Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Equine I > Lameness > Flashcards

Lameness Flashcards

1
Q

What does tension of the brachiocephalicus muscle often reflect?

A

Pain in the distal limb

(Will be interpreted as shoulder pain by owner)

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

Aspects of a static clinical exam in a lameness workup

A

Look at the horse:
○ Feet- hoof quality, foot imbalances
○ Legs- conformation, obvious swellings, wounds, or effusions
○ Pelvic region and shoulders- symmetry (atrophy, swellings)
○ Note if the horse is resting any legs or shifting their weight

Put your hand all over the horse and palpate:
○ The musculature for signs of atrophy and pain response
○ The legs for any wounds, swellings, effusions
○ Digital pulses- bounding?

Pick up the legs to test the range of motion (ROM) of the joints
○ Also important to note the horses response to flexing the joints

Use a hoof testers and assess the horse’s response

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

Using hoof testers

A

Hold horse’s leg between your legs so both hands are free to use hoof testers

Work your way around the sole, then put pressure on the backs of the heels and frog

Assess for pain response (snatching foot away, shuffling, etc.)

Also note any ‘sponginess’ of the sole (may indicate area of bruising)

Note- it is not a massive amount of pressure on the hoof testers, gentle pressure is sufficient to elicit a response

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

Spotting forelimb lamaness

A

Head nod (down on sound)

Stride length (shorter cranial phase)

Rhythm (irregularity can be heard)

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

Spotting hindlimb lameness

A

Pelvic tilt/hip movement (hip hike is sacral rise on lame leg)

Assess from side as well to assess stride length (will not track up well)

Rhythm (irregularity can be heard)

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

Horse with pelvic hike AND a head nod?

A

May be two separate primary issues or ‘compensatory’ lameness

Compensatory lameness: in a case of hind limb lameness the weight is redistributed onto the opposite hind limb and also the contralateral fore limb. This weight distribution presents as a ipsilateral forelimb lameness.

‘hind limb lameness can cause compensatory load redistribution evidenced as ipsilateral forelimb lameness’

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

Forelimb flexion tests

A

The entire leg can be flexed (usually utilised in a pre-purchase exam setting) or individual joints can be flexed

The amount of time the limb is flexed for and the pressure used should be consistent between both forelimbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hindlimb flexion tests

A

Due to the stay apparatus of the hindlimb one cannot flex the individual joints of the hindlimb- the entire limb is flexed at once

Again consistency between the legs is important

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

Diagnostic analgesia for lameness

A

Used to localise the source of pain to a region within the limb

This allows for more targeted further diagnostics to be performed in this area

Also guides treatment

The horse should be consistently and sufficiently lame so that any improvement in gait can be detected e.g. The lameness should be ‘blockable’

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

Further diagnostics available for lamaness

A

Radiography

Ultrasonography

MRI of distal limb

Arthroscopy (stifle, tarsus, fetlock, carpus)

Tenoscopy (flexor tendon sheath)

Scintigraphy (‘bone scan’)

CT of distal limb (less commonly performed)

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

Common lameness presentations in racehorses

A

P1 fractures

Carpal slab fractures

SDFT injuries

Overreach injury

Stifle OC/OCD

Osteoarthritis of carpus

DSP impingement (‘kissing spines’)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Common lameness presentations in sport horses

A

OA of Tarsus/coffin/fetlock

DDFT injury with foot (showjumpers)

Navicular syndrome (warmbloods and showjumpers)

Proximal suspensory desmitis (dressage horses)

Back pain

Sacro-iliac issues (showjumpers)

OCD of the tarsus/stifle/fetlock (warmbloods)

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

Diagnostic analgesia step-by step

A
  1. Assess the lameness
  2. Prepare the site for blocking in an appropriate manner
  3. Select an appropriate local analgesia
  4. Perform the block
  5. Test the block
  6. Reassess lameness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Preparation for perineural blocks

A

Clean not sterile

+/- clipping

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

Preparation for joint blocks

A

Sterile preparation

Betadine, Hibiscrub, Surgical spirit

+/- clipping

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

Most popular LA choice for diagnostic analgesia

A

Mepivicaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Why should you not use lidocaine with adrenaline as a nerve block in horses?

A

White hair formation

Dehiscence

Tissue ischaemia and necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Risks of nerve blocks

A

Haematoma

Needle trauma resulting in soft tissue swelling

Cellulitis

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

Risks of joint blocks

A

Joint flare (non-septic)

Septic

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

Common nerve blocks used in diagnostic analgesia

A

Palamar digital nerve block

Abaxial sesamoid nerve block

Low 4-/6- point block

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

Nerves blocked with a palmar digital nerve block

A

Medial and lateral palmar/plantar digital nerves

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

Technique for a palmardigital nerve block

A

In a conscious horse, elevate the leg and palpate the neurovascular bundle beneath the skin about 1 cm proximal to the collateral cartilage of the foot (Medial and lateral)

Insert a 25 gauge 5/8 needle in a distal direction with the tip of the needle ending at roughly the level of the pastern joint

Inject 1-2ml of local anaesthetic agent at each site

23
Q

Areas desensitised with a palmar digital nerve block

A

all of the sole,

navicular apparatus,

soft tissues of the heel,

distal interphalangeal joint (coffin joint),

deep digital flexor tendon,

distal sesamoid ligaments.

Pastern may be partially desensitised

24
Q

How to test palmar digital nerve block

A

Loss of skin sensation to coronary band of the heel

25
When should you assess a palmar digital nerve block?
10 minutes post block
26
Nerves blocked by an abaxial sesamoid nerve block
medial and lateral palmar/plantar digital nerves
27
Technique for an abaxial sesamoid nerve block
In a conscious horse, elevate the leg and palpate the neurovascular bundle beneath the skin at the abaxial aspect of the proximal sesamoid bones of the fetlock joint (palmar-/plantar-medial and palmar-/plantar-lateral) Insert a 25 gauge 5/8 needle in a distal direction with the tip of the needle ending at the level of the base of the sesamoids Inject 1-2ml of local anaesthetic agent at each site
28
Areas desensitised by an abaxial sesamoid nerve block
the foot, P2, PIP joint, distopalmar/distoplantar aspect of P1, distal SDFT and DDFT, distal sesamoidean ligaments, digital annular ligaments. ***Distal aspect of fetlock joint maybe partially desensitised***
29
Testing abaxial sesamoid nerve block
Loss of skin sensation to the coronary band of the heel and the toe
30
When should you reassess lameness after an abaxial sesamoid nerve block?
10 minutes post block
31
When would you do a low 4-point block?
When assessing lameness in a forelimb that has not blocked to lower blocks
32
When would you do a low 6-point block?
When assessing lameness in a hindlimb that has not blocked to lower blocks
33
Which nerves are blocked in a low 4-/6- point block?
medial and lateral palmar/plantar metacarpal/metatarsal nerves, medial and lateral palmar/plantar nerves, lateral and medial dorsal metatarsal nerve in hindlimb
34
Technique for low 4-/6- point block
In a standing leg horse use a 25 gauge 1 inch needle to inject 2-5 ml of local anaesthetic agent at each nerve site Medial and lateral palmar/plantar metacarpal/metatarsal nerves: insert needle just distal to the button of the splint (N.B. Caution-close to the fetlock joint!) Medial and lateral palmar/plantar nerves: insert needle between suspensory ligament and DDFT 3-5cm proximal to button of the splint (N.B. Caution- close to digital tendon sheath) Medial and lateral dorsal metatarsal nerves: insert needle either side of the common digital extensor tendon and perform a subcutaneous ring at the level of plantar metatarsal nerves
35
Areas desensitised by a low 4-/6- point block
fetlock joint, proximal sesamoid bones, flexor tendons distal to block, digital flexor tendon sheath, limb distal to block
36
How to test a low 4-/6- point block
Loss of skin sensation to dorsal and palmer/plantar aspects of fetlock
37
Considerations for joint/synovial blocks
Use the smallest gauge needle possible but make sure it's big enough not to break Subchondral bone pain will not necessarily be blocked Know which joints communicate with each other
38
What are the three approaches to a distal interphalangeal/coffin joint block?
dorsal perpendicular approach, dorsal parallel/inclined approach, lateral approach
39
Dorsal parallel/inclined approach for diatal interphalangeal/coffin joint block
In a conscious standing animal palpate the dorsal pouch of the DIP joint just proximal to the coronary band Insert a 1.5 inch 20-22 gauge needle abaxial to the extensor tendon 1cm dorsal to the coronary band at a 45 degree angle OR horizontal to the ground just above the coronary band midline Inject 5-10ml of local anaesthetic agent
40
Areas desensitised by a distal interphalangeal/coffin joint block
DIP joint, navicular bursa, DDFT insertion and sole may also be blocked
41
When to reassess lameness after a distal interphalangeal/coffin joint block
At 5 minutes then again at 20 minutes post blocking
42
What are the 4 approaches to a fetlock joint block?
proximopalmar, dorsal, distopalmar, palmar
43
Proximopalmar approach to fetlock joint block
Either in a flexed or standing leg insert a 21 ga 1.5 inch needle in a dorsal-distal direction distal to the button of the splint, dorsal to suspensory ligament, palmar/plantar to the cannon and proximal to the sesamoids Inject 10ml of local anaesthetic agent
44
Areas desensitised by a fetlock joint block
Proximal sesamoid bones, suspensory branches and digital flexor tendon sheath may also be blocked
45
When to resassess lameness after a fetlock joint block
10 mins post blocking
46
Technique for a tarsometatarsal joint block
Use a 21 gauge 1.5 inch needle to inject 3-5ml of local anaesthetic agent into the palpable depression just proximal to the lateral splint (MT IV) and distal to the 4th tarsal bone Insert the needle at a roughly 45 degree angle in a craniomedial direction i.e. Aim to the forelimb fetlock of the contralateral side
47
Areas desensitised by a tarsometatarsal joint block
Tarsometatarsal joint. Distal intertarsal joint will be blocked by diffusion in 76% of cases. The proximal portion of the suspensory ligament and MT III may also be blocked.
48
When to reassess lameness after tarsometatarsal joint block
10mins post blocking
49
Technique for tarsocrural joint block
Use a 21 gauge 1.5 inch needle to inject 10-20ml of local anaesthetic agent on either the lateral or medial side of the saphenous vein The saphenous vein traverses joint approx. 1-1.5 inch distal to the medial malleolus of the tibia The joint pouch is easily palpable and the joint capsule is thin
50
Areas desensitised by a tarsocrural joint block
tarsocrural joint. Proximal intertarsal joint directly communicates with the TC joint
51
Needle and volume to inject in a stifle block
Use an 18 gauge 1.5/2 inch needle to inject 20-30ml of local anaesthetic into each compartment
52
Three compartments of the stilfe joint capsule for blocking
Medial femorotibial: insert needle between medial patellar ligament and medial collateral ligament proximal to tibial tuberosity Femoropatellar: insert needle between medial and middle patellar ligament proximal to tibial tuberosity Lateral femorotibial: insert needle caudal to lateral collateral ligament proximal to proximal-lateral edge of tibia
53
Communications between compartments of the stifle joint
The medial femorotibial compartment normally communicates with the femoropatallar compartment. The lateral femorotibial compartment communicates with the femoropatellar compartment in a small proportion of horses. Important to note that LFT and MFT never communicate

Equine I (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions