LASx Exam 1: Chronic Laminitis and Diagnosing Lameness in Horses

Question 1

Laminitis is considered chronic after ______ hours of

continual pain or when rotation of distal phalanx occurs

Answer 1

48 hours

Question 2

What are the clinical signs of chronic laminitis?

Answer 2

Shifting weight to hind feet

Unwilling to walk

Sinking at the coronary band

Coffin bone rotation

Non-parallel growth rings

Question 3

Non-weightbearing lameness is a huge risk factor for laminitis,

and if you see it, your immediate concern should be with

the _________ limb

Answer 3

CONTRALATERAL

Question 4

Which Obel Grade does the following describe?

No lameness at walk, short stilted gait at TROT

Answer 4

Obel Grade 1

Question 5

Which Obel Grade does the following describe?

Stilted gait at a walk, foot can be lifted

Answer 5

Obel Grade 2

Question 6

Which Obel Grade does the following describe?

Reluctant to walk, resists lifting foot

Answer 6

Obel Grade 3

Question 7

Which Obel Grade does the following describe?

Refuses to move, may become recumbent

Answer 7

Obel Grade 4

Question 8

What are some therapeutic shoeing techniques that can

help treat laminitis?

Answer 8

Dorsal hoof wall resection, heart bar shoe, reversed horse shoe

Question 9

This treatment is a LAST RESORT and is performed on

horses with quickly progressing laminitis as an attempt

to stop the rotation of the coffin bone

Answer 9

DDF TENOTOMY

Question 10

Aladdin’s Slipper can develop as a result of

___________

Answer 10

chronic laminitis

Question 11

What type of suture pattern is used to reconnect small

tendon lacerations?

Answer 11

Locking loop

Question 12

What are the 2 tendons effected by trauma to the forelimb

and where do you see the severance?

Answer 12

Common digital extensor (CDE) tendon

and

Lateral digital extensor (LatDE) tendon

Between the FETLOCK and CARPUS

Question 13

What are the 2 tendons effected by trauma to the hindlimb

and where do you see the severance?

Answer 13

Long digital extensor tendon (LongDE)

and

Lateral digital extensor tendon (LatDE)

Below the hock

Question 14

What tendons are effected by overloading and

where does the severance occur?

Answer 14

Flexor tendons

Between the carpus/hock and fetlock

Question 15

If you can hold the stifle and flex or extend the hock,

what did you just get a positive test for?

Answer 15

Tendon laceration!

Question 16

Tendon laxity is seen in _______ with their toes pointed up

Answer 16

FOALS

Question 17

If this tendon ruptures, you will have immediate NWB-lameness

Answer 17

Achilles tendon

Question 18

Anytime you cast a horse, you must bandage the

________ limb for support

Answer 18

contralateral

Question 19

What are the 3 causes of lameness in a horse?

Answer 19

Neurologic

Metabolic

Mechanical

Question 20

If a horse warms into or out of a lameness,

what is the cause?

Answer 20

Osteoarthritis

Question 21

_________% of lameness comes from the foot,

which is why you start here with hoof testers

Answer 21

80 - 90%

Question 22

You will see increased gluteal excursion in the

______ limb

Answer 22

LAME

Question 23

“Down on the sound” only applies to ________ lameness

Answer 23

forelimb

Question 24

What AAEP Grade of Lameness does the following describe?

Difficult to observe and inconsistent lameness

Answer 24

Grade 1

Question 25

What AAEP Grade of Lameness does the following describe? Difficult to observe in a straight line, but consistently apparent under certain conditions (like circling, hard surface, or incline)

Answer 25

Grade 2

Question 26

What AAEP Grade of Lameness does the following describe? Consistently observable at a trot in all circumstances

Answer 26

Grade 3

Question 27

What AAEP Grade of Lameness does the following describe? Obvious lameness with marked head nod, hitching, and shortened stride

Answer 27

Grade 4

Question 28

What AAEP Grade of Lameness does the following describe? Inability or reluctance to move, minimal or non-weightbearing

Answer 28

Grade 5

Question 29

What are the 5 pathognomonic lamenesses diagnosed at a walk?

Answer 29

Peroneus tertius rupture Upward fixation of patella Stringhalt Fibrotic myopathy Sweeny

Question 30

At a walk, a horse has weight bearing lameness but is dragging his foot. During your flexion test, you can extend the hock while the stifle is flexed. What is wrong with this horse?

Answer 30

Peroneus tertius rupture

Question 31

How do you treat peroneus tertius rupture?

Answer 31

Strict stall rest for 3 months

Question 32

T/F: To help treat upward fixation of the patella, you should give anti-inflammatories

Answer 32

FALSE! You want inflammation locally to thicken the ligament!

Question 33

How do you treat locking patella?

Answer 33

Medial patellar ligament DESMOPLASTY to increase inflammation and fibrose the ligament (or desmotomy in severe cases)

Question 34

Fibrotic myopathy is seen in these muscles and results in a shortened cranial phase

Answer 34

hamstrings- semimembranosus, semitendonosus

Question 35

What joints are being flexed during distal limb flexion?

Answer 35

Fetlock Pastern Coffin

Question 36

What joints are being flexed in proximal limb flexion?

Answer 36

Shoulder Elbow Carpus

Question 37

The Spavin Test is a flexion test of this

Answer 37

proximal hindlimb | (not hock specific)

Question 38

Why do you NOT sedate a horse for a diagnostic nerve block?

Answer 38

It can alter their gait

Question 39

What is the most common agent for local anesthesia in nerve blocks in a horse?

Answer 39

2% Mepivicaine (Carbocaine)

Question 40

T/F: You can use Bupivicaine/Marcaine for diagnostic nerve blocks

Answer 40

FALSE! only therapeutically

Question 41

What are the reasons that a palmar digital nerve block would fail?

Answer 41

Adhesion between the navicular bone and DDFT Osteoarthritis of the coffin Concurrent proximal disease Improper/incomplete anesthesia

Question 42

What nerves are being blocked in a Low 4-point block?

Answer 42

Lat/Med PALMAR nerves Lat/Med PALMAR METACARPAL nerves

Question 43

If you want to block the lateral and medial PALMAR nerves, where do you inject?

Answer 43

Between the SL and DDFT

Question 44

If you want to block the lateral and medial PALMAR METACARPAL nerves, where do you inject?

Answer 44

Between the palmar MC3 and MC2 + MC4

Question 45

What block would you perform if you wanted to block the origin of the suspensory ligament?

Answer 45

LATERAL PALMAR nerve block

Question 46

What structures are anesthetized in a HIGH 4-point block?

Answer 46

Suspensory ligament Some flexor tendons Some MC3 and MC4

Question 47

Which radiographic views are required in order to diagnose osseous abnormalities as a cause of lameness?

Answer 47

Minimum of 4 views: 2 oblique 1 lateral 1 DP

Question 48

This diagnostic imaging modality is best to identify articular and osteochondral disease, and is great for examining stifles.

Answer 48

ULTRASOUND

Question 49

This diagnostic modality is utilized when the site of lameness cannot be determined, as in grade 1 lameness, if multiple limbs are lame and not following the expected blocking pattern, upper limb/pelvic limb lameness, or suspected fracture that is not seen on rads.

Answer 49

Nuclear Scintigraphy (Bone scan)

Question 50

This compound is used in order to visualize abnormalities on nuclear scintigraphy. It has a 6.5 hour half life and is eliminated by the kidneys

Answer 50

Technetium-99 Labeled Phosphorus Compound

Question 51

This is the modality of choice for imaging bone, and can accurately delineate osseous lesions

Answer 51

CT

Question 52

This is the modality of choice for imaging soft tissue structures that are not accessible by U/S, such as structures within the hoof capsule, and intra-articular ligaments

Answer 52

MRI

Question 53

This modality can be diagnostic as well as therapeutic

Answer 53

Diagnostic Arthroscopy

Question 54

What is Equinosis Q?

Answer 54

It is a tool that uses inertial sensors and a wireless tablet to objectively detect and quantify body movement irregularities