Horse examination:

ARTERIES to palpate:

Transverse Facial Artery

• Location: Caudal to the lateral canthus of the left eye.

• Technique:

  • Use three fingers to gently stroke the area until the vessel is found.

  • Count the pulse for 15 seconds and multiply by 4 to get beats per minute (BPM), or count for 10 seconds and multiply by 6.

• Importance: This artery is a good site for measuring pulse rate.

Facial Artery

• Location: Alongside the ventral aspect of the mandible.

• Technique:

  • Place fingers on the ventral aspect and stabilize between the index and ring fingers.

  • Again, count pulse for the same durations (15 sec = x 4, or 10 sec = x 6).

• Note: Another effective location for pulse rate measurement.

Lymph nodes in Horse:

1. Submandibular Lymph Nodes

• Location: Just caudal to the facial artery.

• Technique:

  • Use hands in the same direction as when palpating the facial artery.

  • Apply pressure dorsally while allowing the lymph nodes to slide laterally between the fingers.

  • Grab with fingers upwards

• Observation:

  • Make sure that both lymph nodes are symmetrical and check for any abnormalities.

2. Retropharyngeal Lymph Nodes

• Location: Under the dorsolateral edges of the larynx; intermandibular space at the angle of the mandibles.

• Technique:

  • Place hands under the dorsolateral edges of the larynx and move over the larynx to reset hand position.

  • Move hands laterally into the intermandibular space to isolate lymph nodes.

• Observation:

  • Check for symmetry and any abnormalities in the nodes.

3. Parotid Lymph Node

• Location: Caudal to the ramus of the mandible, near the ear.

• Technique:

  • Place fingers caudal to the ramus and move fingers upward towards the ear.

• Observation:

  • Typically palpated muscular attachments or tenderness in this area.

  • The lymph node may be felt here, but it can vary by individual anatomy.

4. Pre-scapular lymph node

   • located under muscle, we do not feel it unless swollen, or enlarged.

4. Pre-femoral lymph node

   • we cannot feel it unless swollen/enlarged

   

CARDIOVASCULAR SYSTEM

Looking at mucous membranes - color, CRT, mandibular artery, jugular furrow - filling of jugular vein.

Landmarks:

• Left side:

  • 3rd ICS (at level of elbow) - pulmonic valve (furthest cranial)

  • 4th ICS a little above - aortic valve

  • 5th ICS - mitral valve

• Right side:

  • tricuspid valve - at level just above elbow in armpit (3rd-4th ICS)

Rate

Rhythm

quality

Very much sound, volume of heart

A lot of physiological murmurs in horses!

The different heart sounds:

1. lub (S1)

2. dub (S2)

3. S3 + S4 (additional heart sounds, not as loud or intense) - but horses may have also these.

Most important is lub-dub sound!

RESPIRATORY EXAMINATION:

Looking at the effort of breathing, nostrils, overall thorax etc. Watch for nasal flaring, history.

Systematic Approach to Examination

• Sequential Examination: Start from the front of the horse and move toward the back.

• Nose Assessment:

  • Look for any nasal discharge or abnormal smells; certain infections may cause distinct odors.

  • Inspect nostrils for lumps or tumors using a finger or visual inspection.

• Mucous Membranes:

  • Lift the upper lip to check color and refill time; a healthy horse should have pink membranes and normal capillary refill time (1-2 seconds).

Facial Examination

• Symmetry is crucial; horses with sinus issues may present unilateral nasal discharge or facial asymmetry.

• Percussion:

  • The technique is used to detect fluid or pus in sinuses by tapping on the skull and listening for dullness vs. hollow sounds.

    • Sinuses → tapping with fingers, getting hollow sounds

Palpation Steps

• Check submandibular lymph nodes; swollen nodes can indicate respiratory infections.

• Palpate larynx and thyroid gland; observation of any coughing or unusual lumps is critical.

  • Larynx → pinching, cranially to thyroid gland

Trachea Examination

• Palpate the trachea and feel for the tracheal rings.

• Important for procedures like tracheostomy, which is performed between specific tracheal rings.

Auscultation of the Respiratory System

• Using the Stethoscope:

  • Proper orientation of earpieces - going forward from you.

  • Use the diaphragm side for furry animals.

• Respiratory Rate Measurement:

  • Observe thoracic movement and abdominal muscle effort to gauge respiratory effort.

  • Count breaths via nostrils if necessary.

  • a lot of effort with abdominal muscles during breathing → can indicate allergic problems → problems with expiring the air

  Auscultating:

  • auscultating trachea → breathing through pipe, if we hear anything wet → abnormal.

  • then proceed with lungs:

Techniques to Elicit Deep Breaths

• Nostril Pinching: Encourages deep breathing for better sound assessment.

• Rebreathing Bag: Using a large plastic bag to increase carbon dioxide and stimulate deeper breaths.

Additional Diagnostics

• Other diagnostic techniques may include:

  • Transtracheal or Bronchoalveolar Lavage: Sampling fluid from the airways for testing.

  • Radiology: Useful for detecting issues in foals.

  • Ultrasound: Helps identify fluid in the chest.

• Observing the horse during exercise may give insights into respiratory difficulties.