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RUSVM Large Animal Surgery 2017 > Lameness and Hoof Surgery > Flashcards

Lameness and Hoof Surgery Flashcards

(117 cards)

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1
Q

How long does it take for the entire hoof to grow?

A

1 year

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2
Q

How much hoof grows per month?

A

6mm

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3
Q

How much the hoof appear?

A

Perpendicular and parallel to the ground and symmetrical

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4
Q

How should the sole of the hoof appear?

A

Parallel and symmetrical

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5
Q

What instruments do you use to pull shoes?

A

Shoe puller
Clinch cutter
Hammer
Nail puller

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6
Q

What instruments do you use for Hoof trimming?

A

Hoof nippers
Hoof knife
Rasp

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7
Q

What breed is allowed to have a longer toe?

A

Standardbreds

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8
Q

Why do we leave the toe longer on Standardbreds?

A

Increase stride length and will allow the horse to pace faster

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9
Q

What is wrong with a horse that comes up lame after shoeing?

A

Nail bound

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10
Q

Sidebones

A

Calcified hoof cartilages seen in older or carriage horses due to microfractures created by each step causing concussion destabilizing the area

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11
Q

Why would you use a Full bar shoe?

A

Eliminate the hoof mechanism to allow for fracture healing

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12
Q

How do you shoe for Navicular disease?

A

Elevate the heel

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13
Q

Why do you elevate the heel in treating navicular disease?

A

Elevating the heel allows the deep flexor tendon to put minimal pressure on the navicular bone

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14
Q

Break over

A

the moment the toe touches the ground

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15
Q

How do you shoe a horse to facilitate break over?

A

Rocker toe shoe

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16
Q

How would you shoe for a Ruptured flexor tendon?

A

Shoe with elongated heels

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17
Q

What clinical sign do you see with superficial digital flexor tendon rupture?

A

Fetlock drops

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18
Q

What clinical sign do you see with deep digital flexor tendon rupture and superficial digital tendon rupture?

A

Fetlock drops and toe points up

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19
Q

What clinical sign do you see with all flexor tendon rupture?

A

Leg is on the ground

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20
Q

What are the clinical signs of Puncture wounds or Solar abscess?

A

Lameness
Thumping digital pulse
Draining tract at coronary band
Swelling

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21
Q

How do you diagnose Puncture wound or solar abscess?

A

Hoof testers
Sterile probe draining tract
Radiography

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22
Q

How do you treat Puncture wounds or solar abscess?

A

Establish drainage
Tetanus: toxoid/antitoxin
Antiseptic solution
Bandage

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23
Q

Keratoma

A

abnormal keratinization in response to chronic injury

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24
Q

What are the clinical signs of Keratoma?

A

Lameness
Fistulous tract at coronary band
Deviation of white line

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25
How do you treat a Keratoma?
Use periosteal elevators to remove that section from the hoof
26
Necrosis of the Collateral Cartilage (Quittor)
Chronic purulent inflammation of collateral cartilage
27
What are the clinical signs of Necrosis of the Collateral Cartilage (Quittor)?
Lameness Localized pain over cartilage Chronic suppurative sinus tract
28
How do you treat Necrosis of the Collateral Cartilage (Quittor)?
Surgical excision of necrotic cartilage
29
Thrush
Degenerative condition of the frog
30
What are the clinical signs of Thrush?
Fetid odor Undermined frog Black discharge with sulci of frog Draft horses
31
How do you treat Thrush?
Removal of all loose horn | Caustic agents: Copper sulfate
32
How do you treat Angular Limb Deformities?
Dalmer shoes
33
Laminitis
Inflammation of the laminae of the foot
34
Chronic Laminits
after 48 hours of continual pain or when rotation of the distal phalanx occurs
35
What are the clinical signs of Laminitis?
``` Shifting weight to hind feet Unwilling to walk Sinking in at coronary band Non-parallel growth rings Sole abscess ```
36
What is a sign of several bouts of laminitis?
Non-parallel growth rings
37
Obel grade 1
No lameness at walk, short stilted gait at trot
38
Obel grade 2
Stilted gait at walk, foot can be lifted
39
Obel grade 3
Reluctant to walk, resists lifting foot
40
Obel grade 4
Refuses to move, may become recumbent
41
What do you see on radiographs with chronic laminits?
``` Bone remodeling "ski-tips" Distal marginal fractures Osteolysis Osteomyelitis Rotation Sinking Radiolucent lines ```
42
What are risk factors for Laminitis?
``` Pony Fat Horse Late summer High carbs Non-weightbearing lameness ```
43
What are the treatment options for chronic laminitis?
Therapeutic shoeing: Dorsal hoof wall resection, Heart bar shoe, or Reversed horse shoe Deep digital flexor tenotomy Euthananasia
44
What causes tendon laceration?
Trauma Overloading Infection
45
What tendons in the Fore limb are prone to laceration?
Common digital extensor tendon | Lateral digital extensor tendon
46
What tendons in the Hind limb are prone to laceration?
Long digital extensor tendon | Lateral digital extensor tendon
47
How do you treat Tendon laceration?
Corrective shoeing Bandage Cast Surgery
48
What suture pattern is used to fix tendons?
Locking loop
49
What do you observe during a lameness exam?
``` Stride Foot flight arc Path of the foot flight Foot strike Joint angels Gluteal excursion ```
50
What is the rule for fore limb lameness?
"Head Down on Sound" | Head Appears to rise when lame limb weight bearing
51
Observing Hind Limb lameness
Head goes down with lame limb weight bearing | Increased gluteal excursion in lame limb - "Hip Hike" or "Hip Drop"
52
Grade 1 Lameness
Difficult to observe, inconsistent
53
Grade 2 Lameness
Difficult to observe in a straight line but consistently apparent under certain circumstances
54
Grade 3 Lameness
Consistently observable or a trot under all circumstances
55
Grade 4 Lameness
Obvious lameness with marked head, nod, hitching, shortened stride
56
Grade 5 lameness
Minimal weight bearing/ non weight bearing and inability to move`
57
What 5 pathognomonic lameness' are diagnosed at the walk?
``` Peroneus tertius rupture Upward fixation of patella Stringhalt Fibrotic myopathy Sweeney ```
58
What is the clinical sign of Peroneum Tertius Rupture?
Simultaneous extension of the hock and flexion of the stifle
59
How do you treat the Upward fixation of the patella?
Exercise | Medial Patellar Desmotomy
60
What medication will cause a lameness to change?
Xylazine
61
What are the different methods of Local Anesthesia?
Perineural block Regional Direct infiltration of site IA
62
What local anesthetics are used for Lameness exam?
2% Lidocaine 2% Mepivacaine 0.5% Bupivacaine
63
When would you use Bupivacaine for lameness?
Shoeing manipulations/therapeutic effect
64
What structures are anesthetized by the Palmar Digital Nerve Block?
``` Entire Sole Navicular apparatus Soft tissues of heel Coffin joint Digital portion of DDFT ```
65
What structures are anesthetized by the Abaxial Nerve Block?
``` Foot P2 Distopalmar P1 Proximal and distal interphalangeal joints Distal SDFT and DDFT Distal Sesamoidian ligament Digital annular ligament ```
66
What nerves are blocked by Low 2-point nerve block?
L/M palmar metacarpal n. | L/M palmar n.
67
Where do you perform the Low 4 point nerve block?
Between Palmar MCIII and MC II and IV | Between SL and DDFT
68
What structures are anesthetized by the High 4-Point Nerve Block?
Suspensory ligament Flexor tendons MCIII and MCIV
69
Where do you perform the High 4 point nerve block
Below carpus in groove between suspensory and DDFT
70
What are the indications for Nuclear Scintigraphy?
``` Lameness site cannot be determined Lameness is localized but not detectable with radiographs or US Multiple limb lameness Intermittent lameness Upper limb/pelvic lameness Suspect fracture not seen on rads ```
71
What is important to know about Nuclear Scintigraphy?
The animals must be isolated because they are radioactive | Leave for 24-48 hours and detect radiation levels before handling the animal
72
What is a disadvantage of Nuclear Scintigraphy?
Not very specific | poor anatomic detail
73
What would you use if the lameness cannot be determined with radiographs or US?
MRI
74
Crimp pattern of the tendon
Allows for "stretch" of tendon Load applied, lose crimp Followed by a linear phase of stretching
75
How long can a tendon rupture?
can extend 12-20% before rupture
76
Tendon Repair
Scar tissue formation resulting in less elastic tendon
77
Tendonitis
Inflammation of a tendon most commonly from overuse but can be from infection or traumatic injury
78
What causes tendon injuries?
Overstrain | Percutaneous Trauma
79
Overstrain
Sudden overload or strain induced
80
What causes strain induced Overstrain?
Repetitive microtrauma - a phase of molecular degeneration which progressively weakens the tendon
81
where do you find the most serious percutaneous trauma?
Palmar aspect of the pastern/metacarpus
82
Which tendons are most prone to injury?
SDFT | SL
83
What are the predisposing factors for tendonitis?
``` Increased stress on tendon/ligament Poor/deep ground surface Inadequate training and muscle fatigue Poor conformation Poor hoof care Improper bandaging/boots ```
84
What is the best tool for diagnosing tendonitis?
Ultrasound
85
What type of probe should be used for diagnosing tendonitis?
7.5-12 MHz linear transducer
86
What do you see on Ultrasound with Acute tendonitis?
Enlargement hypoechogenicity Reduce striated pattern changes in shape, margin or position
87
What so you see on ultrasound with chronic tendonitis?
variable enlargement echogenicity irregular striated pattern - fibrosis
88
What is the treatment for tendonitis?
cold therapy, rest, and controlled exercise program Compression and coaptation NSAIDs
89
What is the goal of treatment for Tendonitis?
``` Restoration of the tensile strength of the tendon without peritendinous granulation tissue and adhesions Reduce inflammation Speed healing/return to work Increase tensile strength Decrease risk of re-injury ```
90
What are other non-surgical treatments for tendonitis?
Intra-lesional injections Electro shock wave therapy Therapeutic Ultrasound Laser
91
What is used for Intralesional injections?
Platelet Rich Plasma Stem cells Bone marrow
92
How does Shock Wave Therapy help tendonitis?
Increases Vascularization | and growth factors in the area
93
Surgical repair of tendonitis
Suturing tendon Superior check desmotomy Annular ligament desmotomy
94
What are the two layers of the synovial membrane?
Subintimal | Intimal
95
What is contained in the subintimal layer o the synovial membrane?
Blood supply and innervation
96
What is contained in the intimal layer o the synovial membrane?
Synoviocytes
97
Subchondral bone
"Shock absorber" | More deformable than cortical bone
98
Articular Cartilage
specialized extracellular matrix that distributes compressive loads Used to define the health of the joint and create a joint surface
99
Aggregans
forms aggregates with HA | Protects collagens from damage
100
What is the backbone of the cartilaginous matrix?
Hyaluronic acid
101
What provides a sponge-like shock absorbing effect?
Glycosaminoglycans
102
What are the gross cartilage changes associated with Osteoarthitis?
``` Yellow Fibrillate Dull Ulcerated Pitted ```
103
What are the changes associated with Joint disease?
Sclerosis Osteophyte formation Enthesiophyte formation
104
What are the clinical signs of Osteoarthritis?
Lameness Joint pain Decreased range of motion Joint effusion
105
What are the goals of treatment of joint disease?
Reduce/ minimize inflammation Slow progression of degeneration Reduce/eliminate pain Restore synovial fluid to normal
106
What are the options to manage joint disease?
``` Chondroprotectives Corticosteroids NSAIDs Blood based products Cell based treatments ```
107
What are the chondroprotective agents?
Hyaluronic acid Polysulfated glycosaminoglycans Polyglycan Pentosin Gold plus Halo
108
What does Sodium Hyaluronate/ Hyaluronic acid do?
``` Provides viscoelasticity, boundary lubrication Modulates chemotactic response Scavenges free radicals Increases production of endogenous HA Decreases degradation of aggrecan ```
109
What is the most efficacious way of administering HA?
Intra-articularly
110
Polysulfated Glycosaminoglycans
inhibit degradative enzymes Reduction of synovial effusion Counteracts deleterious effects of IL-1
111
How does Adequan work?
up regulation of glycosaminoglycans and collagen synthesis Decrease in inflammatory mediators Improvements in synovial membrane
112
What should you add with Adequan?
Antimicrobial
113
Polyglycan
Post surgical lavage
114
What is the most effective for mild synovitis/capsulitis?
HA
115
What is the most effective for severe synovitis/capsulitis or chronic OA?
PSGAGs (Polysulfated Glycosaminoglycans)
116
Why use Triamcinolone acetonide?
Chondroprotective effects
117
What with wrong with using Methylprednisolone acetate?
deleterious effects on articular cartilage

RUSVM Large Animal Surgery 2017 (14 decks)

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