Equine Orthopedic Examination

Steps of an equine orthopedic physical examination

1.) examine the foot

2.) forelimb palpation

3.) hindlimb palpation

4.) palpate the back

5.) observe posture/symmetry

what to look for when examining the foot

size, shape, confirmation, and symmetry

What three things should be done when examining the foot

1.) take a digital pulse

2.) clean the feet

3.) use hoof testers

After examining the foot, what comes next?

palpating the forelimb

What two positions of the forelimb should you palpate

1.) weight bearing

2.) lifting the forelimb

Three soft tissues structures palpated on the palmar surface of the distal forelimb:

1.) superficial digital flexor tendon

2.) deep digital flexor tendon

3.) suspensy ligament

When palpating the forelimb when it is weight bearing, what should you be feeling for during palpation?

any heat, effusion, swelling,

What structures should you palpate when the forelimb is lifted?

carpal (knee) and fetlock joints, checking for range of motion; soft tissue structures on the planar surface

What two positions of the hindlimb should you palpate

1.) weight bearing

2.) lifting the hindlimb

What structures should you palpate when the hindlimb is weight bearing?

-stifle, knee, and fetlock joints

-soft tissue structures on the plantar surface

What structures should you palpate when the hindlimb is lifted?

-range of motion for the joints

-soft tissue structures

What are you checking for when palpating the spine?

sensitivity; the horse will crouch and bend into the pressure you place if the area is sensitive

Base wide conformation

hooves positioned wider at the ground than the points where the legs attach to the chest

Base narrow conformation

horse's forefeet are closer together than their shoulders

toed in conformation

pigeon-toed; front limb condition where a horse's hooves point inward

toed out conformation

Fetlocks are directly under the hocks but the toes turn out under the fetlocks

Camped out conformation

Forelimbs too far forward from body to decrease weight bearing of the forelimb

Camped under conformation

Forelimbs too far under the body to decrease weight bearing of the hind limb/put more weight on the forelimb

Sickle-hock conformation

excessive angulation of the hock from the side

Straight behind conformation

less than normal angulations of the hock and stifle joints

What can cause asymmetrical posture?

muscle atrophy

Four findings from palpation

1.) effusion

2.) cellulitis

3.) fibrosis

4.) edema

effusion

fluid accumulation within a joint

edema

fluid accumulation in the interstitial spaces of tissues

cellulitis

diffuse swelling of the distal limb

fibrosis

the thickening and scarring of connective tissue, usually as a result of injury

Four gaits to observe the horse in motion

1.) walk

2.) trot in straight line

3.) lunge

4.) canter

walk

four beat gait; all four feet are in contact with the ground at all times

trot

two beat gait where opposite limbs are in contact with the ground at any given point

lunge

trotting the horse in a circle, both going clockwise and counterclockwise

canter

there beat gait; at any given point three feet are in contact with the ground

Six lameness grades:

1.) grade 0

2.) grade 1

3.) grade 2

4.) grade 3

5.) grade 4

6.) grade 5

grade 0 lameness

no lameness

grade 1 lameness

Difficult to observe, not consistently apparent regardless of circumstances

grade 2 lameness

difficult to observe at a walk or when trotting in a straight line but consistently apparent under certain circumstances

grade 3 lameness

Lameness is consistently observable at a trot under all circumstances, whether in a straight line or lunge

grade 4 lameness

Lameness is obvious at a walk with marked nodding, hitching, or shortened stride

grade 5 lameness

lameness is at minimal weight bearing at rest and inability to move

Seven components of equine lameness examination

1.) obtain a history

2.) assess conformation

3.) physical examination

4.) observe horse in movement

5.) selected examinations

6.) diagnostic analgesia

7.) imaging

What should you observe when the horse is in motion

head carriage, symmetry, and, weight placement of limbs

Difference between trotting in a straight line and on a lunge line

on the lunge line, the horse will put more weight on the inside limbs

What should you look for when observing for forelimb lameness

head nod

What does "down on sound" mean?

the horse will nod its head down when the unaffected limb touches the ground, and will nod its head up when the affected limb touches the ground

What should you look for when observing for hindlimb lameness

hip hike

hip hike

when the lame hind limb hits the ground, there is a hike in the limb, meaning the pelvis goes higher on the sound side and the pelvis goes lower on the lame side

The intrinsic healing capacity of tendons and ligaments is ________

low

Tendons connect _______ to ______

Ligaments connect _________ to ________

muscle to bone

bone to bone

Two types of tendons and ligaments functionally

1.) positional

2.) energy storing

Positional tendons and ligaments

low strain and elasticity; keep things in place

Energy storing tendons and ligaments

high strain and elasticity; load bearing

Main type of collagen found in tendons and ligaments

type I

What do tendons look like in a longitudinal histologically?

crimp pattern

What do tendons look like in a cross section histologically?

packaged collagen fibers are present into fascicles

Six parts of the interfascicular matrix

1.) paratenon

2.) epitenon

3.) endotenon

4.) fascile

5.) collagen fiber

6.) collagen fibril

Paratenon

outer connective tissue around the whole tendon

Epitenon

inner connective tissue around the whole tendon

Endotenon

connective tissue surrounding collagen fascicles

Collagen fascicles are made up of...

individual collagen fibers

collagen fibers are made up of...

Collagen fibrils

The endotenon is aka...

interfasicular matrix

What is the interfascicular matrix made of?

1.) elastin

2.) lubricin

3.) lower levels of collagen

What is the fascicular matrix made of?

1.) mainly collagen type I fibers

2.) small amounts of collagen type III

Two things that allow for tendon elongation

1.) interfascicle sliding

2.) collagen fiber crimp

Interfascicle sliding

fascicles of within a tendon or ligament slide amongst themselves to allow for elongation

What allows fascicles to slide against each other?

the interfascicular matrix

Tendon cells (tenocytes)

sole cell responsible for extracellular matrix turnover in homeostasis and healing

Tenocytes synthesize _________

collagen

stage of tendon/ligament healing that has the longest duration, and can extend beyond 8-10 months from the onset of injury

remodeling/inflammation