Anatomy and Physiology of Femur Diaphysis Fracture in Dogs PDF

ANATOMY AND PHYSIOLOGY OF OS FEMUR DIAPHYSIS FRACTURE IN DOGS EDITOR : DR. YENI DHAMAYANTI Introduction  A 2 year old male golden retriever mix is admitted to a veterinary hospital with the following condition: ✔ Experienced paralysis due to accidentally being run...

ANATOMY AND PHYSIOLOGY OF OS FEMUR DIAPHYSIS FRACTURE IN DOGS EDITOR : DR. YENI DHAMAYANTI Introduction  A 2 year old male golden retriever mix is admitted to a veterinary hospital with the following condition: ✔ Experienced paralysis due to accidentally being run over by a car ✔ The right hind leg is painful upon palpation ✔ There seems to be two bones in the femur area ✔ Appears healthy with a good appetite and drinking habits ✔ Behavior is quiet ✔ Difficulty with defecation and urination due to inability to support the hind legs ✔ Heart rate frequency is 100 beats/min, pulse frequency is 68 beats/min ✔ Respiratory rate is 24 breaths/min ✔ Examination of the oral mucosa and conjunctiva showed no signs of abnormalities ✔ Examination of the cardiovascular and respiratory systems is normal. How do you know only by palpation ??? X-RAY FRACTURE IN DIAPHYSIS OF OS FEMUR Cause ??? ANATOMY OF TARGET ORGANS TARGET → DIAPHYSIS OS FEMUR [CORPUS OSSIS FEMUR] Cylindrical in shape, bounded by the proximal and distal metaphysis  Muscles attached to Diaphysis of Os Femur: Facies cranio-proximal, in the subtrochanteric region, becomes the origo of: M. VASTUS LATERALIS M. VASTUS INTERMEDIUS M. VASTUS MEDIALIS M. ADDUCTOR LONGUS Facies Caudal becomes the insertion of: M. ADDUCTOR MAGNUS ET BREVIS 1/3 distal on the caudo-medial side becomes the insertion of: M. PECTINEUS M. SEMIMEMBRANOSUS  SURGERY TREATMENT PROCEDURE: POSItion: trochanter major os patella ✔ Lateral Recumbancy ✔ Orientation: a) proximal → trochanter major b) distal → os patella  trochanter major SURGERY PROCEDURE : 1. An incision of the skin, fat tissue, and subcutaneous fascia is made on the lateral side, along the craniolateral margin of the femoral diaphysis. 2. The incision is made from the distal part of os patella the greater trochanter of the femur to the patella SURGERY PROCEDURE: M. TENSOR FASCIA LATA 3. Next Incision will do on distal M. TENSOR FASCIA LATA, along cranial side M. BICEPS FEMORIS M. BICEPS FEMORIS lokasi insisi, cranial BF SURGERY PROCEDURE : 4. M. BICEPS FEMORIS is retracted caudally until the body of the femur is visible → wrapped in fascia. 5. An incision is made in the fascia (aponeurotic septum) of the VASTUS LATERALIS, and the VASTUS LATERALIS is retracted cranially." SURGERY PROCEDURE : 6. Exposure of the corpus femur is performed by separating the fasciae of the vastus lateralis and vastus intermedius muscles that are attached to the cranial side of the corpus femur  WHY IS THE SURGICAL PROCEDURE PERFORMED ON THE CRANIOLATERAL SIDE OF REGIO OS FEMUR ?  Lat Ca Cr Med Pay attention to the anatomical structures on the craniolateral side! [Cross-section at the middle of the femoral region] Cranio-lateral os femur structures Lat A. M. QUADRICEPS FEMORIS Ca ✔ M. VASTUS LATERALIS ✔ M. RECTUS FEMORIS ✔ M. INTERMEDIUS B. M. SARTORIUS VENTER CRANIALIS Cr Caudo-lateral os femur structures Med A. M. BICEPS FEMORIS ✔ PARS CRANIALIS NOTE : Its not dangerous because this incise ✔ PARS CAUDALIS anatomically would not tough big blood vessel and nerve filament  Lat Ca Cr Med WHERE IS M. TENSOR FASCIA LATA ? VASCULARIZATION OF THE REGION  It is a continuation of the external iliac artery is a. Lat femuralis and becomes the popliteal artery in the popliteal region.(near patella) Ca In the middle of the femoral body, it is located between the quadriceps femoris muscle on the cranial side and the adductor and semimembranosus muscles on the caudal side. On the medial side, it can be used to check the pulse. Cr Med A./V. FEMURALIS  ✔ BRANCHES : Lat 1) A. CIRCUMFLEXA ILIACA SUPERFISIAL 2) A. CIRCUMFLEXA FEMORALIS Ca LATERAL 3) A. FEMORALIS CAUDAL - PROXIMAL 4) A. GENUCULARIS DESCENDENS 5) A. SAPHENOUS Cr 6) A. FEMORALIS CAUDAL - MEDIAL Med 7) A. FEMORALIS CAUDAL - DISTAL A. FEMURALIS NOTE : A. CIRCUMFLEXA ILIACA PROFUNDA → branches off from the AORTA ABDOMINALIS, extending distally until it reaches the prefemoral ligament. B. CIRCUMFLEXA FEMORALIS MEDIAL → is the terminal artery [continuation of] the A. FEMORALIS PROFUNDA → enters the nutrient foramen of the femur diaphysis, becoming the A. NUTRITIA. C. In the case of a fracture → the A. NUTRITIA undergoes hypertrophy and forms new capillary networks, initiating the healing process PAY ATTENTION TO THE BRANCHING SCHEME OF A. FEMORALIS ON THE SIDE! [SUPERFICIAL PART FROM THE MEDIAL SIDE] Explain: 1. The location of the A. FEMORALIS and its branches 2. Its path towards which direction? (cranial, caudal, distal?) 3. Does it penetrate muscle fibers?  a/v circumflexa femoralis nedialis a.Circumflexa femoralis lateralis a/v.Circumflexa femoralis medialis a/v. femoralis a/v saphenus INNERVATION  Superficial branches of the N. Lat FEMORALIS → located approximately in the area of the M. ILIOPSOAS, on the Ca medial surface of the M. TENSOR FASCIA LATA, and gives off muscular and cutaneous branches. The muscular branch extends toward the Cr cranial and caudal sides of the M. SARTORIUS. Med The cutaneous branch is located on the N. SAPHENOUS cranial side of the A. FEMORALIS → extends distally along the medial surface of the M. QUADRICEPS FEMORIS. The N. SAPHENOUS is located at the plantar joint of the knee (genu).  Originates from Plexus lumbosacral -- > L6, L7, S1 and occasionally, S2 Lat Ca Cr Med N. ISCHIADICUS ✔ After exiting the foramen ischiadica major, moving distally, it is located between the M. QUADRATUS FEMORIS, M. ADDUCTOR, and M. SEMIMEMBRANOSUS. ✔ At approximately 1/3 of the proximal thigh, it branches into the N. FIBULARIS COMMUNIS and N. TIBIALIS. LYMPHATIC SYSTEM !  LN. POPLITEAL Oval-shaped, with a length of approximately 20 mm, surrounded by fatty tissue. Location: medial margin of the M. BICEPS FEMORIS and lateral margin of the M. SEMITENDINOSUS. The afferent vessels originate from the distal part of the popliteal lymph node. The efferent vessels lead to the LN. ILIACA MEDIALIS. Duct thoracicus dog ends in the neck venous system (left external jugular vein or jugulo- subclavian angle) Thank You Thoracic duct: (HORSE) The vessel usually starts from the level of the eighteenth thoracic vertebrae (T18) and extends to the root of the neck, travelling cranially through the mediastinum and along the left side of the trachea until it empties into the cranial vena cava or commonly the left jugular vein.