4 Limbs: Clinical

For this session we will have a guest clinician discuss the common clinical diseases and disorders of the limbs that they see in their large animal veterinary practice.

Equine Clinical topics:

• Navicular disease – (The most relevant objectives: A2.1, A2.3, A2.6)
• Osteoarthritis (OA) and Osteochondritis dissecans (OCD) of the tarsus – (The most relevant objectives: A3.1, A3.2, A3.6)
• Proximal suspensory desmitis of the hindlimb – (The most relevant objectives: A1.3, A2.4, A3.3)

Common Clinical Terms and Terminology

• -itis = inflammation of…
• Synovitis/capsulitis – the synovial membrane or joint capsule (e.g., “bog spavin” of tarsus)
• Tenosynovitis – the fluid-filled sheath surrounding a tendon
• Tendinitis – tendons, and their muscle or bone attachment
• Desmitis – ligaments, and their bony attachments (e.g., suspensory ligament)
• Bursitis – a bursa (near e.g., olecranon, calcanean tuberosity, nuchal ligament, greater trochanter, etc.)
• Laminitis (aka Founder) – loss of the integrity of the laminae to attach (hoof and P3)
• Many of these can be: idiopathic, or due to degenerative joint disease, trauma, infection, etc
• Neurectomy – a nerve block that severs or removes a nerve
• Desmotomy – to sever or remove a ligament
• Tenotomy and Tenectomy – used to treat inflammation of the tendon. Tenotomy detaches the affected tendon from the bone. Tenectomy removes part or all of the tendon.

Application Objectives 1-3:

From Application 1:

A1.1 Describe and differentiate regions and bones of the (proximal) thoracic limb (from scapula to carpus) by using correct directional/regional terminology.

A1.2 Identify and describe the joints, joint angles, joint actions, and muscle groups of the (proximal) thoracic limb.

A1.3 Identify and describe all components contributing to the equine suspensory apparatus and forelimb stay apparatus.

A1.4 For each region of the forelimb, provide the name and describe the general location of the nerves innervating flexor and extensor muscle groups and identify clinical signs of nerve damage.

A1.5 For each region of the forelimb, identify the pathway/distribution and components of the major arterial trunk and clinically relevant veins.

From Application 2:

A2.1 Describe and differentiate regions and bones of the (distal) thoracic limb by using correct directional/regional terminology.

A2.2 Identify and describe the joints, joint angles, and joint actions of the (distal) thoracic limb; describe the location of muscle groups which result in flexion/extension of these joints.

A2.3 Identify and describe the components of the hoof.

A2.4 Identify and describe the ligaments and tendons of the foot in equine and bovine.

A2.5 Describe the main vessels and nerves supplying the foot and digit(s).

A2.6 Describe laminitis, navicular syndrome, and common foot disorders in bovine; identify the related anatomical structures.

From Application 3:

A3.1 Describe and differentiate regions and bones of the hind limb by using correct regional/directional terminology.

A3.2 Identify and describe the joints, joint angles, joint actions, and muscle groups of the pelvic limb.

A3.3 Describe and identify and describe all components contributing to the equine suspensory apparatus and hind limb stay apparatus; identify components that are similar to the forelimb stay apparatus.

A3.4 For each region of the hind limb, provide the name and describe the general location of the nerves innervating flexor and extensor muscle groups and identify clinical signs of nerve damage.

A3.5 For each region of the hind limb, identify the pathway/distribution and components of the major arterial trunk and clinically relevant veins.

A3.6 Describe clinical syndromes involving the equine hock joint.