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LIFE

LIFE. “We must be willing to get rid of the life we’ve planned, so as to have the life that is waiting for us.” -Joseph Campbell. DISEASES OF THE MUSCULOSKELETAL SYTEM. MSK - FUNCTIONS. Support (skeletal system) bones attach structural support for the entire body Storage

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LIFE

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  1. LIFE “We must be willing to get rid of the life we’ve planned, so as to have the life that is waiting for us.” -Joseph Campbell

  2. DISEASES OF THE MUSCULOSKELETAL SYTEM

  3. MSK - FUNCTIONS • Support(skeletal system) • bones attach • structural support for the entire body • Storage • Minerals (calcium) and lipids. • Blood cell production. • site of formation for all types of blood cells. • Protection • vital organs of the body • ribs surround the visceral organs • central nervous system is encased within the skull and spinal cord. • Leverage • Many of the joints of the body act as levers therefore assisting with movement.

  4. Bone anatomy Anatomy of long bones. A) Using the femur as an example of a long bone, Epiphysis is the enlarged area at either end of the bone Diaphysis is the long shaft in the middle portion of the bone Metaphysis is the joining point between the epiphysis and diaphysis The periosteum is the fibrous covering around the outside of the bone not covered with articular cartilage. The endosteum is the fibrous and cellular tissue lining the medullary cavity of the bone

  5. Types - bones vertebrae and certain facial bones humerus, radius, femur, tibia, metacarpals, and metatarsals patella, and proximal and distal sesamoid bones of the digits. carpal and tarsal bones sternum, ribs, scapula, and certain skull bones

  6. MUSCULOSKELETAL SYSTEM:DISRUPTION • TRAUMA • Fractures • Ligament ruptures • Poor conformation • Luxating patella • Degenerative disease: • Osteochondritisdissecans (OCD) • Degenerative joint disease (DJD) • Nonunitedanconeal process INFLAMMATION Myositis Panosteitis NEOPLASIA Osteosarcoma

  7. TRAUMA: CLINICAL SIGNS OF LONG BONE FRACTURES Lameness, swelling, hx of abuse lameness Deformity of bone, swelling

  8. MS Diseases • Fractures • Classification: • ( 1 ) type (e.g ., spiral, comminuted, Salter-Harris) • (2) location (e.g., mid-diaphysis) • (3) position of fracture fragments

  9. Fractures • Incomplete: greenstick, fissure, depression vs. Complete: transverse, oblique, spiral, comminuted (multiple pieces, fracture line interconnects) • Open (compound) – broken skin vs. Closed (simple) – intact skin • Simple – 1 break: oblique, transverse, incomplete vs. comminuted or multiple fracture • Stable – ends apposed and fixed (i.e. greenstick) vs. Unstable • Compression: vertebrae

  10. Trauma – Incomplete – long bones Greenstick fracture Fissure fractures

  11. Trauma - Long bone fractures - Complete Spiral Fractures: 1 part of bone is twisted Comminuted fracture

  12. Trauma - Long bone fractures - Complete Oblique fracture Transverse fracture

  13. TRAUMA: OPEN VS. CLOSED FRACTURES In open fractures bone is exposed through the skin

  14. TRAUMA: METHODS OF FIXATION OF LONG BONE FRACTURES SPLINTS It is critical that the splint support both the joint above and below the injury !

  15. TRAUMA: METHODS OF FIXATION OF LONG BONE FRACTURES Splints Plastic splint METASPLINT

  16. ROBERT JONES BANDAGE • Especially useful for traumatized extremities with a great deal of swelling or edema • After knee surgery

  17. TRAUMA: METHODS OF FIXATION ON FRACTURES SCHROEDER-THOMAS SPLINT SPLINTS immobilize any fracture distal to the midfemur or midhumerus

  18. CASTS • Casts can be made for the entire body, as for spinal injuries, for any portion of the body (spica cast), or for just the extremities.

  19. TRAUMA: METHODS OF FIXATION OF FRACTURES IM pins with cerclage wires, Need other methods to prevent Rotation and compressive forces

  20. TRAUMA: METHODS OF FIXATION OF LONG BONE FRACTURES Bone plates and screws

  21. TRAUMA: METHODS OF FIXATION External fixators are pins that penetrate the skin and bones that are attached to fixed bars or acrylic using special clamps

  22. Bone Fractures – Client Info • Restrict activity • Watch for drainage, swelling, heat • Metal (plate, pin) stronger than bone – refracture may occur • Follow up x-rays necessary • Metal should be removed after healing • Metal may cause cold sensitivity

  23. LET IT GO! “People have a hard time letting go of their suffering. Out of a fear of the unknown, they prefer suffering that is familiar.” -Thich Nhat Hahn

  24. Ligament Injury – Anterior Cruciate Ligament • ACL and PCL (posterior cruciate ligament) stabilize knee joint • Intra-articular structures • Ruptured ACL – most common knee injury => DJD • May be complete rupture or partial tear => unstable joint => DJD

  25. Anterior and Posterior Cruciate Ligaments

  26. TRAUMA: CRUCIATE LIGAMENT INJURY/RUPTURE

  27. TRAUMA: CLINICAL SIGNS OF CRANIAL CRUCIATE LIGAMENT INJURY/RUPTURE Middle-aged obese dog Highly active, athletic animals ACUTE

  28. TRAUMA: CLINICAL SIGNS OF CRANIAL CRUCIATE LIGAMENT INJURY/RUPTURE Animal is non wt. bearing on the rear leg Exercise: hyperextend stifle joint Joint effusion

  29. TRAUMA: CCL RUPTURE Cranial drawer test + in CCL Tibial compression test stabilize the dog’s femur with one hand, while flexing the ankle with the other: + tibia goes forward

  30. TRAUMA: CRANIAL CRUCIATE LIGAMENT RUPTURE http://www.youtube.com/watch?v=9jg9E2nBt_E&feature=related

  31. TRAUMA: CRANIAL CRUCIATE LIGAMENT RUPTURE REPAIR Extra-articular Stabilization *Most successful in patients less than 15kg From flabella to tibial crest and imbrication of joint

  32. TRAUMA: CRANIAL CRUCIATE LIGAMENT RUPTURE REPAIR Intra-articular stabilization – Over-the-top patellar tendon graft The graft is usually passed through drill holes in the femur and tibia and, is attached to the soft tissues of the femur or tibia.

  33. TRAUMA: CRANIAL CRUCIATE LIGAMENT RUPTURE http://www.youtube.com/watch?v=4nU2QZjjByg

  34. TRAUMA: CRANIAL CRUCIATE LIGAMENT RUPTURE REPAIR Intra-articular stabilization technique TPLO – Tibial Plateau Leveling Osteotomy

  35. TRAUMA: CRANIAL CRUCIATE LIGAMENT RUPTURE http://www.youtube.com/watch?v=-1pxxX4TXko&feature=fvw

  36. ACL – Client info • Restrict activity 3-4 weeks post surgery • Cage rest • Leash walk only to urinate and defecate • Gradually increase exercise 4-8 wks post sx • Full activity 8-12 weeks • Opposite cruciate often tears within 1 yr • Weight loss helps • DJD of stifle joint likely • If no surgery, joint thickens - fibrosis

  37. ACCEPT YOURSELF “There’s a period of life when we swallow a knowledge of ourselves and it becomes either good or sour inside.” - Pearl Bailey

  38. POOR CONFORMATION: LUXATING PATELLA

  39. POOR CONFORMATION: LUXATING PATELLA

  40. POOR CONFORMATION: LUXATING PATELLA

  41. POOR CONFORMATION: LUXATING PATELLA PATELLA IN GROOVE PATELLA OUT OF GROOVE

  42. POOR CONFORMATION BOW-LEGGED STANCE MAY OCCUR IN MEDIAL LUXATIONS KNOCK-KNEED/PIGEON-TOED, OR COW-HOCKED STANCE MAY OCCUR IN LATERAL LUXATIONS

  43. POOR CONFORMATION: TREATMENT OF PATELLAR LUXATION TROCHLEAR WEDGE RESECTION

  44. POOR CONFORMATION: TROCHLEAR WEDGE RESECTION

  45. POOR CONFORMATION: TIBIAL CREST TRANSPOSITION

  46. POOR CONFORMATION: TIBIAL CREST TRANSPOSITION

  47. http://video.google.com/videosearch?hl=en&q=patella+luxation+surgery&um=1&ie=UTF-8&sa=N&tab=wv#http://video.google.com/videosearch?hl=en&q=patella+luxation+surgery&um=1&ie=UTF-8&sa=N&tab=wv# • http://www.youtube.com/watch?v=GfnQbIk284g

  48. POOR CONFORMATION: HIP DYSPLASIA YOUNG DOGS AND MATURE ANIMALS WITH CHRONIC DISEASE

  49. POOR CONFORMATION: HIP DYSPLASIA • HX • Decreased activity • Difficulty rising • Reluctance to run, jump, climb • Intermittent or persistent hind limb lameness; worse after exercise • Bunny hopping or swaying gait • Narrow hind limb stance

  50. POOR CONFORMATION: HIP DYSPLASIA Poor conformation combined with genetic, environmental and nutritional factors

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