Large Animal Sx- Lameness exam by Brown

untimely's version from 2015-09-13 01:50

Brown's Passive Lameness Exam

Question Answer
what is a passive exam?exam of horse at rest
which exam should be conducted first- active or passive exam?passive
best location for a passive lameness exam?Although the equine passive musculoskeletal exam is best done in a large, well-lit stall, it can be performed in any location that is free of distractions to the horse
first thing to do for the passive lameness examThe horse should first be observed from a distance of several feet to look at overall condition, conformation, and other conditions that may or may not be related to the lameness problem.
what is a problem that is better seen from far away from the horse instead of near?synovial effusion in the carpal joints
where should the palpation portion of the exam be started?should be started from the front end of the left side of the horse
which muscle in the neck might indicate lameness, and why?not specific, but if there is soreness in the sternocephalicus muscle, , usually head carriage is abnormal in the lame horse and therefore soreness in this muscle will yield additional information
why might you want to palpate the jugular groove? Palpation of the jugular groove may reveal injection sites that may be related to attempts to treat the lameness.
how do you check for foot balance?To check for foot balance, that is whether the foot is level in a medial to lateral plane, face the back end of the horse and grasp the limb in the metacarpal area and let the foot hang freely. Sight down the central sulcus of the frog as you would down a gun barrel. This will allow evaluation of medial to lateral balance.
where do you palpate the flexor tendons?pastern area
The course of the palmar digital nerves should also be followed....why? to check for neuromas from a possible previous neurectomy
which sesamoids, and which part of the sesamoids do you want to palpate and why?Palpate the base of the proximal sesamoids, then the apices. These sesamoids are the anchor for the suspensory (interosseus) ligament/apparatus and help prevent overextension of the fetlock
how do you palpate the dorsal cortex of the cannon bone? What should you not do? what are you looking for?exerting firm pressure with the finger tips. Be careful not to squeeze on the flexor tendons during this process. Look for pain or change in contour of the bone.
when you palpate the superficial digital flexor tendon, what are you looking for?Slide your hand from proximal to distal, allowing the tendon to flow between your finger tips. Look for pain responses and changes in size and shape. The amount of pressure exerted on the tendons with the fingertips is only mild to moderate during this palpation process
Palpate the deep digital flexor tendon in a similar fashion to the superficial digital flexor tendon. Palpate the inferior check ligament next by..(and where is it?)exerting lateral to medial thumb pressure in this area. The inferior check ligament occupies the space between the deep digital flexor tendon and the proximal suspensory ligament
where can you palpate the body of the suspensory ligament?palpate the body of the suspensory ligament as it emerges from between the splint bones. Follow it distally to the bifurcation and to its insertion on the sesamoid bones.
how do you test fetlock flexion (and how do you prevent other stuff from flexing?)done by cupping the toe in your hand and bracing it against your shin or knee. This fixes the position of the foot. The other hand is placed over the dorsum of the distal radius and is used to forcibly flex the fetlock. Look for a pain response or a limited range of motion.
how do you hold to palpate the carpus?To palpate the carpus, the pastern is placed between the thighs. The fingers of each hand are used to grip the limb adjacent to the carpus so that firm thumb pressure can be exerted on the dorsal borders of each carpal bone.
Know the carpal bones.... pic to learn (back view)
order in which you palpate carpal bones?(bottom row first) 2nd, 3rd, 4th. Then top row- ulnar, intermediate, radiocarpal
where do you put pressure on the radius, and why?Next put pressure on the caudomedial aspect of the radius at the level of the chestnut. This is the area of origin of the superior check ligament. Look for a pain response
where is the origin of the superior check ligament?caudomedial aspect of the radius (near chestnut)
If you apply firm digital pressure to the longissimus dorsi muscles, what is a normal response?Normally, you will see a slight bobbing response to this pressure. More extensive dropping of the back (several centimeters) would be considered abnormal.
where is gluteal soreness most commonly found?This is most commonly found in the area caudal to the tuber coxa
what's the Churchill hock test/ how to do?performed by setting the thumb of the inside hand transversely over the dorsum of the proximal cannon bone and distal tarsal bones. The middle and index fingers are positioned on the head of the medial splint bone and on the first and second tarsal bones. The back of the nail of your index finger usually rests against the chestnut. The test is performed by squeezing the tips of the middle and index fingers towards the thumb. A positive response is indicated by abduction of the limb, not flexion. Limb flexion is not a positive response
how is the patellar fixation test performed?performed by standing with your back against the horse and your feet perpendicular to the long axis of the horse's body. Place the palm of your caudal hand, with the fingers and thumb pointing medially, on the horse's patella. The horse must be positioned so that the stifle is in full extension and the horse will advance the limb being tested when the handler takes the horse ahead one step. Once the horse is properly positioned, brace your elbow against your hip and lean into the patella. Have the handler advance the horse one step. A catching or snapping of the patella indicates a positive test
how last step of the passive lameness exam?hoof testers on the feet

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