Which of the following is TRUE?
when the horse is walking past you, you are watching for a head bob
when the horse is walking toward you, you are watching the hips and pelvis
when the horse is walking away, you are watching for fetlock drop
it is important that the horse is always walking in a straight line
Which of the following tend to have acute onset? Check all that apply.
tendon injuries
ligament injuries
fractures
degenerative problems
Effusion is fluid in a synovial structure. Edema is fluid in tissue.
Which of the following is FALSE?
worn heels predispose for navicular disease
having a steep angle to the foot means the horse is club footed and may develop suspensory problems
if the coronary band is higher on one side of the heel it indicates weight bearing toward that side of the foot
having a less steep angle to the front feet indicates that the horse is bearing too much weight in the front limbs
Having a post legged stance predisposes a horse to flexor tendon issues.
A dropped hip could be due to muscle atrophy or a fractured hip.
horses will only flex their neck away from you if they are having cervical vertebral issues
high lameness is uncommon
a hot splint bone area means there is active inflammation, the horse will respond to palpation of the swelling
a foot may feel hot if it is covered by the bedding/hay/etc. in the stall
By placing the leg in this position, the tendons are relaxed. This make it easier to tell the difference between the superficial and deep digital flexors. However, it makes it a little more difficult to palpate the suspensory.
What is a positive Churchill test?
aduction of limb, means proximal hock pain
abduction of limb, means proximal hock pain
aduction of limb, means distal hock pain
abduction of limb, means distal hock pain
Which of the following is CORRECT?
Grade 1 lameness: lameness not perceptible under any circumstance
Grade 2 lameness: lameness is consistently observable
Grade 3 lameness: lameness is obvious at a walk
Grade 5 lameness: lameness produces minimal weight bearing in motion and/or at rest or a complete inability to move
Which of the following are watched for ONLY with hind limb lameness? Check all that apply. (Please don't curse me too much)
pelvic hike- up on lame
arc of flight of foot
altered flight path of foot
length of stride
angles of joint flexion
drifting away from lame limb
It is best to focus on specific landmarks while observing a horse walk past you.
When a horse is lame the fetlock drop will be deeper.
During a carpal flexion test hold for 30 seconds, a normal horse's fetlock will contact the caudal surface of the radius (or the heel bulb will touch the elbow). If this is not the case, there is decreased range of motion.
upper forelimb flexion: this test is better for elbow issues than shoulder issues
digital flexion in hindlimb: must try to keep foot close to the ground to limit amount of hock and stifle flexion
upper hind limb flexion: hold for 90 seconds, keep leg underneath the horse to help the horse maintain balance
hock extension test: tries to exacerbate pressure on hock, usually the horse will not tolerate for more than 1 minute so you can substitute multiple short times of extension in place of a single long time period
Which of the following is TRUE about the navicular wedge test?
stretches the back of the leg
increases pressure on navicular
use for 60 seconds
can also use it at the medial and lateral sides to check the collateral ligaments
All of the above are true
What is the correct order of sensations lost?
cold, warmth, touch, pressure, pain
pressure, touch, pain, cold, warmth
pain, cold, warmth, touch, pressure
touch, pressure, cold, warmth, pain
Which of the following structures is NOT blocked by the palmar digital nerve block?
sole
hoof wall
navicular bone
insertion of the deep digital flexor tendon
Which of the following is a common lameness that can be isolated by the palmar digital nerve block? (Remember that further diagnosis is required for a definitive diagnosis)
P3 wing fractures
low ring bone
laminitis
luxation of pastern joint
The structures blocked by the abaxial sesamoid block are dorsal hoof wall, coronary band, coffin joint, pastern joint, sesamoidian ligaments.
Which of the following blocks requires sterile preparation of the skin because of the high likelihood of the needle to enter a joint space?
low 4-point
high 4-point
wheat
tibial and peroneal
It is ok to do the tibial and peroneal blocks to both hindlimbs.
Which of the following are correct? Check all that apply.
valgus- lateral deviation of limb distal to site of pathology
valgus- medial deviation of limb distal to site of pathology
Varus- medial deviation of limb distal to site of patholgy
varus- lateral deviation of limb distal to site of pathology
Which of the following is FALSE regarding etiology of angular limb deformity?
incomplete ossification of cuboidal bones
laxity of periarticular structures (usually in one joint)
unbalanced nutrition (trace mineral balance, crib feeding)
excessive exercise/trauma (microfractures)
To determine if a horse has a valgus or varus deformity you should stand perpendicular to the horse's midline.
If manipulation leads to straightening of the limb, the deformity is due to perinatal causes.
Which of the following is FALSE about management strategy of limb deformities?
stall rest is a good conservative therapy option for periarticular laxity
transphyseal bridging is used for growth acceleration
splints/casts are used for incomplete ossification
hoof trimming is a conservative therapy that may help
Which of the following is TRUE regarding hoof trimming as management of angular limb deformity?
trim the medial side for a valgus deformity
trim the lateral side for a varus deformity
trim flat if both valgus and varus deformities are in the same limb
Which of the following are true of periosteal transection and elevation? Check all that apply.
short side surgery
long side surgery
can't over correct
can overcorrect
requires second procedure
doesn't require second procedure
used in more aggressive cases
osteoarthritis- chronic disease of the joint which may or may not involve inflammation
osteoarthopathy- disorder of movable joints characterized by degeneration and loss of articular cartilage
osteoarthrosis- any disease of the joints and bones
degenerative joint disease- any disease state inducing degeneration of a joint
Which of the following is FALSE about mechanisms of OA?
Theory #1- defective cartilage with abnormal biomechanical properties, assumes normal mechanical forces are encountered by the joint
Theory #2- abnormal change in subchondral bone (cartilage doing all the work b/c the bone cartilage interface is more stiff)
Theory #3- normal cartilage exposed to abnormal forces (seen in joint incongruity secondary to trauma, altered chondrocyte metabolism)
The synovial membrane regulates inflammatory cell access. It also secretes anabolic and catabolic enzymes (prostaglandins, cytokines, MMPs).
Which of the following is FALSE about "primary" synovitis/capsulitis?
can be secondary to chip fragment debris/mediators or OCD
repair is by fibrosis and results in acute decreased range of motion that resolves after a few months
involves biomechanical damage due to continuum of repetitive trauma or a single incident
mediators released from the affected joint's cartilage or bone will alter the metabolism of the synoviocytes
Which of the following is NOT seen histologically with synovitis?
edema
hyperplasia of intimal cell lining
hypervascular
MMPs
Chondrocytes release the same mediators as the synovium.
Which of the following is FALSE about matrix metalloproteinases?
secreated by synoviocytes and chondrocytes
capable of breaking down extracellular matrix and fluid components
they are all "bad guys"
MMPs are secreted as inactive protein
ADAM stands for A Disintegrin And Metalloproteinase.
Which of the following cytokines are modulatory? Check all that apply.
IL-1
TNF-alpha
IL-4
IL-10
IL-13
Which of the following is FALSE regarding the IL-1 family?
IL-1 alpha amplifies the inflammatory process by stimulating an increase in monocyte infiltration
Monocytes produce IL-1 beta
IL-1 beta up regulates the production of IRAP as a positive feedback to make more IL-1 alpha
matrix metalloproteinases are inhibited by IL-1s
Anabolic cytokines include insulin-like growth factor and transforming growth factor. These promote chondrocyte production of prostaglandins and type 2 collagen.
nitric oxide degrades hyaluronan and collagen, IL-1 promotes its production
PGE-2 is associated with synovitis and pain
IRAP is a naturally occurring inhibitor derived from the animal's own body
tissue inhibitors of metalloproteinases (TIMPs) bind 1:1 with MMPs forming inactive complexes, research is very promising
Which of the following is FALSE regarding therapy?
cold therapy is more useful in acute injury
phenylbutazone seems better in the treatment of orthopedic issues, banamine seems better for visceral pain
corticosteroids are effective for OA treatment with intra-articular administration as well as systemic administration
if give a horse carprofen make sure it is the horse formulation, not the dog formulation
Which of the following whole body doses of the common corticosteroids is INCORRECT?
TA (triamcinolone acetate) <18 mg
MPA (methylprednisolone acetate) <20 mg
betamethasone <30 mg
Post-injection flare and joint sepsis are easily distinguished from each other.
IA polysulfated glycosaminoglycans (adequan) makes it easier for an infection to develop by reducing the number of bacteria needed to induce an infection.
What is my favorite flavor of ice cream?
strawberry
chocolate
cookie dough
moose tracks
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