Quick Review on Veterinary Surgery

Vetnepal Review Note 2019-03-15

TERMINOLOGY

  • Luxations: Luxations involve loss of integrity to one or more joint ligaments as well as damage to other joint structures such as the fibrous joint capsule and surrounding tendons.
  • Sprain: A sprain may defined as the stretching or tearing of supporting ligament of joint by forced movement beyond its normal range
  • Fracture: A fracture is a breach/ break/ dissolution in the continuity of a hard tissue like bone and cartilage with or without displacement of fragments.
  • Splints: A typical splint is an exostosis on the splint bones (small metacarpals or metatarsals) as a result of localized ostoeperiostis.
  • Ring Bone (Phalangeal Exostosis): Exostosis on the phalangeal bone is called ring bone. It is an osteoarthritis involving the interphalangeal joints
  • Navicular Diseases:   Chronic ostitis of the navicular bone, associated with navicular bursitis and inflammation of the plantar aponeurosis
  • Corns: A corn is a contusion (bruise) of the sensitive and insensitive tissues of the sole at the angle formed by the wall and bar. This condition occurs due to improper shoeing.
  • Canker: Canker is a chronic hypertrophy of the horn producing tissues of the foot, which may involve one or all of the feet. Most often found in hind feet although it is rare. The etiologic agent is presumed to be unhygienic stabling.
  • Thrush: Thrush, a degenerative condition of the frog involving the central and lateral sulci, is characterized by the presence of a black necrotic material in the affected areas and caused by unhygienic condition along with involvement of Spherophorus necrophorus.
  • Coronitis: It is an inflammation of the coronary band; may involve the whole of the coronary band or only a portion of it.
  • Evulsion (Avulsion) of Hoof: Separation of the horny covering of the hoof exposing the sensitive laminae is called evulsion of hoof.
  • Stringhalt: Stringhalt is an involuntary overflexon and lifting of a limb during progression. It is the condition of hind limbs.
  • Gonitis: Inflammation of the stifle joint, may be acute or chronic. It is more common in bullocks than in horse.
  • Spavin: An exostosis in the hock region below the level of tibiotarsal articulation is called spavin. It is an osteo-arthritic disease.
  • Laminitis (Founder): Laminitis is the inflammation of the sensitive laminae of the foot. It is commonly seen in fore-foot.
  • Foul in foot/ Foot rot: It is a subacute or acute necrotic infection originating from a lesion in the interdigital skin. Pain, pyrexia and partial anorexia leading to mild or severe lameness are major signs of the disease.
  • Spondylitis: It is a chronic type of arthritis and anchylosis affecting the vertebral column.
  • Torticollis: Twisting or distortion of the neck is called torticollis or wry neck
  • Kyphosis: It is an upward curvature of vertebral column
  • Scoliosis: It is a side curvature of vertebral column
  • Entropion: Entropion is the inversion of the eyelid and its margin that causes eye lashes and lid hairs to irritate the cornea and conjunctiva.
  • Ectropion: Ectropion is an eversion of the lower eyelid and its margin that exposes the conjunctival and corneal surfaces.
  • Distichiasis: Extra rows of cilia which arises from the tarsal (meibomian) gland ducts.
  • Trichiois: Refers to misdirected eyelashes
  • Ectopic cilia: Misdirected hair follicle or cilia
  • Epiphora: Pathologic overflow of tears
  • Chemosis: Edema of the conjunctiva
  • Blepharospasm: Spasm of the eyelid
  • Dermoids: Dermoid is a misplaced embryonic cutaneous tissue arising in the conjunctiva and consisting of dermal elements such as- epidermis, dermis, fat, sebaceous glands and hair follicles.
  • Symblepharon: Symblepharon is an adhesion between the bulbar and palpebral conjunctiva.
  • Conjunctivitis: It is defined as the inflammation of conjunctiva.
  • Glaucoma: Glaucoma is a group of ocular diseases in which intraocular pressure (IOP) is elevated above normal levels and damages the optic nerve head and retina. If the IOP can not be reduced, an overall increase in size of the globe may result (bupthalmos).
  • Cornial Opacity: It is indeed a symptom of chronic keratitis.
  • Cataract: The opacity of the lens or its capsule is called a cataract
  • Carpal hygroma: A firm or fluctuating swelling involving precarpal bursa

BONE AS A TISSUE

The bone is generally formed by:

  1. Intramembranous ossification: It is the primary means of bone formation in the embryo by which flat bones of the skull (frontal, parietal, temporal & occipital) are formed.
  2. Endochondral ossification: Notably the long bones are formed by this process

STRUCTURE

Macroscopically, bone can be divided into two types-

  • Hard compact cortical bone: Found in shaft of the long bones,
  • Spongy or cancellous bone: found in vertebrae, in most of flat bones and in ends of long bones.

There are three types of osteogenic cells

  • Osteoblast: Covers most of the bone surface and do not divide
  • Osteocytes: Also known as imprisoned osteoblast. Osteocytes are osteoblast that have been engulfed in the matrix that is being synthesized.
  • Osteoclasts: Multinucleated cells that is scattered along bone surface & mostly seen on surface at which bone resorption is occuring.

CONSTITUENTS OF BONE

  • Organic matrix: Synthesized by osteoblasts. Primarily composed of the protein collagen (i.e. 95%)
  • Bone mineral: Primarily a calcium phosphate, whose structure resembles that of a naturally occurring mineral species ‘apatite’.
  • Water: Tightly bounded to the matrix.  Remains after mineralization

BLOOD SUPPLY

  • Nutrient artery (50-70%)
  • Metaphyseal arteries combined with epiphyseal arteries after closure of the growth       plate (20-40%)
  • Periosteal arteries (10-20%)

        Syanovial fluid = Dialysate of blood plasma + Hyaluronic acid

FRACTURE AND CLASSIFICATION

On the basis of communication of the site to the environment

  • Simple fracture: There is no wound at the surface
  • Compound fracture: Communicate with outside environment
  • Complicated fracture: A close fracture along with injury to the neighbouring vessels or nerves

On the basis of extent of bone damage or pattern of fracture

  1. Incomplete fracture: Characterized by partial loss of continuity
  • Greenstick fracture: The bone is partially fractured and bent like greenstick
  • Fissured fracture: One in which there is a crack or fissure extending through the bone in a transverse direction without causing displacement of the fragments
  1. Complete fracture: A complete fracture is one in which there is total disruption of the bone and is generally associated with displacement of fragments

I. Single fracture: Bone is broken in one place only.

  • Transverse fracture:The fracture line is at right angle to the long axis of the bone
  • Oblique fracture: Fracture line runs oblique to the long axis of the bone.
  • Spiral fracture: The fracture line spirals along the long axis of the bone
  • Longitudional fracture: Fracture line is in longitudional direction

II. Double fracture

  • Multiple fractures: The bone is fractured into three or more pieces that do not meet.
  • Comminuted fracture: The several fracture lines all communicate at a common point.

On the basis of portion of the bone involved/ according to the location of the bone

  • Diaphyseal fracture: Fracture involves the diaphysis of long bone.
  • Metaphyseal fracture: A fracture withinthe metaphysic of the long bone.
  • Epiphyseal fracture: Occurs in mature animals after closure of the epiphyseal plate.
  • Condylar fracture: Fracture of the condyle.
  • Articular fracture/ Intra-articular fracture: Fracture involving subchondral bone or articular cartilage.
  • Periarticular fracture: Fracture close to the bone.

On the basis of stability following anatomical reduction:

  • Stable fracture: Fractured fragments more or less interlock after reduction, thus maintain appropriate length of the segments. Example: Transverse, greenstick and impacted.
  • Unstable fracture: Fractured fragments slide by each other out of position (i.e. unstable) E.g. Oblique, Spiral etc.

PROCESS OF FRACTURE HEALING

Long bone heals in two distinct fashions:

  1. Healing by callus formation/ Secondary bone healing
  2. Primary bone healing/ Direct haversian healing

Phases of bone healing by callus formation

Inflammatory Phase: 

  • Stage of impact
  • Stage of inflammation

Reparative Phase

  • Stage of induction
  • Stage of soft callus
  • Stage of hard callus

Remodelling Phase

ARTHRITIS

Inflammation of joint is known as arthritis.

  1. Infectious Arthritis: Infectious arthritis is the inflammation of the synovial membrane
  2. Joint ill (Neonatal poly arthritis):     Joint ill in calves is a tertiary hematogenous septic arthritis
  3. Septic Arthritis in Older Cattle: In older cattle, it tends to be monoarticular
  4. Dgenerative Joint Disease (DJD): DJD is a chronic progressive, non-infectious and initially non-inflammatory disease characterized by primary degeneration of articualr cartilage.