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56 Cards in this Set
- Front
- Back
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List the 5 steps outlined for a complete and systematic orthopedic exam in the dog or cat.
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S-Signalment, History, & PE
O-Observation of ambulation, grade & characterize gait A-Awake patient ortho examination (localize areas of pain) R-Restrained ortho exam (chemical restraint/general anesthesia) R-Radiographic evaluation |
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Know the 3 historical aspects of the chief complaint vital to a complete patient history.
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1. Manner of onset
2. Signs seen by owner 3. Duration of signs |
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Know the four grades characterizing a lameness
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Grade I- barely perceptible
Grade II- noticeable lameness, but weightbearing most of the time Grade III- only occasionally weightbearing, usually to catch balance Grade IV- non-weightbearing lameness |
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Know the four listed aspects of the local examination of the affected limb in the specific orthopedic exam.
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1. Careful palpation- don’t forget to inspect the skin, as well as bones, muscles & joints
2. Symmetric evaluation 3. Palpate all bones and joint in affect extremity- paw → up 4. Neurologic exam |
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Know the hallmark of a complete orthopedic exam (localize the lameness to a specific part of a specific limb).
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Judged by the animals reaction on awake exam. Goal of exam, in order to establish differential.
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Know the five listed purposes of the radiograph exam in a complete orthopedic exam.
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-Dx localized lameness
-Confirm ortho exam Dx -Make prognosis from radiograph of ortho disease -R/O diseases considered in differential Dx -Evaluate unrelated/ sign. problems that may influence the Tx of the orthopedic disease |
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List the 3 most common long bone tumors in the dog in the order of frequency of occurrence.
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1. Osteosarcoma
2. Chondrosarcoma 3. Fibrosarcoma |
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List the breed size and two most common locations for long bone osteosarcomas.
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Large and giant breed dogs tend to get osteosarcomas in the distal radius and proximal humerus (Away from the elbow, towards the knee)
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Describe the general biologic behavior of long bone osteosarcomas in the dog
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Osteosacromas in the dog are usually productive, more likely to metastasize (esp. to lungs)
Arise from the metaphyseal region, but don’t cross joints. |
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Describe the general biologic behavior of long bone osteosarcomas in the cat
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Osteosacromas in the cat are usually lytic=more pathologic fractures, & less metastasis, amputation can cure.
Occur in the hind limb more often than the fore limb |
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Know the 3 most common sites for chondrosarcoma in the dog.
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Ribs, Nasal Cavity, Pelvis
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Know the 5 most common nonosseous tumors directly invasive to bone.
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Squamous cell carcinoma***- oral cavity & digits
Malignant melanoma**- oral cavity & sublingual Acanthomatous Epulis Oral Fibrosarcoma Synovial Sarcoma |
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Know the 3 most frequent secondary bone tumors in the dog (metastatic dissemination from a primary neoplasm elsewhere in the body).
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Mammary carcinoma
Primary lung carcinoma Prostatic carcinoma Thyroid carcinoma hemangiosarcoma |
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Know the appropriate diagnostic steps in evaluating bony lesions suspected of neoplasia
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Physical exam, radiographic exam of the affected part, thoracic evaluation for metastasis, biopsy
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Describe the technical aspects of a proper bone biopsy of a suspected neoplastic lesion.
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Michelle trephine/Jamshidi needles
Must completely penetrate the cortex, through the medulla, to cortex on other side Need to take multiple samples from center of lesion Use stab incision & biopsy in different planes- minimize fracture to bone |
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Know the typical breed and signalment
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Young, growing (5-13 month) large & giant breed dogs
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Know the typical breed and signalment for Craniomandibular Osteopathy
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3-8 month old (terriers)
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Know the typical clinical signs (including history)
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sudden onset lameness, chronic leg shifting lameness, localized pain on digital pressure
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Know the most common bones affected
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NEAR the elbow, distal humerus, proximal ulna & radius
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Know the typical treatment for Panosteitis
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Restricted activity & NSAIDs/corticosteroids for pain
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Know the typical breed and signalment for Hypertrophic Osteodystrophy.
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young (3-7 months), rapidly growing large & giant breed dogs
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Know the typical clinical presentation for Hypertrophic Osteodystrophy.
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, painful swellings of metaphyseal regions of long bones (distal radius, ulna, tibia)
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Know the typical location of radiographic presentation for Hypertrophic Osteodystrophy.
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Early: radiolucent bands w/in the metaphysis parallel to the growth plates
Late: ossified cuff around metaphysis |
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Know the prognosis for Hypertrophic Osteodystrophy.
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Guarded, can spontaneously recover or cause permanent bony changes & deformities
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Know the etiologic controversy regarding hypovitaminosis C for Hypertrophic Osteodystrophy.
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Vitamin C deficiency-Scurvy in people
Overnutrition/mineral imbalance |
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Know the typical treatment Hypertrophic Osteodystrophy.
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Correct nutritional imbalances, analgesics, supportive therapy
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Know Treatment for Hypertrophic Osteopathy.
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treat infections/remove tumors=signs will regress, bones will heal
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Know disease description for Hypertrophic Osteopathy.
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Quadrilateral disease of the extremities of periosteal bone proliferation, most common in old dogs
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Know most common etiology for Hypertrophic Osteopathy.
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primary or metastatic pulmonary neoplasms, also associated with infections
Rapid increases in BF to extremities-vascular tissue & periosteal bone formation- possibly mediated (caused) by vagal stimulus |
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Know clinical signs for Hypertrophic Osteopathy.
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lameness in all four limbs; warm, painful, swollen limbs; no edema, stiff, stilted gait
Radiographic signs: Periosteal proliferation, new bone formation, soft tissue swelling parallel to the bones |
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Know the 4 most common sites of OCD development.
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Shoulder-most common caudocentral
Elbow- usually w/ FCP medial humeral condyle Stifle- lateral femoral condyle Talus- proximal medial ridge |
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Understand the pathogenesis of OCD.
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Failure of norm endochondral osteogenesis of articular cartilage=increased thickness & separation from bone. Flap-allows synovial fluid to contact epiphyseal bone. Can be partial (flaps)/complete (joint mice)=pain & lameness, communic. of subchondral fracture w/ articular surface
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Know the typical signalment of a dog likely to develop OCD.
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Young (4-8 months), large and giant breed dogs
Bilateral in many, other joint problems commonly develop (hip dysplasia) |
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the 2 major objectives in surgical treatment of OCD
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Remove the cartilage flap
Stimulate cartilage bed (by scraping or forage) |
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Rank the prognosis based on the joint involved.
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Best in the shoulder
Worst in the hock Intermediate prognosis in the elbow & stifle |
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Know the common direction & frequency of directions in luxation
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Traumatic luxation- medial or lateral, usually larger dogs, causes a leg carrying lameness
Congenital luxation- usually medial (generally small breeds) |
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Know the muscles torn in traumatic luxations in either direction
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Medial/lateral glenohumeral ligaments usually torn in trauma
Supraspinatus-cranial Teres minor-caudal Infraspinatus- lateral Subscapularis- medial |
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the 4 major muscles of support to the scapulohumeral joint
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Supraspinatus-cranial
Teres minor-caudal Infraspinatus- lateral Subscapularis- medial |
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the recommended repair by biceps tendon transposition (IV 2a&b)
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Medial luxation=medial transposition
Lateral luxation=lateral transposition |
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Six diseases of the elbow
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UAP
FCP OCD Traumatic luxation Congenital luxation Subluxation -Radius curvus -Asynchronous growth of radius & ulna |
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Know the disease description of UAP
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Failure of the 4th ossification center to unite w/ the unla by 16-18 weeks
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Know the clinical signs of UAP
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Instability of the elbow, decreased flexion/extension of the elbow, secondary DJD
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Know the time of definitive radiographic diagnosis of UAP
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Cannot be done definitively before 20 weeks (takes that long to fuse in normal animal)
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Know the surgical treatment of UAP
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Proximal ulna osteotomy*
Surgical removal of loose UAP-still have instability, just not lame, leads to DJD Screw fixation- piece too small to fix effectively w/ screws |
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Know the lesion site of FCP
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Medial coronoid process of humerus
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Know the clinical signs of FCP
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Young (6-10 month old), large/giant breeds
Uni/bi-lateral disease, causes weightbearing lameness Pain on flexion & extension, but no joint distension |
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Know the diagnosis of FCP
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Difficult to see on radiographs due to superimposition/deterioration of the joint w/ OCD
Suspect in all large, young dogs with elbow DJD w/o arthritis or UAP |
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Know the surgical treatment of FCP
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Surgical removal
Arthroscopic removal |
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Know the site of elbow OCD
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Medial humeral condyle of young, large/giant breed dogs
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Know the surgical treatment of elbow OCD
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Surgical removal via medial approach, check for FCP
Scrap/forage the subchondral bed to stimulate new cartilage growth |
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Know the prognosis for elbow OCD
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Good if surgery before DJD starts, but not as good as OCD in other joints
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Know the 2 types of elbow luxation
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Congenital-lateral, think bulldog
Traumatic-usually caudolateral |
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Know the therapeutic indications for traumatic elbow luxation
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Closed reduction-
Open reduction- |
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Know the etiologies of ligamentous Carpus/tarsus injury
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Trauma
Immune-mediated joint disease |
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Know the clinical findings of ligamentous Carpus/tarsus injury
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Joint pain and swelling
Gait and stance abnormalities (palmo-, plantigrade) Increased laxity/instability/ hyperextension |
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Know the main categories of treatment optionsof ligamentous Carpus/tarsus injury
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Repair the ligaments
Conservative= coaptation (splinting) in flexion Arthrodesis + coaptation (partial or complete) |
