Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y4 EQ - Orthopaedics > Foal Orthopaedics > Flashcards

Foal Orthopaedics Flashcards

1
Q

What do the following abbreviations stand for:
DOD
ALD
FLD

A

DOD = Developmental orthopaedics diseases
ALD = angular limb deformity (frontal plane deformity)
FLD = flexural limb deformity (sagittal plane deformity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are developmental orthopaedic disease?

A

Group of diseases of the musculoskeletal system that occur during the growth phase or development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

An angular limb deformity is a lesion of which plane?

A

A frontal plane deformity!
So will see a lesion medially or laterally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When diagnosing an angular limb deformity what information must be obtained about it?

A
  1. Congenital = born with ALD -> pregnancy problems, premature/dysmature
  2. Acquired = normal at birth; ALD acquired later -> age, duration, uni- or bilateral, nutrition
  3. Which joint?
  4. Which direction?
  5. How much deviation?
  6. Bone or joint centred?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe the clinical examination for diagnosis of angular limb deformities

A

The sooner the better!!!
Assessment from distance (standing and dynamic)
- Which joint(s)? Which direction?
- How much deviation?
Palpate and manipulate
- Can you correct the deviation?
- Bone or joint centred?
- Check each single joint separately as multiple can be affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the names given for medial and lateral angular limb deformities?

A

VALGUS – lateral deviation
VARUS –medial deviation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the possible origins of deformity for ALD

A
  1. Bone
    - Physis
    - Epiphysis
    - Cuboidal bones: Carpus, Tarsus
    - Diaphysis (rare)
  2. Soft tissue laxity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How can bone vs soft tissue origin of ALD be confirmed in foals?

A

Neonatal foal
- Can’t straighten limb manually = Bone
- Can straighten limb manually - Dysmature - Peri-articular laxity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe radiography of ALD

A

Long cassettes
Centred over deviation site
Views:
- Dorsopalmar (carpus, fetlock)
- Lateromedial (tarsus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How can the origins of deformity by located on radiography

A

Plumb lines
- Angulation
- Intersection = site of deformity
Are joints and physes parallel?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How should incomplete ossification of carpal bones be managed and monitored?

A
  • High risk of crushing injury to cuboidal bones
  • Restricted exercise
  • Bandage with splint: Light, Digit not within the splint
  • Repeat radiographs every ~2w
  • Balanced nutrition
  • Usually improves unless systemic involvement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How is peri-articular laxity managed?

A

Controlled exercise to strengthen peri-articular soft tissues
Careful with bandaging
Usually resolves unless other systemic problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

List the 3 main causes of acquired ALD

A

Imbalanced nutrition
Genetics (rapid growth)
Trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does imbalanced nutrition lead to acquired ALD

A

Excessive Energy (grain, concentrates)
Mineral imbalance (lack of Cu, excessive Zn)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does trauma lead to acquired ALD

A

Damage to growth cartilage -> abnormal/asymmetric growth (e.g. Salter Harris fracture)
Overload opposite limb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does the treatment choice of ALD depend on?

A
  • Aetiology of ALD
  • Age: Remaining growth potential, Before the physis closes
  • Which joint involved?
  • ALD severity
  • Concomitant problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe conservative treatment of ALD

A
  • Limited exercise
  • Bandages, splints
  • Corrective hoof trimming: Medial-lateral foot balance
  • Glue-on shoes
  • Limit mare & foal nutrition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Describe surgical treatment of ALD

A

Growth acceleration
Growth retardation
(Oste-otomy/-ctomy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How would you hoof balance a foal with Valgus?

A

Lower lateral foot balance
For valgus you want a medial extension to increase the pressure on that side of the leg to try and straighten the leg
The side that you trim and the side you apply the extension are opposite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe how and when to hoof balance in ALD cases

A

Every 2-3 weeks
Lightly rasp concave side
Avoid drastic changes&raquo_space; joint problems
Mild cases – as only treatment
Moderate-to-severe cases – combine with surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Surgery for ALD is always combined with?

A

Hoof balance, restrict diet, rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How can you stimulate growth in ALD surgery?

A

On the concave side - Elevate periosteum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How can you prevent growth in ALD surgery?

A

Retard growth (convex side) - Bridge the physis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Where is the surgical site for periosteal elevation?

A

Concave
Just proximal to physis
Elevate periosteum
Does not over-correct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

When is ALD prognosis good?

A

Early treatment
Physis or epiphysis

26
Q

When is ALD prognosis fair - poor?

A

Diaphyseal
Crushed cuboidal bones
Severe angulation
Secondary DJD

27
Q

A flexural limb deformity is a deformity of which plane?

A

A sagittal plane deformity!
Deformed when looking from the side

28
Q

Where is the origin and insertion of the SDFT

A

Origin
- Distal humerus - FL
- Proximal radius - HL
Insertion:
- Accessory ligament - distopalmar radius (AL-SDFT)
- Distal PI
- Proximal PII

29
Q

What is the function of the SDFT?

A

Flexion of MCP/MTP joint

30
Q

Where is the origin and insertion of the DDFT

A

Origin:
- Humeral epicondyle
- Medial olecranon
- Proximal radius
Insertion:
- Palmar PIII

31
Q

What is the function of the DDFT?

A

Flexion of DIP joint

32
Q

Describe the main features of digital hyperextension (tendon laxity)

A

Neonates
Relatively common
Laxity of flexor tendons

33
Q

How is mild/moderate vs serve digital hyperextension (tendon laxity) managed?

A

Mild – moderate:
- With exercise laxity reduces
- Corrects in 1-2 weeks
Severe: Protect heel bulbs/palmar fetlocks
- Palmar/plantar extensions
Bandages: avoid if possible
- Light bandages
- NO splints…

34
Q

Compare congenital and acquired flexural limb deformities

A

Congenital = born with FLD
Acquired = normal at birth, FLD developed later
- Age
- Fast growth
- Uni- or bilateral
- Pain?

35
Q

Describe the aetiology of flexural limb deformities

A

Lots of suggested aetiologies – little evidence
Commonly = intrauterine positioning and genetic predisposition

36
Q

How are flexural limb deformities diagnosed?

A

Inspection - Lying down and standing
Palpation & manipulation:
- Can it be straightened?
- Palpate each one of flexor tendons to check which one/s most affected

37
Q

Describe conservative treatment of flexural limb deformities

A

Farriery
Physiotherapy
Splints
Medication

38
Q

Surgical treatment for flexural limb deformities depends on?

A

Location
Response to conservative therapy

39
Q

Why is important that foals with FLD can stand?

A

Need to be able to nurse

40
Q

How can you force extend joints with FLD?

A

Splints (cast)
BUT Causes pain

41
Q

Describe analgesia for foals with FLD

A

NSAIDs (risks: GIT ulcers, kidney – GIT protectants, hydration)

42
Q

Describe the use of oxytetracycline in cases of FLD

A

Oxytetracycline induces a dose-dependent inhibition of collagen gel contraction by equine myofibroblasts AND inhibits tractional structuring of collagen fibrils

43
Q

If using oxytetracycline in foals what MUST be considered?

A

Hydration as it is nephrotoxic

44
Q

How is farriery used in FLD?

A

Lower heel
Extended toe shoe - Acrylic

45
Q

Describe management of flexural limb deformities of the distal interphalangeal joint

A

Surgical treatment = Desmotomy of AL-DDFT (distal check ligament)
Combine with conservative tx

46
Q

Describe management of flexural limb deformities of the fetlock/carpal joint

A

Palmar/plantar splint
- Mould to limb
- Change frequently
- Careful pressure sores!!
Oxytetracycline
ANALGESIA

47
Q

Describe surgical management of flexural limb deformities of the fetlock

A

Palpate which tendon/s most affected (contracted) when extension is forced:
If SDFT&raquo_space; AL-SDFT desmotomy
If DDFT&raquo_space; AL-DDFT desmotomy +/- AL-SDFT desmotomy
Severe cases: Both

48
Q

What is the most commo route of septic synovitis ?

A

Haemoatogenous

49
Q

What is the most common site of entry for bacteria -> septic synovitis?

A

Umbilicus

50
Q

Describe the aetiology of septic synovitis in foals

A

Systemic disease
Impaired defences
Failure of passive transfer IgG

Sub-infective dose of bacteria

51
Q

List the clinical signs of septic synovitis in foals

A
  • May be reluctant to stand
  • Joint effusion: single or multiple
  • Peri-articular swelling
  • Lameness: Often progressively increasing, Not always lame initially
  • Filling of mare’s udder due to not sucking
52
Q

How is septic synovitis diagnosed?

A
  1. Full history (very important in foals)
  2. Complete physical exam: Other joints, Umbilicus (patent urachus, omphalitis…)
  3. Radiography
    - Bone involvement (fracture, osteomyelitis)
    - Radiographs lag behind pathologic changes in bone
  4. Ultrasonography: Umbilicus and affected joint
  5. Synoviocentesis
53
Q

Describe the radiographic changes seen which indicate septic physitis

A

Irregular/widened physis
Radiolucency
Soft tissue swelling

54
Q

How is a blood culture used to diagnose septic physitis?

A

Septicaemia
Check other physes/synovial structures

55
Q

How is a Synoviocentesis used to diagnose septic synovitis?

A

Aseptically
Away from wound if present
Collection tubes:
- EDTA – Total & differential nucleated cell count
- Plain/with culture media – Culture & sensitivity
Total protein: Ideally straight, EDTA can affect reading

56
Q

How will the findings on the fluid from a Synoviocentesis show septic synovitis is present?

A

Turbid, serosanguineous, reduced viscosity
> 20x10^9 nucleated cell/L
> 80% neutrophils
Total protein >30-35g/L

57
Q

Describe the treatment options for septic synovitis

A
  1. Tx underlying causes
    - Failure of passive transfer
    - Umbilical infection
  2. Lavage of synovial structure
  3. Aggressive antimicrobial therapy
  4. NSAIDs - limited and judicious use
58
Q

When is prognosis of septic synovitis fair-good?

A

Rapid treatment
Single joint
No bone involvement
Systemically well

59
Q

When is prognosis of septic synovitis guarded-grave?

A

Long time between dx and tx
>1 joint involved
Bone involvement - epiphyseal or physeal
Concurrent systemic illness

60
Q

List the 4 ways of classifying ALD

A

Congenital or acquired
Mild, moderate or severe
Bone versus soft tissue
Valgus versus varus

61
Q

Compare bone centred and joint centred ALD

A

Bone centred – disparity in growth rates across physis
Joint centred – dysmature or periarticular laxity

62
Q

Describe the key points of fetlock ALD

A

Must act fast – window for treatment is much shorter than other joints
- Farriery
- Periosteal elevation
- Transphyseal bridge

Y4 EQ - Orthopaedics (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions