Computer test - Locomotor system

Question 1

What ancillary methods can be used to test muscles ?

Answer 1

EMG
Biopsy
CK
LDH
AST
ALT
US
MRI
Urinanalysis (myoglobinuria)

Question 2

Bone clinical examination ?

Answer 2

Physical examination : general inspection palpation (pain, consistency, crepitation, movement, T°), percussion

Question 3

Locomotor system evaluation ?

Answer 3

History
Physical exam
General impression
Inspection, palpation, percussion of the given organ
Compare symmetrical parts of the body

Question 4

What to check when suspecting locomotion problems ?

Answer 4

History
Physical exam
General impression (standing, moving, recumbency)
Inspection, palpation, percussion of the given organ (functional unit of BAM)
Compare symmetrical parts of the body (musculoskeletal signs / systemic diseases)
Further exams : rectal palpation, Xrays, MRI, CT, arthroscopy, US, EMG, scintigraphy imaging, biopsy, aspiration cytology, CBC, serum biochem, serology

Question 5

Lab test performed if suspecting bone illness in horse ?

Answer 5

CT, Xray, Scintigraphy
Ca, P
ALKP (increased osteoclast activity), PTH, PTH related protein, vit D metabolites
CBC
Kidney function
Haematology - acute osteomyelitis
Biopsy, histopathology
Cytology, fluids, exsudates
Microbiology

Question 6

Tests for muscle function ?

Answer 6

Examine relaxes animal, standing, recumbent

Question 7

What can be examined by inspection of joints ?

• Skin
• Swelling
• Angle
• Deformities
• Symmetry
• Movement
• Pain

Answer 7

• Skin
• Swelling
• Angle
• Deformities
• Symmetry

Question 8

Synovial fluid description ?

Answer 8

Clear, light-straw in colour, sticky, viscous feel, strand forming-between fingers

Question 9

Joint’s motion ?

Answer 9

Easily movable according to the given joint’s range of motion. Passive movement is free of pain and no constant crepitation

Question 10

Examination of bones ?

Answer 10

• General impression/inspection (at rest, during motion)
• Palpation (T°, deformities, pain, surface, contour, consistency, moveability, crepitation, symmetry)
• Percussion (sound, pain)
• Extra exams :
  -CT (better for hard tissue; cranium, sinuses, spine)
  ‐Radiography
  ‐Nuclear imaging (scintigraphy : malignancies)
• Chemistry: Ca, P, ALKP (increased osteoclast activity), PTH, PTH-related protein, Vit. D metabolites, kidney functions
  ‐ Haematology – acute osteomyelitis: CBC, inflammatory markers (globuline, CRP) : septic disease
  -Biopsy, histopathology
  ‐Cytology, fluids, exudates
  ‐Microbiology
  ‐Rectal examination (Pelvis, symphyseolysis after parturition in cows)

Question 11

Examination of joints and ligaments ?

Answer 11

• Inspection
• Palpation
• Passive range of motion
• Further examination :
• Radiography
  -Arthrocentesis and joint fluid analysis (cytology, microbiology +/ - biochemistry (globuline) → physiologic finding in synovial fluid: clear, light-straw in colour, sticky, viscous feel, strand forming (between fingers, glass slide)
  ‐CT, MRI -‐Arthroscopy (diagnostic and therapeutic)
• US
• Others: CBC, serum biochemistry, urinalysis (+ source of bacterial infection, etc.), serology, ANA

Joint fluid tapped : normal = very small amount, clear, straw coloured, viscous

Question 12

Examination of muscle and tendons ?

Answer 12

• Inspection
• Palpation

* Extra exams :
‐EMG -
‐Biopsy 
‐US 
‐CT, MRI 
- Blood examination, complete blood count (CBC), serum biochemistry: CK, LDH, AST,  ALT (myocyte injury), Ca, Mg, myoglobinemia 
- Urinalysis (myoglobinuria)
‐Serology (Toxoplasma, Neospora, ACh-Receptor-Ab, etc.)