-
Where are growing long bones prone to fracture?
physis aka growth plate since endondrosis hasn't occurred yet
-
By what age do must physes close?
by 1 year of age
-
How are physeal fractures classified?
Salter Harris fractures
-
How many Salter Harris fracture types are there? What are each of them?
- 5 types
- I. fracture through physis only
- II. Through the physis and metaphysis
- III. Through the physis and epiphysis (articular)
- IV. Through the joint and across physis
- V. Compression fracture of physis
-
What is the most common type of physeal fracture?
Type II, through the physis and metaphysis
-
Which physeal fractures have good prognosis?
Type I, II
-
Why do type 3 and 4 physeal fractures have poorer prognoses?
They must be completely aligned since there are articular surfaces involved, otherwise fracture will lead to DJD
-
How are compression and traction physeal fractures treated?
- compression: immobilization
- traction: immobilization and counteract the pull of the attached muscle since these occur at olecranon and calcaneus which are always contracting
-
Which physes take longer than a year to close?
- iliac crest (1-2.5 years)
- pelvic symphysis (5-6 years)
- possibly head of the humerus
-
What are the last physes of the shoulder and stifle to close?
- head of the humerus
- tibial tuberosity
-
When does the physis of the anconeal process close?
4-6 months...after this it's considered ununited
-
Why is the median nerve more in danger in the cat than dog if the humerus is fractured?
the humerus of the cat has the supracondylar canal that encloses the vessels.
-
What is the landmark for locating heat valves during auscultation?
olecranon @ 5th intercostal space
-
What is failure of the anconeal process to fuse with the ulna by 6 mos?
ununited anconeal process
-
What improper development usually leads to arthritis of the elbow?
fragmented medial coronoid process
-
What small sesamoid bone on the medial side of the carpus may be mistaken as a chip fracture in radiographs?
sesamoid bone of the oblique extensor carpus tendon
-
Name the following fractures:
bone twisted apart
skull bone pushed inward
separation of small bone fragments where ligament of tendon attaches
bone splintered in to many fragments
broken ends of the bone are driven in to each other
- -spiral fracture
- - depressed fracture
- - avulsion fracture
- - comminuted fractures
- - impacted fracture
-
What is inflammation or infection of the bone?
osteomyelitis aka osteitis
-
What is a piece of dead bone separated from the rest of the bone in osteomyelitis?
sequestrum (it must be removed to heal)
-
Name 3 of 4 common sources to harvest cancellous bone
tibial tuberosity, greater tubercle of humerus, greater trachanter, wing of ileum
-
What is inflammation of a tendon and a tendon sheath?
tendonitis/tendosynovitis
-
What is osteochondrosis (OC)?
defect in endochondral ossification which causes deeper layers of articular carilage to die
-
What is osteochondrosis dissecans (OCD)?
osteochondrosis with a dissecting flap or separated piece of cartilage ("joint mouse")
-
What is the most common place for osteochondrosis in dogs?
shoulder; head of humerus
-
List name for inflammation of a joint
arthritis; osteoarthritis...
-
What is an infection in a joint w/ bacteria, fungus and/or virus that causes cartilage damage?
septic arthritis
-
What is an osseous outgrowth seen radiographically?
osteophyte/ bone spur
-
What is the term for an increase in bone density?
sclerosis
-
What is immobility and consolidation of a joint due to disease, injury or sx procedure?
ankylosis
-
What is destruction of a bone, seen as reduced density on rads?
lysis
-
What is a luxation/dislocation?
complete separation of joint from articular surface
-
What are articular fractures difficult to treat?
articular surfaces must be ressected and perfectly realigned in order to prevent DJD
-
What is a possible sequela to salter type 5 fracture?
angular limb deformity aka deviation of bones from axis of the limb past joint
-
What is valgus and varus?
- valgus= lateral deviation of bones past joint
- varus= medial deviation of bones past joint
-
What results from twisting/over-stretching a joint, causing ligament to tear/separate from its bony attachment?
sprain
-
What muscles must be transected to remove entire forelimb including the scapula?
all extrinsic muscle of forelimb
-
what is atrophy of supraspinatus and infraspinatus m which causes prominent scapular spine called and what causes it?
Sweeney; due to suprascapular n damage
-
What results from radial nerve paralysis of the extensors of the thoracic limb?
limb can't be extended--> knuckling in dogs
-
What is the most important layer that must be opposed when closing a paramedian midline incision?
external rectus sheath!
-
What is the most important structure to close in midline incision?
linea alba
-
How would u locate the trachea for a 911 tracheostomy?
skin incision in ventral neck and separate strap m
-
What muscle and nerve must be functional to bear weight on pelvic limb?
quadriceps m innervated by femoral n
-
What muscles are paralyzed w/ obturator nerve damage resulting in lateral slipping on a slick surface?
adductor m
-
What does an animal knuckle over on the pelvic limb with fibular nerve damage?
fibular nerve innervates lateral malleolus, which paralyzes extensors of digits
-
What do the 3rd, 4th and 6th cranial n innervate?
extrinsic muscles of the eye
-
What muscles are innervated by cranial n 9 & 10?
pharynx
-
Why can a broken neck result in respiratory paralysis?
The phrenic nerve to the diaphragm stems from the cervical and brachial plexuses
-
What is the panniculus (cutaneous trunci) response?
contraction of cutaneous trunci muscle in response to pin prick of trunk
-
What is the relex arc for the panniculus response?
Sensation from the skin of trunk over thoracic and lumbar spinal n, out to cutaneous trunci
-
Clinically what is the panniculus response used to evaluate?
tests the level of thoracic spinal cord damage
-
Where is the spinal cord damage if the panniculus response is absent caudal to the level of the 12th thoracic vertebrae?
Level of T10
-
For standing large animal flank surgeries, what must be blocked?
Both of the dorsal and ventral branches of abd nerves as dorsal branches are sensory to the top of the flank
-
What nerve must be considered when removing the anal glands?
caudal rectal n because damage can lead to paralysis of external anal sphincter, thus fecal continence and potential early demise
-
Define clonus/clonic muscular spasms?
these are rapidly alternating involuntary muscular contraction/relaxation (UMN sign)
-
How does a tetanic animal present?
"pump handle" tail, "saw horse" stance, "lockjaw" and "sardonic grin"
-
How does coonhound paralysis present?
ascending flaccid paralysis, starting at pelvic limbs, then to frontlimbs
-
Describe the pathophys of tick paralysis
tick paralysis blocks neuromuscular junctions, leading to flaccid paralysis that ascends the spinal cord.
-
How does tick paralysis present?
flaccid paralysis that ascends spinal cord
-
What is the common serious injury of all the nerves of the forelimb?
Complete tearing (avulsion) of the brachial plexus associated with hit by car.
-
What are the signs of complete avulsion of the brachial plexus?
Complete paralysis , extended flaccid limb and unable to support weight/dragging dorsum of paw
-
What is Sweeney?
Damage of suprascapular n, resulting in paralysis of suprspinatus/infraspinatus, resulting in lateral instability of the shoulder joint. With time, muscle atrophy corrects the instability but results in prominent scapular spine....mostly in horses
-
What are the 2 types of radial nerve injury?
high and low radial n damage
-
What is the most common and clinically significant nerve problem of forelimb?
radial paralysis
-
What are sign of high and low radial n damage?
high - inability to bear weight on limb, dropped elbow and knuckling over digits
low- knuckling over digits
-
What sensory loss is diagnostic for radial nerve injury?
los of sensation on dorsal manus
-
What results from femoral nerve injury and why?
can't bear weight and can't extend stifle due to analgesia of medial limb
-
Injury to what nerve causes lateral slipping on slick surface?
obdurator n
-
What are the signs of fibular n damage?
knuckling over due to analagesis of the pes
-
How does an animal compensate for femoral/peroneal n damage?
by flipping paw as advanced
-
What is fibular n paralysis similar to in the thoracic limb?
lower radial n paralysis
-
What is the an iatrogenic cause of ischiatic n damage and what does it result in?
Injection in the rear limb, resulting in paresis/paralysis of that limb
-
What is the definition of proprioception?
proprioception= sensing movements and position of body parts (think proper reception)
-
What tests are used to evaluate proprioception? Give example
Postural rxns ie: placing animal's weight on dorsal paw, which should result in immediate adjustment to normal position
-
What does loss of proprioception tell you clinically?
Indicates neurological problem anywhere along the proprioceptive pathway aka peripheral n, spinal cord, brain stem, cerebrum, cerebellum but lesion isn't localized
-
Define paralysis and paresis?
- paralysis is the complete loss of motor activity
- paresis is weakness due to partial loss of voluntary motor activity
-
What are the suffixes -paresis and -plegia used to describe?
-paresis and paralysis respectively
-
Differentiate b/w flaccid and spastic paresis/paralysis
- flaccid= decreased/no muscle tone
- spastic= hypertonicity
-
Define ataxia and what can cause it?
Ataxia is the lack of coordinated movement w/ or w/o spasticity/paresis. It can be caused by lesions to entire nervous system
-
Define intention tremor and what it indicates
A tremor is a small, rapid, alternating movement at rest that becomes worse with initation of movement and disappears at rest...indicates cerebellar disease
-
Define nystagmus and at rest, what does it indicate?
nystagamus is involuntary eye movements in either rotary/vertical/horizontal direction. Eyes will move to the side of the lesion and snap back. At rest it indicates vestibular dysfunction.
-
Define dysmetria and what does it indicate?
Dysmetria is improper measurement of distance in muscular activity, either too short or too long. It indicated cerebellar disease
-
How do you screen for neuro problems?
- Oberserve:
- 1. mental attitude/consciousness, behavior and/or seizures
- 2. stance/head position
- 3. gait/strength
- 4. proprioceptive positioning
-
Why is mental attitude/consciousness, behavior, seizures observed in neuro screening?
This screens cerebrum and brain stem probs
-
What does observation of stance and head position check?
Cerebellar problems
-
What abnormal stance/head position indicates neuro problems in the cerebellum/vesibular system?
Head tilt, wide based stance; head tremor
-
What does gait and strength observation evaluate?
entire nervous system
-
Do gait abnormalities localize neuro lesion?
No, just that there's a neuro problem that can be anywhere from cerebrum, cerebellum, brainstem, spinal cord, peripheral nerves or vestibular system
-
How is strength tested on a neuro exam?
push down on standing animal
-
What does weakness indicated during neuro screening?
nervous problem somewhere other than cerebellum or peripheral vestibular system
-
What is the only part of the nervous system that won't result in weakness if injured?
cerebellum
-
hat is the most common postural reaction used to screen for neuro problems?
knuckling aka proprioceptive positioning
-
For what does proprioceptive positioning test?
conscious perception of the location of limbs
-
What does loss of proprioception tell u clinically?
doesn't localize the lesion but it's indicative of a neuro problem along proprioceptive pathway
-
What is a CSF tap and where is it done?
CSF tap retrieves cerebrospinal fluid from subarachnoid space. It's done in the cisterna magna or lumbar cistern, extensions of the subarachnoid space
-
What is epidural anesthesia and where is it commonly given?
This is anesthesia in the spinal n area, through lumbosacral opening in to epidural space
-
To where do LMN signs localize the lesion?
Peripheral nerves or spinal cord segment of brain stem that LMN arises from
-
List 4 LMN desease signs
- flaccid paralysis
- rapid atrophy
- decreased muscle tone
- decreased/absence of reflexes
-
List 4 UMN disease signs
- spastic paralysis/paresis
- normal/increased muscle tone
- slow atrophy
- normal/increased reflexes
-
List how the reflexes are checked in the limbs? how is it done?
withdrawal reflex; pinch toe for superficial/deep pain to check reflex
-
How is tone evaluated?
palpate muscles of the limbs
-
Localize the lesions:
flaccid paralysis, absent reflexes, and tone and rapid atrophy to the pelvic limbs with normal thoracic limb
This is LMN: lesion in area 4 (L4-S1)
-
Localize lesion: spastic paresis, increased reflexes and tone to the left pelvic limb and flaccid paralysis, decreased reflexes and tone to left thoracic limb
Lesion in area 1 (C1-C6)
-
Localize lesion: spastic paresis, increased reflexes and increased tone to all limbs
Lesion cranial to C6
-
Localize lesion: spastic paresis, increased reflexes and tone to pelvic limbs and normal thoracic limbs
T3-L3 (area 3) UMN to Pelvic limbs; normal +/- shiff-sherrington)
-
List presenting signs to transection of the spinal cord:
C1-5 spinal cord
spastic paresis, increased muscle tone/reflexes to all 4 limbs. No LMN
-
What signs would present if cervical enlargement, C6-T2?
LMN to thoracic limbs, UMN to pelvic limbs
-
What signs would present with transection to spinal cord at T3-L3?
UMN to pelvic limb +/- Shiff-sherrington
-
What signs would present with transection of spinal cord at L4-S1
no effect on thoracic limbs, LMN to pelvic limbs
-
What causes a coma?
damage brainstem...disconnection of RAS from cerebral cortex
-
List 3 primary deficits that may be seen with lesions to the cerebrum?
seizures, behavior/mentation abnormalities, depression, abnormal posture w/ normal gait, blind with normal pupillary reflexes, compulsive pacing, head pressing, proprioception deficits.
-
Unilateral cerebral lesions will cause _____ signs
contralateral
-
How is brain stem disease characterized?
abnormal gait + abnormal posture and cranial nerve deficits, decreased mental states, proprioception deficits/weakness
-
What is the range of decreased levels of consciousness due to brainstem lesions?
depression - coma
-
When should brain stem disease be suspected?
If cranial n abnromalities + UMN paresis or decreased consciousness
-
What do vestibular system lesions affect?
ability to control posture in relationship to gravity and eye movements in relation to head movements
-
How does cerebellar lesion present?
Uncoordinated w/o paresis; proprioceptive deficits, vestibular signs
-
What are signs of vestibular disease?
nystagmus, head tilt, asymmetric ataxia w/o possibly circling
-
What is the primary diagnostic concern w/ vestibular disease?
differentiating peripheral (no pareses or depression)from central vestibular disease (paresis and depression)
-
What is the 1st deficit to show w/ neuro deficit?
proprioceptive positioning
-
What does BAR stand for?
Bright, alert and responsive
-
What does multiple dysfunction of cranial nerves indicate?
Brain stem lesion
-
What would cause a dropped jaw?
damage to the trigeminal nerve (CrN5)
-
How is the auriculopalpebral nerve manipulated clinically? In what species?
Blocked to paralyze eyelids for eye procedures in large animals
-
How is the facial n commonly injured in the horse?
lying on a harness buckle during surgery (buccal on buckle)
-
What cranial nerves are associated w/ the following complaints?
Blindness
aniscoria (unequal size pupils)
strabismus (uncontrolled deviation of the eye)
dropped jaw/head atrophy
increased/decreased facial sensation
- -optic n (CrN2)
- - sympathetic/parasympathetic (3)
- - oculomotor, trochlear, abducent
- - trigeminal
- - trigeminal
-
What cranial nerves are associated w/ the following complaints?
- facial paralysis
- deafness and/or loss of balance
- dysphagia (difficult swallowing)
- megaesophagus
- laryngeal paralysis
- paralysis of tongue
- -facial n.
- - vestibulocochlear n
- - vagus n and glossopharyngeal n
- - vagus n
- - vagus n, recurrent laryngeal n
- - hypoglossal
-
How is the facial/trigeminal reflex arc checked?
prick face, pulling away indicates intact trigeminal n, twitch of face muscles indicates intact facial n
-
What cranial nerve problem can be seen with middle ear infections?
facial nerve paralysis, leading to dry eye
-
What procedure can be used to facilitate exam of the eye and how?
blocking auriculopalpebral n to eliminate blinking eye
-
What are signs of damage to the recurrent laryngeal nerve?
hoarseness, high pitched whistling on inspiration and exercise intolerance, hemiplegia (failure of glottic cleft to open)
-
Discuss clinical significance of the accessory n?
little/none
-
Describe pupillary ligh reflex and what structures it involves?
shining a light in the eye, noting if pupil constricts in the eye and then in the other eye. this checks both cranial n II and III
-
What is dysfunction of sympathetic fibers to the eye?
Horner's syndrome
-
List cardinal signs of Horners
Miosis (small pupil), enophthalmos (small eyes), ptosis (drooping of eyelid), protrusion of 3rd eyelid (nictitating membrane)
-
What results in swelling or draining pus below the carnivore's eye?
abcess of carnassial tooth (upper P4)
-
How is aging of a dog via teeth used practically in dogs?
- baby teeth should be in by 6 weeks aka vax
- adult teeth in by 6 months aka spay/neuter
-
Which dog teeth have 3 roots?
last 3 cheek teeth on top
-
Which cat permanent teeth have 3 roots?
Upper PM4 aka carnassial
-
A laryngnotomy to open the larynx goes through what paired muscles to expose the larynx?
sternohyoid m aka middle strap m
-
The esophagus is accessible to sx in the ____ half of the neck region on the _____ side
caudal, left side
-
What surgical landmark indicates the ventral midline of the larynx?
cricothyroideus m aka bow tie m
-
How is a tranquilized dog intubated?
gently pull tongue rostrally, push soft palate up with endotrach tube and hold epiglottis down with tube, direct tube between vocal folds in to trachea
-
What is the most important layer that must be opposed when closing a paramedian midline incision?
external rectus sheath
-
What is the incision opening the abdomen called?
laparotomy aka celiotomy incision
-
What structures can be visualized through a xiphoid to pubic laparotomy incision w/o manipulation, and their locations?
- cranial: falciform ligament
- middle: greater omentum +/- tail of spleen
- caudal: bladder
-
What abd structures can be used to orient abd organ locations in your mind during sx?
descending duodenum on right side
-
How are the abd gutters visualized?
pull duodenum and mesoduodenum or colon and mesocolon medially, packing off the rest of the viscera
-
How would you locate a bleeding ovarian stump during a spay?
pull d. duodenum or d. colon and their mesentary medially and look in to abd gutter, caudal to kidney
-
What must be ligated when doing OHE?
Ovarian and uterine arteries
-
How is ovary moved in to the abd incision during OHE?
strum the suspensory ligament until it breaks
-
How does conformation of bitches genital tract affect how an artificially inseminating/speculum exam of bitch is performed?
You must be cognizant of vertical ventral slope of caudal repro. tract...place speculum/tube dorsal/caudal wall of vestibule, bypassing the clitoral fossa and ex. urethral orifice, then over the pelvic symphysis and parallel to symphysis to the opening of cervix (not in to vaginal fornix)
-
What may be mistaken for the cervical opening during art. insemination?
fornix of vagina
-
When do the testicles usually descend in carnivores?
shortly after birth, otherwise cryptorchidism
-
Define open and closed castration
- closed castration= spermatic cord is ligated before parietal vaginal tunic is cut
- open castration= parietal vaginal tunic is cut before spermatic cord is ligated
-
What type of castration would you perform if the environment wasn't sterile and why?
open because then if infection occurs, you can drain it vs keeping it in abd
-
Define:
phimosis
paraphimosis
- phimosis= can't protrude penis
- paraphimosis= protruded penis won't retract
both have stenotic prepuce
remember: long word for long penis and short word for short penis
-
where do calculi/concretion usually lodge to obstruct the urethra in the dog?
proximal to os penis
-
What is FUS (feline urolithiasis, 'plugged tomcat') syndrome?
calculi blocking urethra, common in tomcat. Must be unblocked as 911 or death may occur
-
What would be seen in r-sided heart problems aka pulmonic circ?
blood backs up in the body (caudal vena cava), filling abd with fluid and into jug --> jugular pulse/distention
-
What is the cranial part of the heart silhouette in lateral rad?
right ventricle, passes from right of left around cranial side of heart)
-
Where is the intercostal space incised to open thorax?
centrally to avoid vessels caudal to ribs
-
What vessels are of concern in midsternal tharacotomies?
internal thoracic artery and vein
-
How is the intestine cut when doing a resection and anastomoses?
angle cuts twd lesion (antimesenteric > mesenteric side of removed piece)
-
What is the surgical opening of the stomach and where should it be performed?
gastrotomy , b/w 2 curvatures b/c minimal vessels here
-
What vessel in the roof of the mouth can be opened when extracting teeth?
major palatine artery
-
Why can't a tourniquet be effectively used in the middle of the antebrachium?
caudal interosseous is protected from occlusion by deep position b/w bones
-
What vessels are ligated during OHE?
Uterine artery and vein, ovarian artery/vein
-
What vessel is used as landmark to find adrenal gland?
phrenicoabdominal vein
-
What vein is commonly used to bleed cattle?
median caudal vein, jugular v
-
Why is knowing the drainage area of lymph nodes and the destination of their efferent vessels important to clinical diagnoses?
b/c they enlarge in response to infection/ cancer
-
To where do neoplastic cells metastacize in lymph channels?
through heart to lungs
-
To where do hematogenous metastases from abd GI organs go?
portal vein to liver
-
To where do neoplastic cells metastasize via lymphatics or all veins except those forming portal v?
through heart to lungs
-
Where is the heart located in relation to the intercostal spaces?
B/w 2/3 - 5/6
-
What is the memory aid for the heart valve's point of max intensity?
PAM 345, rt. AV: low 5th rt
-
What is an ectopic cilia?
misplaced eyelash that may contract and scratch cornea
-
What is CRT?
capillary refill time aka time it takes mucosa that have been blanched via finger pressure to return to pink
-
What is clinical significance of umbilicus?
surgical landmark for umbilical hernias
-
What is the clinical importance of prepucial discharge?
normal
-
What is onychectomy and how is regrowth prevented?
removal of dorsal ungual crest must be cut
-
list common venipuncture sites in order they're used most often
- cephalic
- external jug
- saphenus (lateral in dog, medial in cat)
- lingual
-
How do u raise cephalic vein on restrained dog?
crus of thumb behind the elbow and index finger over cranial elbow...pull laterally straighten out vein
-
Where is venipuncture usually performed on cephalic vein?
forearm above carpus so that if you miss, you can move up
-
Describe the clavicle in the dog and cat
- Cat: separate, nonarticular bone
- Dog: rudimentary or absent, embedded in the brachiocephalicus
-
What does the spine of the scapula divide?
Lateral scapula in to infraspinatus and supraspinatus fossae
-
What is the acromion?
End of the spine of the scapula
-
What is the caudal projection of the acromion found in the cat?
suprahamate process
-
What is the glenoid fossa/cavity and what's it's function?
Shallow cavity of the scapula articulating with the humeral to form the shoulder joint
-
What is the supraglenoid tubercle and what's it's function?
cranial process near the glenoid cavity for the attachment of the biceps brachii m
-
What and where is the great tubercle?
projection located craniolateral to the head of the humerous- point of the shoulder
-
What is the intertubular aka bicapital groove?
the sulcus b/w the greater and lesser humeral tubercles for the biceps brachii tendon
-
What is the condyle of the humerus? How many are they per humeri?
Entire distal end of the humerus; there's is 1 per bone
-
What arises from the epicondyles of the humerus?
- lateral [extensor] epicondyle: extensors of forearm
- medial [flexor] epicondyle: flexors
-
What foramen is found in canine and feline humeri and what passes through them?
- Dog: supratrochlear foramen- nothing
- Cat: suprachondylar canal; median n brachial vessals
-
What is the function of the olecranon? what is a common name for it?
serves as a lever arm for the extensor muscle of the elbow; also known as the point of the elbow
-
What and where is the styloid process of the radius?
distal pointed end of the radius; it's medial.
-
Name the depression of the ulna that articulates with the humerus and it's proximal and distal ends?
- trochlear notch (semilunar notch)
- - proximal end= anconeal process
- - distal end= medial and lateral coronoid processes
-
What and where is the styloid process of the ulna?
It is at the distal end of the ulna on the lateral side.
-
List the parts of the manus from proximal to distal (and the bones of each part)
- Carpus (w/carpal bones)
- Metacarpus (metacarpal bones)
- digits (proximal, middle and distal phalanges and associated sesamoid bones)
-
What does the term carpus designate?
Carpal bones and compound joint formed by these bones or the region b/w the forearm and metacarpus
-
Name the bones of the carpus and indicate where they are in each row?
Proximal row for medial to lateral: radial and ulnar and accessory bones
Distal row: numbered from 1-4 medial to lateral
-
Which carpal bone is located laterally and palmarily and is considered a landmark?
accessory carpal bone
-
List the bones of the digits and their locations
proximal, middle and distal phalanges, 2 proximal sesamoid bones (1 for dew claw) on palmar side of metacarpophalangeal joints, 1 dorsal sesamoid bone for digit 1-4
-
What is the fingernail like structure covering the ungual process?
horny claw
-
what is the shelf of the distal phalanx covering the root of the claw?
ungual crest
-
What is the digit (P1, P3, 1 proximal sesamoid) + MtC that does reach the ground?
dew claw
-
What is the configuration of the shoulder joint (scapulohumeral, humeral)?
ball and socket joint
-
What type of motion is allowed by the shoulder joint?
all movements (universal) but mainly extension and flexion
-
What protects the biceps tendon in the intertubercular groove?
extension of the shoulder joint capsule acting as a tendon sheath
-
What stabilizes the shoulder joint?
there are no true collateral ligaments but the infraspinatus tendon stabilizes it laterally while the subscapularis tendon helps stabilize it medially
-
What bones make up the elbow (cubital) joint?
Humeral condyle, trochlear notch of the ulna and head of the radius
-
What type of joint is the elbow/cubital joint and what action is it allowed?
hinge joint, also compound for flexion and extension
-
What powerful ligament bind sides of all limbs except the shoulder?
How does this affect their movement?
collateral ligaments (lateral and medial); limits mainly to flexion and extension
-
What type of joint is the carpus and what movement does it allow?
compound/composite hinge joint, flexion and extension as well as gliding and rotation
-
List the joints of the carps and the movement that each allows
- Antebrachial joint: flexion and extension
- middle carpal: extension and flexion yet relatively less
- carpometacarpal: very little movement, mainly gliding
- intercarpal joints: gliding
-
List the boundaries of the carpal ulna
- Carpal bones, covered by palmar carpal fibrocartilage
- accessory carpal bone
- flexor retinaculum (transverse carpal ligament)
-
List the joints of the digits (the bones they're b/w)
- metacarpophalangeal joints (MIP) b/w metacarpal bone and proximal phalanx, proximal interdigital joint b/w P1 and P2
- distal interdigital joint (DIP) b/w P2 and P3
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What bones are located on the palmar side of the metacarpophalangeal joints?
2 palmar sesamoids, 1 for dewclaw
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What ligament extends from proximal P2 to dorsal P3?
dorsal elastic ligament, which is unique to carnivores
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What flexor muscles effect the interphalangeal joints?
- Proximal IP: DDF and SDF
- Distal IP: DDF only
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What is the function of the elastic dorsal ligament of the cat's digits?
oppose DDF, keeping claw retracted ("sheathing the claw")
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What is the loose irregular connective tissue deep to the skin?
Superficial fascia, SQ tissue, subcutis (hypodermis, sq layer, sc tissue)
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What is the fascia deep to the superficial fascia surrounding and compartmentalizing the muscles?
Deep fascia
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List 2 synonyms for superficial fascia
Subcutaneous connective tissue, hypodermus, subcutis, tea subcutanea
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What local thickening of the deep fascia hold tendons in place?
retinaculum
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What are the extensions of the deep fascia compartmentalizing the muscles?
septa
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List 2 cutaneous muscles
cutaneous truncii, platysma, prputial/supramammary m
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In which layer are the cutaneous m located?
superficial fascia
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What muscles connect the thoracic limb to the head, neck and trunk?
extrinsic muscles of the limb
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Name 5 of the 8 extrinsic muscles of the thoracic limb?
trapezius, omotransversarius, brachiocephalicus, superficial and deep pectoral, latissimus dorsi, serratus ventralis and rhomboideus
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Which extrinsic m supports the weight of the trunk?
serratus ventralis; it forms a sling for the trunk
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What muscles originate and insert on the bones of the thoracic limb?
intrinsic muscles of the limb
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What muscles replace collateral ligaments for the shoulder joint?
subscapular, infraspinatus, supraspinatus, biceps brachii m mainly
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What nerve innervates the supraspinatus and infraspinatus m?
suprascapular nerve
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What is the common insertion of 4 heads of the triceps brachii m?
olecranon
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Where do the biceps brachii muscle originate?
supraglenoid tuberosity
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What nerve innervates the triceps and other extensors of the elbow, carpus and digits?
radial nerve
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How are the forearm muscles grouped?
- craniolateral antebrachial muscles= extensors of digits and carpus
- caudal antebrachial muscles= flexors of digits and carpus
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Where do most of the extensors of the digits and carpus arise?
on or near lateral (extensor) epicondyle
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What muscles arise from the medial epicondyle of the humerus?
caudal antebrachial muscles (flexor)
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What innervates the extensors of the digits and carpus?
radial nerve
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What innervates the caudal antebrachial muscles (flexors)?
Median and ulnar n
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Where does the superficial digital flexor (SDF) and DDF insert? What is the clinical significance of this?
- SDF= middle phalanges
- DDF= distal phalanges
- DDF affects the distal interphalangeal joint, SDF doesn't
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Where are most of the vessels and nerves of the arm? Why is this?
They are mostly on the medial side of the arm for protection
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List the main arteries to the forelimb and their locations
- Subclavian a- medial to 1st rib
- axillary a in axilla
- subscapular a (along caudal scapular)
- brachial a (in arm)
- common interosseous a (last branch of brachial)
- median (in forearm)
- digital a (in paw)
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What are the locations of the cephalic and accessory cephalic veins of the manus? Where do they joint and continue as cephalic vein?
cephalic palmar paw; accessory cephalic-dorsal paw. They meet above carpus to travel cranial to forearm
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Can the lymph nodes of the thoracic limb be palpated?
Axillary lymph nodes cannot be palpated but accessory lymph nodes can if present and so can cervical lymph nodes
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What nerves does SS-MAR-MU stand for and from what areas of the brachial plexus do they arise?
- SS: Cranial (supraspinatus and supracpularis)
- MAR: Middle (musculocutaneous, axillary, radial
- MU: Caudal (medial, ulnar)
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What nerves innervate the extensors and flexors of the paw?
extensors are innervated by radial n while flexors are innervated by medial and ulnar nerves
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Where does the radial n become superficial and thus in danger of damage?
Laterally, under the triceps brachii muscle
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What are the 2 cutaneous areas of the forepaw?
- Dorsal paw: radial n
- abaxial 5th lateral digit innervated by ulnar n
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What normal structures can be mistaken for lytic area of the cortex?
nutrient foramina
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What should be done if question arise from a radiograph of a limb?
Shoot a comparison film of the opposite limb
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The different views of a radiograph ____ different sides of the bone
silhouette
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What does the lateral view of a radiograph highlight?
lateral view shows cranial and caudal or dorsal and palmar/plantar bone surfaces
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What are radiographic landmarks for the lateral side of the limb?
spine of scapula, greater tubercle of humerus, distal ulna, accessory carpal bone
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What are radiographic landmarks for the medial side of the thoracic limb?
radial carpal bone, dew claw
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What are caudal/palmar landmarks of the forelimb?
head of the humerus, olecranon, accessory carpal bone
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What does the craniocaudal or dorsopalmar view of radiograph highlight?
medial and lateral structures of the limb
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Name 2 normal structures that can be mistaken for fractures in the forearm
- anconeal process of ulna, sesamoid
- bones of digits or lateral collateral ligament of elbow
- accessory ossicle of caudal scapula
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On what wide of the limb is the accessory carpal bone?
lateral and palmar side
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What bone may be mistake for a chip fracture of the carpus?
sesamoid bone of the oblique carpal extensor tendon
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What makes the space b/w bones seen in a radiograph?
joint space and articular cartilage
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Is cartilage seen radiographically?
no, not dense enough so it's inferred
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Since cartilage can't be seen radiographically, how is it evaluated?
check subchondral bone
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What is a pathological osseous outgrowth seen radiographically?
osteophyte aka bone spur
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Define subluxation
It is the partial loss of contact between articular surfaces of a joint
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Do you look for radiographic changes in the cartilage in OC?
No because you can't see cartilage so check the subchondral bone
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List 2 of the 4 common sites of OC
- #1 is shoulder
- medial humeral condyle
- medial and lateral femoral condyle
- proximal medial trochlea
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What is the #1 site for OC in a dog?
Describe OCD appearance compared to normal
caudal aspect of the head of the humerus aka shoulder
- Normal: smooth and round with no flattening
- OCD: flattening or cratering with subchondral bone sclerosis +/- joint mouse
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What can the cat's clavicle be mistaken for in a lateral radiograph?
bone in the esophagus
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What can premature closure of either proximal or distal radial physis cause?
subluxation of the humeral-radial joint
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Where can OC of the elbow be located?
Medial condyle of the humerus
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What is ununited anconeal process?
failure of the anconeal process to unite with the ulna after 5 months of age
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What is fragmented medial coronoid process?
Improper development and fragmentation of the cartilaginous precursor
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How are the medial and lateral epicondyles of the humerus differentiated in a lateral radiograph?
medial "squared" and extends further caudally than rounded lateral condyle
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What is the location of most fractures of the humerous?
shaft aka diaphysis
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What hinders retraction of the median nerve and brachial artery during sx in the cat?
They pass through the supracondylar foramen
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What can cause premature closure of a growth plate?
Injury to physis
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What happens if there is premature closure of the distal ulnar physis?
Cranial curvature of the radius and subluxation of the elbow
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What is the "quick" that bleeds if a horny claw is cut too short?
Artery in the dermis over the ungual process
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How is cutting the quick prevented when trimming pigmented and unpigmented claws?
- In unpigmented claws, don't cut visible pink cone
- In pigmented claw, shave off layers until white area is reached, just distal to the quick and use that 1st nail to judge the rest
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What 2 methods of declawing ensures removal of the ungual crest?
Remove all to P3, or all (including crest) but P3
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How is a declaw operation performed basically?
Guillotine nail clipper, blade in dorsal-distal interphallangeal joint and other distal to digital pad
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What is a sequestrum?
sequestrum is a piece of dead bone
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When is it best to remove dewclaws in dogs?
in neonate aka newborn
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Briefly describe how dewclaw is removed in neonate
Prep, cut dewclaw from metatarsal bones and use single absorbable suture
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What is an unhealed fracture having all the structures of a synovial joint?
false joint
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What is an articular separation called?
luxation, subluxation or dislocation
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With what does the shoulder joint communicate in the canine?
Intertuburcular bursa aka bicapital
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What helps to prevent luxation of the shoulder?
Thickenings of joint capsule (glenohumeral ligaments) and adjacent muscles
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Why is lateral luxation of the dog's elbow more likely?
The lateral epicondyle is smaller than the medial epicondyle
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What can fragmented medial coronoid process cause?
degeneration of the elbow joint
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What muscle is incised to open the elbow joint laterally?
anconeus m
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Where are the subcutaneous injections made?
Through the skin in to the superficial fascia
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How can pus move from one area to another?
Along the fascial planes
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How can a neck infection spread to the thorax?
Infection can migrate down fascial planes to the thorax
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How are fascial planes used in sx?
They're used as cleavage planes to reach deep structures relatively free of blood
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how do you determine unilateral atrophy of shoulder muscles?
compare the muscles on both sides of the body by palpation
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At what level is it easier to amputate the forelimb and why?
Scapular removal is faster and easier than shoulder disarticulation
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Why is leaving the scapula when amputating the forelimb cosmetically unacceptable in shorthaired breeds?
atrophy causes unsightly bony prominences
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What muscles must be transected to removed the entire forelimb inc. scapula
all extrinsic muscles of the forelimb
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How do dogs do on 3 limbs?
most adapt well, it gets harder as size of dog gets larger
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What is tenotomy?
Transection of tendon
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To puncture the jugular vein, first go through the ____ parallel to the vein and then angle/insert needle gently in to it
skin b/c it moves freely
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How is superficial cervical lymph node palpated in the dog?
Retract arm and palpate it deep to brachiocephalicus and cranial to supraspinatus , just dorsal to level of the acromion
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How is the accessory axillary lymph node palpated if present?
Lay hand flat on thorax caudal to arm and stroke caudally
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Does sensation to the caudolateral aspect of the arm rule out complete brachial plexus avulsion? Why?
No, because those muscles are innervated by intercostobrachialis nerve which does not arise from the brachial plexus
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Where are high and low radial n injuries located?
high is before the triceps while low is below them
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To what common condition is low radial nerve paralysis a sequela?
fracture of the humerus
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What are 2 ways to tell if a nerve is damaged?
Loss of skin sensation and motor innervation
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How is loss of motor neurons of the limbs determined?
Observe gait, depression of tone and reflexes; palpation of muscle atrophy
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How is loss of sensory neurons determined?
analgesia
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What is the most cranial aspect of the upper forelimb?
greater tubercle aka point of shoulder
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what is the projection on the palmar and lateral side of the carpus?
accessory carpal bone
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