The Lameness Exam

What are the three parts of a lameness exam?

Observational exam

Global exam

Focused exam

what does the observational aspect of the lameness exam consist of?

posture observation

functional movement analysis

what does the global exam aspect of the lameness exam consist of?

body scan

spinal assessment and proprioception

what does the focused exam aspect of the lameness exam consist of?

passive range of motion

flexibility

joint play

special tests (orthopedic +/- neurologic)

where can you assess for effusion in the carpus?

cranial aspect of joint

where can you assess for effusion in the elbow?

medial and lateral aspects of the elbow joint between the humeral epicondyles and the olecranon

where can you assess for effusion in the tarsus?

caudal and cranial to the lateral malleolus

where can you assess for effusion in the stifle?

medial and lateral to the patellar ligament

should you check for stifle effusion while the joint is in flexion or extension?

extension

where can you palpate the sciatic nerve?

greater sciatic notch (b/w tail and ischium)

lesser sciatic notch (caudal to greater trochanter)

caudal thigh (b/w semimembranosis and biceps femoris)

in what order should you perform your focused orthopedic exam if they present for lameness?

distal to proximal

TF always start with the affected limb with your focuses lameness/orthopedic exam to save time

F

save painful one for last

What are you assessing in each joint during your focused orthopedic exam?

Crepitus

Range of motion

Effusion

End feel

Pain

Instability

(CREEPI)

specialized test for elbow pain and medial/lateral collateral ligament integrity

campbell's test

how do you perform the campbell's test?

flex the elbow and carpus supinating and pronating the forelimb

palpate the medial and lateral elbow throughout

the biceps brachii tendon is on the very ? aspect of the shoulder joint

medial

how do you evaluate the biceps tendon?

Palpate the tendon

Stretch the tendon via shoulder flexion and elbow extension

Palpate while stretching

specialized test to assess for medial shoulder instability

shoulder abduction test

how do you perform a shoulder abduction test?

Lock shoulder in extension while pushing down on the scapula

Abduct the forelimb

dropped tarsus with flexed digits indicates injury to what aspect of the common calcaneal tendon complex?

gastrocnemius m.

how do you stretch the achilles to assess for laxity/stability?

Extend the stifle

Flex the tarsus

landmarks for cranial drawer test?

patella

lateral fabella

tibial tuberosity

fibular head

landmarks for tibial thrust test?

patella

patellar ligament

tibial tuberosity

cranial cruciate tests include?

cranial drawer

tibial thrust

test used to assess the stifle for meniscal injury/click?

McMurray (modified tibial compression test)

how do you perform a McMurrary test?

Flex stifle

Internally and externally rotate the stifle while flexing

Feel for a distinct meniscal click

how do evaluate the patella for luxation?

Trace quadriceps to locate the patella

Extend and internally rotate the stifle while pushing the patella medially

Extend and externally rotate the stifle while pushing the patella laterally

Apply stifle ROM and assess for spontaneous luxation

how do you perform the ortolani test?

Adduct the hip

Apply dorsal pressure while abducting the hip and pushing through the stifle

Feel for clunk

specialized test to assess for hip instability where you elevate the femur and palpate for subluxation of the greater trochanter

Bardens test

muscles to assess during myofascial exam?

origin and insertion of iliopsoas m.

cervical

periscapular m.

hip flexors

epaxials

usually myofascial pain is primary or secondary?

secondary

which component of the lameness exam is considered the most objective and informative when attemptint to localize a mobility issue?

gait analysis

pain on hip extension can indicate what condition other than hip dysplasia?

lumbosacral spinal pain

always start with ? analysis when assessing lameness

gait

what are you looking for on myofascial exam?

taut bands

myofascial trigger points