Flashcards in Exam 1 (Everything) Deck (111)
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1
When a lame forelimb is placed on the ground, how does the dog's head move?
Head will elevate as painful leg bears weight
2
Most of the
1) radius
2) tibia
3 femur
Can be palpated....... (name where each can be felt best)
1) medially
2) medially
3) laterally
3
When checking for patella luxation, how do you rotate to get:
1) medial luxation
2) lateral luxation
1) internally rotate during extension
2) externally rotate during extension
4
Ortlani's sign is a movement that checks for?
laxity associated with hip dysplasia
5
2 most common causes of lameness in MATURE dogs with no hx of trauma?
DJD
CCL rupture
6
Most common juvenile disease found in large, immature breeds with no hx of trauma?
1) in front leg
2) in rear leg
1) OCD of shoulder (or FCP)
2) hip dysplasia
7
3 blood supply sources for long bones?
1) nutrient artery (85% of diaphyseal blood supply)
2) periosteal vessels (can compensate if intramedullary (nutrient) vessels become compromised
3) metaphyseal vessels (penetrate cortex in metaphyseal region)
8
Briefly describe the function of:
1) osteocytes
2) osteoblasts
3) osteoclasts
1) maintain osteon
2) formation of bone (produce osteoid)
3) resorption of bone
9
Which property of bone allows it to sustain a sudden impact (strong when rapidly loaded)
Viscoelasticity
10
Describe which charge is released with the following forces and which cells are subsequently activated:
1) compression
2) Tension
Which property of bone is this?
1) compression--negative charge released; stimulates osteoblasts
2) releases positive charge; stimulates osteoclasts
Piezoelectric property
11
The ability for bone to better withstand loads on its long axis than on it's short axis is which property?
Anisotrophy
12
A complex fracture with significant tissue injury would be indicative of what type of loading?
Rapid loading (high amount of energy produced)
13
Where do the following forces act:
1) axial
2) shear
1) act parallel to long axis (tensile, compressive)
2) parallel to surface
14
Describe the difference btwn Cantilever bending and three point bending.
Cantilever--bone is fixed at one end and load is placed on opposite end (like a lever)
**forces is highest at fixation point
Three point bending equal loads in same direction on each end and an additional load in the middle going opposite direction
15
What type of fx typically results from:
1) compressive force
2) tensile forces
3) bending forces
4) bending + compressino
5) torsion
1) oblique fx
2) transverse
3) transverse
4) butterfly segment
5) spiral
16
Name 4 causes of pathologic fractures
neoplasia
disuses osteopenia
osteomyelitis
implant removal
17
3 basic factors that support bone healing?
blood supply
alignment
stability
18
For bone healing to occur, interfragmentary strain should be....
<25%
19
Mechanism by which long bone grows in:
1) width
2) length
1) intramembranous bone formation
2) endochondral bone formation
20
Primary bone healing requires _____ _____ ______
rigid internal fixation
21
Name the 5 components of articular cartilage
1) Hyaluronic acid
2) collagen
3) GAGs (keratin sulfate & chondroitin sulfate)
4) chondrocytes
5) water
22
What are the components of proteoglycan?
1 link protein
2 core proteins
GAGs
23
How does Ortalni sign differ btwn young and older dogs with hip dysplasia
In younger dogs, the joint has laxity and ortlani sign will be positive
With older dogs, there is DJD present but not laxity (thickened joint capsule); no ortlani sign
24
More common direction of coxofemoral luxation?
craniodorsal
25
Which tx option for coxofemoral luxation has highest re-luxation potential?
Closed reduction
26
Describe the idea behind the toggle pin option of open reduction
used when there's poor joint capsule integrity
--create a synthetic round ligament to anchor femoral head into acetabulum
27
How should the hindlimb be positioned when making your bone cut for FHNE?
limb must be externally rotated with patella pointing straight at ceiling
28
Which procedure would be indicated for young dogs (12-16 weeks) with minimal hip laxity?
*This procedure is NOT for luxated hips*
Juvenile pubic symphysiodesis
*pubic symphysis no longer grows, causing acetabular rims to grow outward over femoral heads
29
Which tx for coxofemoral disease is indicated for DJD and traumatic luxations?
Total hip replacement
30
A coxofemoral disease of young (4-12months) SMALL BREED dogs
Legg-Calve-Perthes
31
Deep cartilage injuries are repaired with?
Fibrocartilage
32
Normal synovial fluid:
1) cell count
2) predominant cell type
1) low (<2 X10^3)
2) mononuclear cells (94-100%)
33
Most common form of arthritis in dogs and cats?
Which form affects which species?
Osteoarthritis (non-inflammatory)
Primary--cats
Dogs--secondary
34
Pain associated with OA arises from which tissue?
Synovium (synovitis)
35
How does the synovial fluid count change with OA?
Doesn't change drastically
may see a slight increase in total cell count
36
Most common route of infection with bacterial infective arthritis?
direct inoculation
37
Which type of dogs (sex and size) commonly get bacterial arthritis? And how do they typically present?
Large, males
Severe, SINGLE LIMB lameness (non-weightbearing) with swollen joint
38
What types of synovial changes are expected with bacterial arthritis?
MARKEDLY increased cell count (40-267)
predominantly neutrophils
39
How does the APPEARANCE of synovial fluid change with RA?
yellow and turbid
40
Which drug is most commonly associated with drug-induced IMPA
Sulfonamides
41
Which stifle stabilizers are lax in flexion?
Caudolateral band of CCL
lateral collateral ligament
42
Describe the location of the CCL in relation to the joint space
intra-articular but extrasynovial
43
Which menisucs lacks a femoral attachment?
Medial
*Lateral attached by meniscofemoral ligament
44
4 functions of CCL?
1) prevents cranial tibial thrust
2) prevents stifle hyperextension
3) prevents internal rotation of tibia during flexion
4) proprioception
45
What location and type of tear is most common in mesincus?
Caudal pole of medial meniscus
longitudinal (bucket-handle tear)
46
Describe cranial tibial thrust test
place proximal hand with index finger over patella/tibial tuberosity & thumb behind fabella
grasp metatarsals with other hand and flex hock while maintaining static angle of stifle
47
Which diagnostic test is the gold standard for CCL disease diagnosis?
arthroscopy or arthrotomy
48
What 3 things are used in non-surgical management of OA/CCL disease?
Weight loss
Pain meds
Nutraceuticals
49
What 5 descriptors should be used for fractures?
Which bone
Location
open/closed
Complete/incomplete
direction of displacement
50
Concerning the pathophysiology of osteomyeltitis, what is the major predisposing factor?
Loss of blood supply
51
Osteomyelitis that occurs from hematogenous spread commonly affects which area of the bone?
Metaphysis of long bones
52
Most common infectious agent causing osteomyelitis?
Staphyloccocus intermedius
53
How does the patient's clincal presentation differ between traumatic osteomyelitis and hematogenous osteomyelitis?
Traumatic= LOCALIZED disease; the animals will not present systemically ill
54
Differentiate between a type 1 and type 2 open fracture
Type1 is <1cm and created from inside out
Type 2 is >1cm and created from outside in
55
Open fractures with extensive soft tissue injury are classified as what type?
Type 3
56
Which type of treatment would NOT be indicated for open fractures?
External coaptation
*risk of instability is worse than risk associated with implants
57
IM pins primarily resist which force(s)?
Bending only
58
Cerclage wire + IM pin is indicated for which type of fractures?
Long oblique
59
Concerning cerclage wire, which type of placement (full, hemi, interfragmentary) is indicated for:
1) transverse & short obliques
2) long obliques & spiral fx
3) for fx on flat, non-weight bearing bones
1) hemicerclage
2) full cerclage (with IM pin)
3) interfragmentary
60
T/F: cerclage wire placed as hemicerclage provides excellent mechanical stability
FALSE
*These are not left in!! Only use to improve alignment while placing primary implant
61
For which type of fx is pin and tension band indicated?
Avulsion fractures
62
Describe the general principle/idea behind pin and tension band?
Allows the pull of the tendon to create compression at fx site
63
Which primary implant would be good for tx of a comminuted fracture with closed technique?
Interlocking nails
*resist ALL forces
64
Differentiate btwn anatomic and biologic reduction
Anatomic--all pieces are replaced; full reconstructed bone
Biologic--major fx segments are realigned
65
For which type of fx would biologic reduction be indicated?
Severely comminuted, non-articular fx
66
Anatomic reduction requires which type of surgical approach?
Open
67
Compare cortical vs. cancellous screws
1) where in bone they're used
2) thread description
1) cortical used in diaphysis; cancellous used in metaphysis & epiphysis
2) cortical--shallow threads
cancellous--deeper threads
68
Describe how lag screw placement works?
Screw is place perpendicular to fracture line and grips ONLY the FAR cortex--compresses the fragments together when tightened
69
Concerning locking and non-locking screws:
1) how do the screw requirements differ
2) which is less likely to fail
1) Non-locking= AT LEAST 3 bicortical screws per segment
Locking=2-3 bicortical screws per segment placed at 90* angle
2) locking is less likely to fail
70
What are the 4 functions/applications of plates
1) compression
2) neutralization
3) bridging
4) buttress
71
For which type of fx is bridging plate application indicated?
non-reducible, non-articular, comminuted diaphyseal fx
72
How large should a screw be relative to bone diameter?
should not exceed 40% of bone diameter
73
What are the 3 components of an ESF?
fixation pins
connecting bar
connecting clamp
74
Concerning ESF placement:
1) how many pins per fragment
2) half vs. full pins?
1) at least 2 pins per fragment (max=4)
2) half pins penetrate the skin on one side only; full go through both sides
75
How do you select the correct pin size?
should be 20-25% of the diameter of the fragment it's being placed in
76
For ESF, describe planar/lateral of each type:
1) 1a
2) 1b
3) 2a
4) 2b
5) 3
1) unilateral, uniplanar
2) unilateral, biplanar
3) bilateral, uniplanar
4) modified bilateral, uniplanar
5) bilateral, biplanar
77
How do type 2a and 2b ESFs differ?
2a is ALL full pin
2b is a mix of half and full
78
What are the 5 major categories of wound dressings
Adherent
Non-adherent
Antimicrobial
Hyperosmotic
Hydrophilic
79
When would an adherent wound dressing be indicated?
contaminated wound in early phases of healing (before granulation tissue formation due to non-selective debridement)
80
During which phases of healing are hyperosmotic wound dressing appropriate?
Inflammatory and early repair phases
81
Which type of wound dressing would be indicated for wounds with moderate to marked exudate?
Hydrophilic (hydrocolloid)
82
How can you monitor for swelling with bandages placed on limbs?
leave 3rd and 4th digits visible to monitor for separation (swelling)
83
Most common complication associated with bandage placement?
Dermatitis
84
For which size of dogs and which type of fracture(s) is external coaptation contraindicated?
Small/toy breeds with fractures of distal radius and/or ulna
85
Which type of fx are well-suited for external coap?
minimally displaced, non-articular, stable fx
*cortices should have 50% contact
86
Which type of splint is used to immobilize the sculohumeral or coxofemoral joint?
Spica splint
87
For which type of luxation is an Ehmer sling contraindicated?
caudoventral coxofemoral
88
Which sling is used to maintain thoracic limb flexion and prevent weightbearing (i.e. following shoulder luxation)
Velpeau sling
89
Which elbow dysplasia abnormalities occur in medial compartment?
FCP
OCD
EI
UMHE (ununited medial humeral epicodyle)
90
By what age should the anconeal physis close?
24 weeks
91
Most common surgical approach used for UAP?
Caudolateral
92
An English setter present for forelimb lameness and palpates painfully on medially side of elbow; based on signalment and clinical signs, what's your top DDx?
UMHE
93
When checking for UMHE on radiographs, when should the medial epicondyle physis close?
by 6months
94
A 8month old cocker spaniel presents for forelimb lameness and is painful in elbow; there is minimal joint effusion; You take a radiograph and see a dark line between the humeral epicondyles... your dx?
IOHC
*should be fused by 8-12 weeks
95
Which radiograph view would be best if you suspect FCP?
Distomedial-proximolateral oblique (DMPLO-35 degrees)
96
Where does OCD occur in the distal humerus
medial humeral condyle
97
Where is the articular-epiphyseal cartilage complex located?
on the end of the secondary ossification center (closest to joint)
98
Most common locations for OCD
1) forelimb
2) hindlimb
1) shoulder--caudal aspect of humeral head
2) lateral femoral condyle & medial trochlear ridge of talus
99
What type of tissue fills defects caused by OCD?
fibrocartilage
100
Which 3 breeds are most commonly affected by panosteitis?
GSD
Basset
Labs
101
A 4month old mix breed present with high fever, lameness, and symmetrical enlargement in carpal area (both legs effected). Radiographs show what appears to be a "double physis"...your top ddx?
HOD
*on metaphyseal side of active physes
102
If you sampled a HOD lesion, what would be the primary cell type on cytology?
Neutrophils
103
Concerning treatment/prognosis of HOD
1) which supplements are contraindicated and why
2) what is a potential negatively sequela following recovery
1) Vitamins C & D--promote dystrophic calcification
2) Valgus deformity
104
Concerning long antebrachial growth:
1) what % does distal radial physis contribute
2) what % does distal ulnar physis contribute
1) 60-70% of radial length
2) 100% of ulnar length
105
Concerning the cuff tendons of the shoulder, which is:
1) cranial
2) medial
3) lateral
4) caudolateral
1) supraspinatus
2) subscapularis
3) infraspinatus
4) teres minor
106
Though they both affect toy breeds of dog, how do congenital shoulder luxations present differently from congenital elbow luxations
Shoulder--will be weightbearing lame (may occasionally carry leg)
Elbow--will be unable to extend elbow (bilateral praying mantis)
107
Which congenital anomaly is associated with ectrodactyly
congenital elbow luxation
108
Concerning the femoral head, define:
1) coxa vara
2) coxa valga
1) decreased angle of inclination
2) increased angle of inclination
109
Two major goals of sx correction of MPL?
containment
alignment
110
An anti-rotational suture helps rotate the _____ toward _____
tibia; midline
111
