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76 Cards in this Set

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Which layer can't really be put on too tight in large animal bandages?
Padding layer
If you want to look "professional" when wrapping a bandage, which way should you wrap?
Distal to proximal
Wrap tendons in
(don't really have to do either though)
T or F:
Elasticon should never be used on the skin.
False!
It can be used with NO TENSION
Name some major pressure points in equine bandaging.
Accessory carpal bone
Medial malleolus of radius
Point of hock
Tendons
Tuber calcanei
How should the lower leg of a horse be splinted?
Over a Robert Jones bandage.
Apply dorsal (or sometimes palmar/plantar) brace
Stabilize in FLEXION
How should a distal radial horse fracture be splinted?
Robert Jones + caudo-lateral splint
How should an upper limb fracture be splinted?
Lateral splint up the entire leg and onto the thorax
What is the typical age of presentation with a DDF contracture? SDF contracture?
DDF - <3 mos
SDF - 12 mos - 2 yrs
DDF contracture affects the __________ joint while SDF contracture affects the ____________ joint.
SDF = fetlock
DDF = coffin
What are some non-surgical treatments of DDF contracture? Surgical?
Non-sx = lower the heels and extend the toe w/shoes
Sx = distal check ligament desmotomy
What are the landmarks for the distal check ligament desmotomy?
Lateral aspect
3 fingers distal to flare of cannon bone
Immediately over DDF tendon
What structures must be identified before performing the distal check desmotomy?
SDF, DDF, suspensory ligament, and distal check ligament
Which layers are closed in the distal check desmotomy? What patterns?
Retinaculum (simple continuous)
Subcut (only if synovial structure encountered)
Skin (simple interrupted or maybe horizontal mattress)
Synovial fluid in a distal check ligament desmotomy is an extension from which structure(s)? How is this handled in surgery?
Extension of carpal/metacarpal joint.
Close subcutaneous!
What are important post-op considerations after a distal check desmotomy?
Compression bandaging
Handwalk
Corrective shoeing/trimming
For valgus correction, the _________ hoof wall is trimmed while in varus the ________hoof wall is trimmed.
Valgus = lateral
Varus = medial
Which of the following are true regarding laminitis?
a) inflammation of the hoof
b) separation between coffin bone and inner hoof wall
c) the developmental phase of laminitis begins at the first sign of lameness and lasts until 48 hours after onset of signs
d) the current theory of laminitis involves uncontrolled release of MMPs.
b) separation between coffin bone and inner hoof wall
d) the current theory of laminitis involves uncontrolled release of MMPs.
What are the phases of laminitis and when does each phase begin/end?
Developmental (inciting cause to first signs of lameness)
Acute (first sign of lameness until chronic)
Chronic (48 hrs after signs or when there is evidence of rotation of distal phalanx)
Which laminitis phase is associated with thickened dorsal hoof wall?
Chronic
Which laminitis phase is associated with increased digital pulse and warm hooves?
Acute (and chronic too I guess)
Which of the following are NOT inciting causes of laminitis?
a) Cushing's
b) Colic
c) Lush grass
d) Viral respiratory dz
e) Increased weight bearing
ALL are inciting causes!
What signs and lab changes would you expect to find in laminitis?
Tachycardia
Hypertension
Increased lactate
Metabolic acidosis
Stress leukogram
Increased FDPs
Which Obel lameness grade is given to a horse willing to walk but with a stilted gait and can lift one leg off the ground?
Grade 2
Which Obel lameness grade is given to a horse that resists having its feet lifted and moves reluctantly?
Grade 3
Which of the following is not conducive with chronic laminitis?
a) positive hoof tester
b) Walk on heels
c) Sinking of P3
d) Concave sole
e) Seedy toe
a) positive hoof tester (often NEGATIVE)
d) Concave sole (should be CONVEX)
Which nerve blocks are used to diagnose laminitis?
Often unnecessary
Use abaxial sesamoid or pastern ring block
Which of the following is not true regarding laminitis?
a) always a medical emergency
b) P3 rotation <11.5 degrees indicates a probable return to function
c) Ratio of dorsal wall to coffin bone length <0.27 indicates laminitis
d) Ice soaks up to 48 hrs can be used
e) exercise is contraindicated
b) P3 rotation <11.5 degrees indicates a probable return to function (<5.5 degrees indicates return to fxn)
c) Ratio of dorsal wall to coffin bone length <0.27 indicates laminitis (should be >0.27)
What are the surgical treatments available for chronic laminitis?
Hoof wall resection
Distal check desmotomy
DDF tenotomy
Neurectomy
Which of the following blocks would block pain in the soft tissue of the entire hoof?
a) Palmar digital
b) Coffin Joint
c) Abaxial Sesamoid
c) Abaxial Sesamoid
Which of the following blocks would block pain in the soft tissue of the heel?
a) Palmar digital
b) Coffin Joint
c) Abaxial Sesamoid
a) Palmar digital
c) Abaxial Sesamoid
Which of the following blocks would block pain in coffin joint DJD?
a) Palmar digital
b) Coffin Joint
c) Abaxial Sesamoid
b) Coffin Joint
c) Abaxial Sesamoid
Which of the following blocks would block pain due to navicular disease?
a) Palmar digital
b) Coffin Joint
c) Abaxial Sesamoid
a) Palmar digital
b) Coffin Joint
c) Abaxial Sesamoid
How is acute laminitis treated?
Sole support
IV fluids
Pain/inflammation control
What is podotrochleosis?
Navicular disease
What is the most common cause of bilateral intermittent and sometimes shifting lameness in horses?
Navicular disease
Which of the following is NOT true regarding navicular disease?
a) Usually only affects forelimbs
b) QH, Paints, and Arabians are commonly affected
c) linked to upright pasterns and small hooves
d) corrective shoeing often helps
b) QH, Paints, and Arabians are commonly affected (Arabians RARELY affected)
What are the 5 considerations when applying corrective shoeing to a horse with navicular disease?
Be sure pastern axis is normal
Raise heels
Increase weight-bearing surface of hoof
Make break-over easy
Allow heel expansion
Which of the following are clinical signs of navicular disease?
a) walking on heels
b) hoof tester shows pain in center of frog
c) concave sole
d) shoulder pain
e) worn toes
a) walking on heels (nope, they try not to land on heels)
d) shoulder pain (nope, they have a short cranial stride that looks like shoulder pain)
T or F:
Most navicular disease horses block with a palmar digital block.
True!
What are pathologic changes with navicular disease?
Increased #/size of synovial fossae
Cartilage erosion in central eminence
Bone erosion + osseous metaplasia
Adhesions of DDF to navicular bone
Possible rupture of DDF tendon
What is the most consistent pathologic change in navicular disease?
Cartilage erosion
What are the types of P3 fractures? Which is the most common type?
Oblique palmar process MOST COMMON (wing; articular and non articular)
Sagittal articular fractures
Communituted (articular/non-articular)
Chip fractures (marginal fractures)
Extensor process fractures
Which feet and which breeds typically get extensor process fractures?
Front feet in QHs and QH crosses.
How are most P3 fractures treated?
Rest >5 months
Prevent hoof wall expansion
Maybe neurectomy
What fracture will present like navicular disease?
Chip fracture (distal border) of navicular bone
Which has a better prognosis, P3 fractures or navicular fractures?
P3 (since most are non-displaced)
What are the infections affecting horse hooves?
Thrush
Subsolar abscess
Septic navicular bursitis
Canker
Quittor
How is thrush treated?
Pick the hooves
CuSO4 or dilute (1:9) bleach
How does Snoop Dogg treat thrush in his horse?
BLEEEYYAAAAATCH!
Black, smelly pus out of a horse's hoof is indicative of...
SUBSOLAR ABSCESSES
What are sequella to untreated subsolar abscesses?
Septic pedal osteitis
Septic navicular bursitis
Laminitis
Fx of P3 or navicular bone
Tetanus
What is the most important aspect to treating subsolar abscesses?
Establish drainage
Septic navicular bursitis is usually caused by puncture wounds to the _______________________.
middle third of the frog
How is septic navicular bursitis treated?
"Street Nail" procedure
Excise central 1/3 of frog
Make window in DDF tendon
Drain and lavage navicular bursa
Provide abx and plate shoe
What is another name for necrosis of the collateral cartilage? How does this occur?
Quittor; due to incomplete treatment of a laceration into the collateral cartilage
What is horse-speak for a chronic hypertropy of the horn-producing tissues of the hooves? What are common signs of this? How is it treated?
Canker
Rear hooves, draft horses, fetid odor
Tx: debride, flush, metronidazole in the bandage
When is suturing used with hoof wall avulsions?
If coronary band is involved
What causes thrush?
Bacteria (F. necrophorum) + fungi
T or F:
Sidebones is most common in the front feet.
True!
T or F:
Hematogenous septic arthritis is uncommon in neonates.
False!
Septic arthritis is ALWAYS hematogenous in neonates pretty much! It is RARE in adults!
What are the 3 classifications of septic arthritis in foals?
Synovial
Epiphyseal
Physeal
What are common bacteria causing septic arthritis in adults? Foals?
Adults (Staph, Strept, Mycoplasma)
Foals (E. coli, Salmonella, Actinobacillus)
Which antibiotics are most commonly used for regional perfusion in horses? Which antibiotic should NOT be used?
Amikacin and Gentamycin
(DO NOT USE ENROFLOXACIN d/t regional necrosis)
What is the most commonly used joint drainage and lavage modality?
Through-and-through lavage
What should you NOT use as a joint lavage solution?
Chlorhex!!!
What are some non-antibiotic medications that can help with septic arthritis?
NSAIDS (give foals PPIs too)
Hyaluronic acid
GAGs
DMSO, hyperimmune serum, etc
How is foal septic arthritis treated?
TREAT THE UNDERLYING CONDITION
What are the phases of wound repair?
Inflammation
Debridement
Repair
Maturation
What are the key components of the repair phase?
Epithelialization
Wound contraction
Which of the following are associated with the debridement phase of repair?
a) fibrin clot
b) fibroblast attraction
c) monocyte chemotaxis
d) leukocyte chemotaxis
e) collagen production
b) fibroblast attraction
c) monocyte chemotaxis
(also monocyte phagocytosis)
A scar is approximately ________% weaker than native tissue.
15-20% weaker
What can veterinarians do to facilitate wound healing?
wound preparation
wound evaluation
prevention/treatment of infection
avoid substances delaying healing
What pressure should be used to lavage a wound and how is this pressure achieved?
7psi (18ga on a 35cc syringe)
What concentrations of chlorhexidine or iodine should be used to lavage wounds?
Chlorhex (0.05% or 1:40)
Iodine (0.1 to 1%; 1:100 or 1:10)
What are the 4 wound closure options?
Primary closure
Delayed primary closure
Secondary closure
Second-intention healing
Which of the following is true regarding delayed primary closure?
a) closed before granulation tissue develops
b) closed after granulation tissue develops
c) often debrided before closing
d) the best method for distal limb wounds
e) usually for very dirty wounds
a) closed before granulation tissue develops
c) often debrided before closing
e) usually for very dirty wounds