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48 Cards in this Set
- Front
- Back
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What are the two overriding classes of lameness? |
Pain or mechanical |
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Does the horse have to be moving to exhibit a lameness? |
NO -- NWB is a type of lameness. |
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What is the Grade 1 lameness according to AAEP? |
A lameness that is difficult to observe, and is inconsistent at any gait |
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What is a grade 2 lameness? |
Difficult to observe in the straight line, but consistently apparent under certain conditions |
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What is a grade 3 lameness? |
A lameness that is consistently observable at TROT under ALL circumstances |
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What is a grade 4 lameness? |
An obvious lameness with marked nodding, hitching or a shortened stride. Can be seen at the walk as well. |
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What is a grade 5 lameness? |
A lameness with minimal to no wt bearing or the inability to move at all. |
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What type of lameness is the most common? |
Painful lameness due to structural or disease process in the musculoskeletal system. |
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What do we call a gait that is due to non painful causes? |
A functional lameness |
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What type of lameness is confusing? |
a mixed lameness. |
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What are some differentials for painful lameness? |
OA, Septic arthritis, lacerations, soft tissue ruptures, OCd, Fxr, foot abscesses |
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What condition do we always need to consider in an animal with a sudden onset of SEVERE lameness? Esp since we live in wet OR? |
Foot abscess. |
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What are some differentials for a mechanical or functional lameness? |
Stringhalt, Neuro deficit, Fibrosis, anklyosis, upward fixation of patella, shoulder subluxation (sweeny), flexural deformity |
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What are the two categories of mechanical lameness? In other words, what are 2 broad categories of causation of mechanical lameness? |
Neurological or structural |
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What should be the first part of your lameness examination? (Hint, you are not touching the animal yet) |
Stand and look at the horse - should be standing square, look at all 4 sides and evaluate conformation |
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What type of confirmation is this? |
"Back at the knee" or "calf knee" -- places more stress on the tendon at the carpal canal. This is OVEREXTENSION OF THE CARPUS |
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After you evaluate conformation, what should you do next (now you can touch the horse) |
PALPATE! |
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When palpating, what are you checking? |
Joints, tendons/ligaments, ROM. |
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Should the palpation be done standing or unweighted? |
both |
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If you note an obvious decrease in ROM, should you think that is normal? |
No |
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What are we noting on palpation? |
Any swelling, sensitivity, asymmetry, decreased ROM |
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Once you have palpated a limb, what should you do? |
Palpate the other one!! |
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If you palpate something in one limb, but you find it in all the other limbs, what does that indicate? |
That there is less likely to be a problem (issues often are asymmetrical) |
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You see a swelling in the hock - what should you be asking your self to see if it is in the joint or not? |
Can I see that joint capsule? Is it a generalized swelling? Are there any normal prominences that are obscured? |
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How do horses "normally" get a large amount of muscle atrophy? |
DISUSE! |
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What do we use the hoof testers on? |
All 4 feet on the sole, the frog and the heel - testing compression |
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What the hell is that hammer for? |
to check PERCUSSION sensitivity versus compression sensitivity-- same areas as the hoof testers - all 4 feet, sole, frog and hoof wall. |
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What should you have before doing the moving exam? |
A differential list |
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What are the parts to the moving lameness exam? |
Straight away - walk and trot Circle in both directions on lunge line +/- canter, under saddle Flexion testing |
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What are the joints that we will do flexion tests on? |
the carpus and lower fore limb Hock, Stifle and lower rear limb |
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Why do we do a circling lameness exam? |
It can bring out a more subtle lameness or a bilateral lameness. We can compare it to the straight away |
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What is a flexion test? |
Where we hold that joint in flexion for an extended period of time (30-90s depending on location) and then trot them off -- are they worse or no change from the trot prior and how long does it take them to come out of it? |
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What are the clinical features of a forelimb lameness? |
Head nod (down on sound), head/neck elevating when the lame limb is supporting wt. |
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What are the clinical features of hind limb lameness? |
Hip excursion (hip hike/drop), asymmetry of pelvis/bony prominences, head nod when on lame limb; short stride, toe dragging, not tracking up; decreased extension of fetlocks |
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The horse is more lame after a carpus flexion test - where is the lameness? |
In the carpus |
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How do we test medial/lateral imbalances or heel down on the flexion testing? |
WEDGE test |
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What are the 5 areas that we do flexion testing on? |
Lower limb (fetlock - incl the pastern, coffin jt and navicular) Carpal Shoulder/elbow Hock/stifle (Spavin test) Wedge testing |
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What are the 6 local anes inj that we do in lameness examination? |
Palmar/plantar digital nerve block Basilar/abaxial sesamoid block low 4 pt high 4 pt Intra-articular jt block |
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When you are doing a perineural block, do you actually inj the nerve? |
No you are injecting PARALLEL to the nerve |
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What nerves is the basilar sesamoid block working on? |
The lateral and medial branches of the metatarsal nerves from deep peroneal |
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What nerves is the low 4 point block working on? |
the palmar/plantar nerve, palmar/plantar metacarpal/metatarsal nerves |
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What nerves is the high 4 point block working on? |
the palmar nerves, palmar metacarpal nerves, lateral palmar nerve. |
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You have done the standing exam, the moving exam, flexion testing and nerve blocks -- where are you going next? |
IMAGING! |
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Which is usually the first step in Diagnostic imaging? |
rads - but remember this is not good for soft tissue |
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What are some other imaging modalities that are available to use in horses? |
US, MRI (traveling units), CT, nuclear scintigraphy and thermography |
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Which modality is best for soft tissue visualization? |
MRI |
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What radioactive isotope is used in nuclear scintigraphy? |
TcM99 (bone metabolism) |
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What do you need to be careful with in thermograph? |
You can easily make up lesions - so you need to be carefully and thoroughly trained in use and interpretation. This is not that popular yet. |
