Joints and Lameness: Arthrocentesis, Septic arthritis, Lameness, OA Flashcards Preview

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Flashcards in Joints and Lameness: Arthrocentesis, Septic arthritis, Lameness, OA Deck (74)
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1

What type of needle (gauge and length) is typically used for arthrocentesis?

20G 1"

2

Why is physical restraint preferred to chemical restraint for arthocentesis?

Drugs renduce inhibition so horse can react more rapidly and exagerated when needle goes in

3

Left forelimb: What structure(s) are indicated by #13? #14? 

13: Extensor brnach of interosseus

14: Flexor tendons

4

What limb is this (fore or hind)? What is indicated by #1, #2, #3, and #6? 

Forelimb (lateral view)

1: Large metacarpal bone (MC III)

2: Proximal sesamoid bones

3: Proximal phalanx

6: Navicular bone

5

What are the landmarks for performing a radiocarpal joint arthrocentesis?

Distal medial ridge of the radius

Proximal edge of the radiocarpal bone 

6

With which joint does the carpometacarpal joint communicate?

Middle/Inter carpal joint

7

With which joint does the tibiotarsal joint communicate?

Proximal intertarsal joint

8

What landmark do you palpate for a tibiotarsal joint arthrocentesis?

Medial malleolus of tibia

9

You know the drill

Blue: Common digital extensor muscle

Pink: Superficial digital flexor tendon

Aqua: Deep digital flexor tendon

Green: Common digital extensor tendon

10

This bone is one landmark used to ID the radiocarpal joint. Identify the bone indicated.

a. Third carpal bone

b. Ulnar carpal bone

c. Metacarpal IV

d. Radial carpal bone

d. Radial carpal bone

11

What is the preferred approach to the metacarpophalangeal joint?

Collateral sesamoidean ligament approach

12

How many compartments does the stifle joint have? What are they? Which should you inject when treating the stifle?

3

Femoropatellar joint

Medial femorotibial joint

Lateral femorotibial joint

Inject all compartments

13

Which which compartment does the femoropatellar joint communicate with more often?

MFT

14

Describe the pathogenesis of septic arthritis.

Decreased HA synthesis

Loss of PG

Joint effusion

Pain

Compromise synovial blood flow

15

What are the types of septic arthritis is foals? What is involved in each type?

S, E, and P 

S: Synvoial structures (membrane, fluid)

E: Epiphysis

P: Physis of long bones +/- joint

16

Which type of septic arthritis in a foal is highly effusive and typically affects multiple larger joints?

S-type

17

Which type of septic arthritis in foals occurs at a few weeks of age usually following another disease such as pneumonia or diarrhea? How does the lameness present?

E-Type

Mild lameness followed by acute exacerbation ("Lame on and off and then suddenly super lame")

18

Which type of septic arthritis in foals presents with swelling but no effusion? How many sites are usually affected?

P-type

One site (e.g. distal physis of MCIII/MTIII, radius, tibia)

19

What should you evaluate and how in addition to the joints in a foal with septic arthritis?

Umbilicus

Ultrasound

20

Which bacterium is usually associated with iatrogenic septic arthritis in adult horses? Traumatic septic arthritis?

Staphylococcus

Enterobacteriaceae

21

T/F: An open joint is only considered infected if there is effusion. 

False, an open joint is always an infected joint

22

What is involved in foal septic arthritis that is usually not involved in adults?

Bone

23

What is the gold standard for diagnosing sepsis?

Microbiology

24

What is the normal TP in synovial fluid?

<2.0 g/dL

>3.5 g/dL is abnormal

25

What are the 2 requirements for successful treatment of septic arthritis?

Rapid recognition of disease

Immediate aggressive treatment

26

What is the mainstay of treatment for septic arthritis?

Lavage

Early and often with large volumes (5-10L) and large G needle (16-18)

27

How should antibiotics be administered for septic arthritis?

Local is vital 

28

How long should you leave the tourniquet when performing regional limb perfusion? What dosage is usually used?

30 min

1/3 of systemic dose

29

What is usually the cause of lameness?

Pain

30

How many steps are there for a classical lameness exam? What are they?

7

1: History

2: PE

3: Palpation (weight-bearing and non + Hoof testers)

4: Observation at exercise

5: Flexion tests

6: Diagnostic nerve blocks

7: Diagnostic imaging