Equine Lameness Exam 2 Flashcards
Why should imaging occur before nerve blocks
To assess lameness grade & insure there’s no fractures
Blocking a fractured limb could lead to catastrophic damage
Onset & duration of lidocaine
Rapid
1.5-3 hours
Onset & duration of mepivacaine
Rapid
2-3 hours
Onset and duration of bupivacaine
Intermediate onset not ideal
3-6 hour duration - ideal for standing surgery
Assessing block improvement
Ideally 100% improvement during block
> 70%, lesser would indicate further blocks
Further injuries if blocks are unsuccessful
Severe lameness
Articular lesions
Deep bone pain/bruise
Laminitis
Gait abnormalities
What needle is ideal for a nerve block
18 G to avoid breakage if limb is bent
20 G when necessary
Palmar digital nerve block
Palmar/ plantar digital nerves
1cm proximal to collateral cartilages
1.5-2ml fluid
5-7 minutes
What structures are blocked during a palmar digital nerve block
Sole
Digital cushion
Navicular bone
Navicular bursa
Navicular suspensory apparatus
DDFT on P3
Palmar digital nerve block
Medial & lateral nerves
70-80% of foot & DP
What injuries would require a palmar digital blocks
Solar bruises, abscesses, penetrations
Navicular disease
P3 fractures
Abaxial /sesamoid block
Blocks palmar and plantar nerves
Mid to base of proximal sesamoid bone
1.5-2 ml
5-7 minutes
Structures block in abaxial sesamoid block
Dorsal hoof wall
Coronary band
Coffin joint
Pastern joint
Sesamoidean ligaments
Common lameness to block abaxial sesamoid
Laminitis
Low ringbone
High ringbone
Low palmar (4 point)
Medial & lateral nerves sub q
- flexor palmar tendons
- suspensory ligaments (dorsal)
Medial & lateral palmar metacarpal nerves
- button of splint
- MCIII
Can also target fetlock & digital flexor tendon sheath
