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EBCM Lab > Lameness in Horses Additional Concepts > Flashcards

Lameness in Horses Additional Concepts Flashcards

(49 cards)

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1
Q

What is the onset and duration of lidocaine?

A

Onset: Rapid
Duration: 1.5-3 Hours

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2
Q

What is the onset and duration of Mepivicaine?

A

Onset: Rapid
Duration: 2-3hrs

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3
Q

What is the onset and duration of Bupivicaine?

A

Intermediate Onset
Duration: 3-6hrs

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4
Q

What are sources of articular pain?

A

Synovium, joint capsule, articular/periarticular ligaments, periosteum, subchondral bone

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5
Q

What structure in a joint has no nerve endings and does not cause pain?

A

Cartilage

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6
Q

What is the correct order that you should perform nerve blocks?

A

Distal to proximal

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7
Q

How do you prepare a patient for a perinural nerve block versus an inteasynovial block?

A

Perineural: Clean, PI and alcohol scrub - brief, but thorough near synovial structures and never touch hub of needle

Intrasynovial: Clip, 5-minute sterile scrub, wear sterile gloves

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8
Q

What sized needles can be used for perineural blocks?

A

25g 5/8in - 18g 1.5inc

Smaller needle - less pain, more likely to break
Larger stronger
General 18G

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9
Q

What kind of syringe should you use?

A

Non-lock and leuer

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10
Q

How do you know if your patient has improved from your block?

A

Very subjective - use manipulation test and circles, aim for 100% improvement (may switch sides) and should achieve >70% improvement

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11
Q

What are some local side effects of perineural analgesia?

A

Local swelling - hematoma, drug-tissue interaction (inflammation), regional swelling (cellulitis)

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12
Q

How can you prevent some of these local side effects?

A

Firm bandages with sweat (alcohol) and prevent swelling

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13
Q

What are some side effects of intrasynovial anesthesia?

A

Flare: acute reactive synovitis (more with lidocaine than mepivacaine)
Hematoma
Infectious synovitis (use new bottle every time)

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14
Q

What are some things to consider with local anesthesia ?

A

-Blocked horse is unsafe to ride - stumble or kick
-Motor nerve blockage
-Stress fractures or incomplete fracture

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15
Q

What is the most distal perineural nerve block you can perform?

A

Palmar digital

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16
Q

What does the palmar digital block numb?

A

70-80% of the foot, Sole, Toe, Navicular and bursa, digital cushion, navicular suspensory apparatus, Insertion of DDF on P3

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17
Q

Where are the landmarks for this injection?

A

Just above the heel bulbs, abaxial/lateral or medial to the DDFT

Or about 1cm above the collateral cartilage

Point distal

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18
Q

What size needle and how much carbocaine should be used?

A

25G
2-3ml carbocaine
x2

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19
Q

What block is performed close to the palmar digital that can be used to desensitize the entire foot and pastern?

A

Dorsal Ring Bock

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20
Q

What is the next perineural block that you would perform after the palmar digital block?

Study These Flashcards
A

Abaxial or Basiseamoid Block

21
Q

Which nerves are blocked?

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A

Palmar digital block proximal to the branching

22
Q

What structures are blocked via the abaxial sesamoid block?

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A

Pastern, dorsal hoof wall, coronary band, coffin joint, pastern joint, sesmoidian ligament

23
Q

What are the landmarks for the abaxial sesamoid block?

Study These Flashcards
A

Locate the proximal sesamoids, palpate the mesial and lateral side to ID the nerve bundle

24
Q

What sized needle and syringe can be used and how much carbocaine?

Study These Flashcards
A

22-25G, 3cc syringes
2-3ml per site
Carbocaine
x2

25
What is the next block to be performed after the basiesesmoids/abaxial sesmoids?
Low Palmar or 4 points
26
What nerves are blocked by the low 4 point?
Medial and lateral palmar nerves Medial and lateral metacarpal nerves
27
What should you do differently when preparing for this block?
Sterile prep in case you get into the fetlock joint
28
What is blocked by the low 4 point?
Fetlock joint, Sesamoid bones, suspensory insertion on sesamoid bones
29
What are the land marks for this injection?
Palmar to the cannon bone, dorsal to the suspensory, just distal to the button of the splint bone Proximal to the button of the splint, on caudal side of suspensory
30
What gauge needle is used and how much carbocaine?
22-25G 4-6ml carbocaine x4 or x2
31
What is the next perineural block that should be performed after the low 4pt?
High 4 pt
32
What nerves are blocked by the high 4 point?
Medial and lateral palmar palmar metacrapal nerves
33
What should you remember about preparation for this block?
Sterile prep should be performed
34
What are the landmarks for this block?
Palpate the head of the splint bone
35
What is an alternative block to the high 4 point?
Lateral Palmar/Wheat
36
Which joint should you start with blocking?
Distal Interphalangeal
37
What does blocking the DI joint block?
DIP, Navicular bursa and toe of sole
38
How much lidocaine should you use for DIP Joint block?
6ml and give it 5-10 min
39
What is the Podotrochlear (navicular) Bursa injection best for?
Specific for navicular problems Radiography to confirm positioning Stand or flexed 3-5ml
40
Is the proximal interphalangeal joint block commonly performed?
Uncommon -cant get much synovial fluid from it -up to 10ml local anesthetic
41
What is the next joint block?
Metacarpophalangeal Joint 10ml 10min
42
What is the next joint after the metacarpophalangeal joint to be blocked?
Carpal Joint Perform separte for specificity 5-10ml each joint
43
How do you perform the low plantar and distal plantar block in the hind limb?
Same as the palmar digital block just easier if not flexed due to the reciprocal apparatus
44
What nerves are blocked in the high plantar block?
Medial and lateral plantar and plantar metatarsal nerves 18G limb off ground 2injection site 5-10mleach Block PSD and TMT joint
45
Intrsynocial in hind similar to forelimb. Ture or False?
Ture - flexed just harder
46
How do you block the tarsometatarsal?
Lateral, proximal head of MT IV 20G 1.5inch 4-8ml Doesn't communicate wit DIT joint
47
Dista Intertarsal joint injection?
Difficult, medial, 22-25G, cuneal tendon Stand opposite side of horse Fluid not normally obtained
48
Tarsocrural - communicates with PIT, saphenous vein overlies dorsomedial pouch 30ml
Ture
49
When injecting the stifle, how many joints need to be injected?
3 separately 20-30ml/joint

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