SA Ortho Exam

Question 1

Lameness diagnosis

Answer 1

History
General physical exam
Neurology exam
Orthopedic exam

Question 2

Neurology exam

Answer 2

CNS, mentation, ambulating, conscious proprioception, spinal reflexes, palpation

Question 3

Orthopedic exam

Answer 3

History
Visual inspection of stance/conformation
Gait analysis
Palpation - standing / recumbent (affected leg LAST)

Question 4

Visual inspection

Answer 4

Observation at distance
General thriftiness/weight
Body symmetry
Muscle atrophy
Abnormal conformation (keep in mind breed standards)
Watch sit/stand

Question 5

Gait analysis

Answer 5

Determine affected leg(s)
Walk, trot, pace, canter, gallop
Lameness can “disappear” in clinic
Stress: tight circles, stair climbing, etc
Ataxia

Question 6

Grading scale

Answer 6

0 - none
1 - mild weight bearing lameness
2 - moderate weight bearing lameness
3 - severe weight bearing lameness
4 - non-weight bearing lameness

Question 7

Thoracic limb lameness

Answer 7

Head bob “down on sound”
Drops when weight being on normal leg; lift on lame leg

Question 8

Pelvic limb lameness

Answer 8

Hip hike
Stride length shortened on lame leg
Normal limb reaches forward faster than lame
Oscillating motion during locomotion (toward normal side)

Question 9

Palpation - standing

Answer 9

Examine contralateral aspects simultaneous
Effusion, swelling, atrophy, malaligned bony landmarks

Flexion,extension, lateral mvt of neck

Pressure to spinous processes along spine (for pain)

Dorsal pressure to LS region; ventral pressure to LS region rectally
Hip/lumbar extension
Tail life

Question 10

Palpation - recumbent exam

Answer 10

Start distal on limb —> palpate all joints
Palpate all joints - ROM, individual joint movement
Palpate entire length of bone
Reflexes

Question 11

Examination of digits

Answer 11

Palpate each digit, joints and long bones of each
Assess pain, swelling, effusion, crepitus, ROM, instability

Question 12

Digital causes of lameness

Answer 12

Wound, foreign body, interdigital dermatitis, broken nails

Question 13

Examination of carpus

Answer 13

Effusion best palpated cranially

Instability - palpated medial/lateral

Question 14

Radius / ulna examination

Answer 14

Long bone palpation

Question 15

Elbow examination

Answer 15

Effusion between lateral epicondyle and olecranon

Question 16

Humus examination

Answer 16

Long bone palpation

Question 17

Shoulder examination

Answer 17

Effusion difficult to palpate

Biceps tendon - medial to greater tubercle

Don’t forget scapula

Question 18

Tarsus examination

Answer 18

Effusion best felt between distal tibia and tuber calcanei
Instability - medial/lateral

Question 19

Stifle examination

Answer 19

Effusion best felt medial to patellar tension
Medial buttress —> thickening of medial joint capsule (chronic disease)
Medial/lateral instability

Question 20

Evaluation of patellar alignment

Answer 20

Push patella medially + internally rotate limb
Push patella laterally + externally rotate limb

Should not be able to lunate patella

Question 21

Cranial drawer test

Answer 21

Assess stifle stability

Hold landmarks (patella, fabella, tibial tub erosion, fibulae head) and try to push cranially

+ cranial drawer = CCL incompetence

Question 22

Cranial tibial thrust

Answer 22

Mimic weight bearing

Hold stifle in flex action, dorsiflex paw

Movement of tibial tuberosity = positive test (corroborate cranial drawer test) = CCL incompetence

Question 23

Examination of hip

Answer 23

ROM, flexion, extension, adduction, abduction, circular

Question 24

Hip luxation

Answer 24

Palpate landmarks - wing of ilium, is hail tuberosity, greater trochanter - should form triangle

*if cranial dorsal hip luxation —> landmarks for a line

Question 25

Ortolani test

Answer 25

Test for hip laxity

Lateral (preferred) or dorso recumbency

Grasp stifle, stabilize spine; adduct/move femur dorsally to subluxation femoral head —> if clunk is felt or heard —> positive for luxation