaning, vital signs, inspecting horse while walking, palpate and hoof testing
  2. Flexion tests systemically- flex joint then watch it run (distal-proximal)
  3. Nerve and joint blocks in a chronological order
82
Q

Normal hoof angle

A

45 degrees in the front
48-52 degrees hind

83
Q

What is the nerve block order?

A
  1. Palmar digital nerve block
  2. Abaxial nerve block
  3. Low palmar nerve block
  4. High volar nerve block
84
Q

Palmar digital nerve block

A

Blocks: medial and lateral palmar digital nerves (not dorsal branches)
Desensitizes: navicular bone and bursa, and digital cushion

85
Q

How should the digital palmar nerve block injection be given?

A

Medially and laterally above the bulbs of the heels after palpating bundle (flexed)

86
Q

What does the palmar nerve block diagnose?

A

Navicular disease and bursitis or impar ligament avulsion

87
Q

Abaxial nerve block (Basiseamoid)

A

Blocks: Medial and lateral palmar digital nerves and dorsal branches
Desensitizes: Pastern joint

88
Q

How do you perform the abaxial nerve block and what does it diagnose?

A

Inject medial and lateral at the base of the proximal sesamoid bones (flexed)
High or low ring bones

89
Q

Low palmar nerve block

A

Desensitizes: Fetlock joint
Blocks: Medial and lateral palmar nerves, medial and lateral palmar metacarpal nerves (not communicating)

90
Q

Where should the low palmar nerve block be given?

A

@ 4 points: two at the end of each splint bone (buttons) and two at the dorsal border of the DDF (standing)

91
Q

What does low palmar nerve block diagnose?

A

Sesamoiditis (proximal sesamoid bones), avulsion of SDF and DDF

92
Q

High volar nerve block (high palmar, 4 point or ring block)

A

Desensitizes: splint bones and proximal suspensory ligaments
Blocks: Communicating branch of the medial palmar, medal and lateral palmar nerves, medial and lateral palmar metacarpal nerves

93
Q

How do you perform the high palmar nerve block?

A

4 injections: @ proximal end of the splint bones (2) and @ proximal border of the DDF (standing)

94
Q

What is high palmar nerve block used to diagnose?

A

Bucked shins (periostitis of cannon bone) or fractured splint bones

95
Q

What does the medial and lateral palmar metacarpal nerve innervate?

A

Interosseous ligaments and muscle

96
Q

What nerves supply the forelimb?

A

The median nerve medially and the ulnar nerve laterally

97
Q

What happens to the median nerve @ the level of the carpus?

A

Median nerve gives 2 branches: medial palmar and the lateral palmar nerves

98
Q

What happens to the ulnar nerve @ the level of the carpus?

A

Gives 2 branches: dorsal branch (ends @ the dorsal surface of the carpus) and the palmar branch

99
Q

What does the medial palmar nerve do at the mid-carpal level?

A

Gives a communicating branch which connects with the lateral palmar nerve and continues are the medial palmar nerve

100
Q

What does the medial palmar nerve do at the fetlock?

A

Splits into two nerves, the medial and dorsal palmar digital nerve that supply the digit medially

101
Q

What does the lateral palmar branch of the median nerve do at the mid-carpal level?

A

Connects with the palmar branch of the ulnar nerve to give the deep branch of the lateral palmar nerve
Continues as the lateral palmar nerve

102
Q

What does the deep branch of the lateral palmar nerve do?

A

Gives the medial and lateral palmar metacarpal nerves and end @ the palmar surface of the fetlock joint

103
Q

What happens to the lateral palmar nerve @ the level of the fetlock

A

Splits into 2 branches: lateral and dorsal palmar digital nerves that supply the digit laterally

2. Anatomy (14 decks)

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