Anatomy of the Palmar Foot
• Those structures that can be associated with lameness:
o
Hoof
•
Digital cushion
•
Collateral cartilages
•
Frog
•
Heels
•
Sole
o
Synovial structures
•
Coffin joint
•
Navicular bursa
•
Digital sheath
o
Bone
•
P2
•
P3
•
Navicular
o
Tendons
•
Deep digital flexor
o
Ligaments
•
Impar
•
Suspensory ligament of the navicular
•
Distal digital annular ligament
•
Collateral ligaments of the distal interphalangeal joint
The Foot
•
Diagnostics - localization
o
Peri-neural anesthesia
•
Palmar digital nerve block
•
Dorsal branches
•
Abaxial sesamoid nerve block
o
Intra-synovial
•
Coffin joint
•
Navicular bursa
•
Digital sheath
•
Palmar digital nerve block
o 1.5 – 2 ml of anesthetic
o
Placed over neurovascular bundle
o
Just axial to collateral cartilages
o
Desensitizes ⅓ to ½ of the foot
o Structures blocked: (Stashak TS Adams Lameness in Horses pp 162)
•
Navicular bone
•
Navicular bursa
•
Navicular apparatus
•
Distal sesamoidean ligaments
•
DDFT, SDFT
•
Digital sheath
•
Digital cushion
•
Frog
•
Sole
•
Palmar coffin joint
•
Palmar ⅓ and distal aspect of P3
•
Dorsal branches – pastern ring block
o
3 to 5 ml anesthetic
o
Just proximal to collateral cartilages
o
Directed dorsally
o
Structures blocked
•
Coffin joint
•
Pastern joint
•
Remainder of P3
•
Remainder of sole
•
P2
•
Abaxial-sesamoid nerve block
o
2 – 3 ml anesthetic
o
Placed over neurovascular bundle at base of the proximal sesamoids
o
Structures blocked (in addition to those with PD)
