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Topic:Diagnostic Technique

Diagnostic techniques in equine medicine encompass a range of procedures and tools used to identify diseases, injuries, or other health conditions in horses. These techniques include imaging methods such as radiography, ultrasonography, and magnetic resonance imaging (MRI), as well as laboratory tests like blood work and tissue biopsies. Each diagnostic method provides specific information that can aid in the assessment and management of equine health issues. Radiography is commonly used for evaluating bone structures, while ultrasonography is useful for soft tissue examination. MRI offers detailed images of both soft and hard tissues, though its use is limited by cost and availability. Laboratory tests can detect biochemical and hematological changes indicative of disease. This page compiles peer-reviewed research studies and scholarly articles that explore the development, application, and efficacy of various diagnostic techniques in equine veterinary practice.
Respiratory fluid analysis in horses: An indispensable diagnostic tool in equine respiratory medicine.
Veterinary journal (London, England : 1997)    September 2, 2009   Volume 185, Issue 2 100 doi: 10.1016/j.tvjl.2009.07.033
Kirschvink N.No abstract available
Identification of racehorse and sample contamination by novel 24-plex STR system.
Forensic science international. Genetics    September 2, 2009   Volume 4, Issue 3 158-167 doi: 10.1016/j.fsigen.2009.08.001
Chen JW, Uboh CE, Soma LR, Li X, Guan F, You Y, Liu Y.Proper identification of racehorses competing in an official race and maintenance of defensible chain of custody are important in doping control regulations. The purpose of this study was to develop a reliable multiplex PCR method for providing genetic evidence for matching donors to test samples by using short tandem repeat (STR) loci. Amplification of 21 STR loci from blood, urine or hair root was achieved in a single tube and STR length polymorphism was analyzed using fluorescent labeled capillary electrophoresis. This novel approach showed an allele confidence interval of 0.19-0.43 bp and ...
Antimicrobial resistance and genetic characteristics of Salmonella Typhimurium isolated from horses in Hokkaido, Japan.
The Journal of veterinary medical science    September 2, 2009   Volume 71, Issue 8 1115-1119 doi: 10.1292/jvms.71.1115
Niwa H, Anzai T, Izumiya H, Morita-Ishihara T, Watanabe H, Uchida I, Tozaki T, Hobo S.In this study, we examined the antimicrobial susceptibility of 16 Salmonella Typhimurium isolates obtained from horses, and applied several genetic methods, namely polymerase chain reaction (PCR) for detecting class 1 integrons, multiplex PCR for detecting multidrug resistant S. Typhimurium definitive phage type 104 (MR-DT104), and fluorescent amplified-fragment length polymorphism (FAFLP). Seven isolates with an ampicillin, chloramphenicol, streptomycin, sulfonamide, and tetracycline (ACSSuT) type resistance pattern, harbored two class 1 integrons with sizes of 1.2 and 1.0 kb, and were identi...
Quantitative differences in activities of back and pelvic limb muscles during walking and trotting between chronically lame and nonlame horses.
American journal of veterinary research    September 2, 2009   Volume 70, Issue 9 1129-1134 doi: 10.2460/ajvr.70.9.1129
Zaneb H, Kaufmann V, Stanek C, Peham C, Licka TF.To assess differences in activities of back and pelvic limb muscles by use of surface electromyography (SEMG) in chronically lame and nonlame horses during walking and trotting. Methods: 12 nonlame horses and 12 horses with unilateral chronic mild to moderate pelvic limb lameness. Methods: On each horse, bipolar electrodes were attached to the skin over the midpoints of the right and left longissimus thoracis (Lot), semitendinosus (Set), biceps femoris (Bif), gluteus medius (Glm), and extensor digitorum longus (Edl) muscles. For each muscle, synchronous kinematic and SEMG recordings were made ...
Prevalence-dependent use of serological tests for diagnosing glanders in horses.
BMC veterinary research    September 1, 2009   Volume 5 32 doi: 10.1186/1746-6148-5-32
Sprague LD, Zachariah R, Neubauer H, Wernery R, Joseph M, Scholz HC, Wernery U.The internationally mandatory complement fixation test (CFT) for testing of equine sera for the absence of glanders has repeatedly led to discrepant results. Not only do "false positive" sera pose a problem for the diagnostician and the animal health authorities but they can also result in significant financial losses for the animal owners.Due to the very low prevalence of glanders in the horse population it is of major importance to use tests with a high specificity to overcome unreliable predictive values. We have compared formalin-fixed B. mallei whole cell antigen and a well characterised ...
A description of the relationship between the nasomaxillary aperture and the paranasal sinus system of horses.
Veterinary journal (London, England : 1997)    August 28, 2009   Volume 186, Issue 2 216-220 doi: 10.1016/j.tvjl.2009.07.023
Tatarniuk DM, Bell C, Carmalt JL.Disease of the paranasal sinuses of the horse is common and treatment often involves lavage and sometimes surgery. The development of minimally-invasive, sinus-specific treatments, such as balloon sinuplasty, requires a thorough understanding of this complex anatomical region. To improve this understanding, 10 heads from dead horses of various ages were grossly dissected. The heads were transected sagittally and each half was dissected to expose the left and right nasomaxillary apertures and associated structures which were then photographed and measured. Entrances from the rostral and caudal ...
Transcutaneous ultrasonographic evaluation of the air-filled equine stomach and duodenum following gastroscopy. Kihurani DO, Carstens A, Saulez MN, Donnellan CM.Gastroscopy with air insufflation was performed in 10 ponies, after which a transcutaneous ultrasound examination of the stomach and duodenum was performed immediately and at 1, 2, and 4 h postgastroscopy, and 24 h after feeding. Stomach measurements included the dorsoventral and craniocaudal dimensions, as well as the stomach depth from the skin surface and stomach wall thickness at the different time periods. Gastric wall folding was observed in one pony, becoming most distinct 2-4 h postgastroscopy. An undulating stomach wall was noted in eight other ponies postgastroscopy. These observatio...
A complementary radiographic projection of the equine temporomandibular joint. Ebling AJ, McKnight AL, Seiler G, Kircher PR.The complexity of the equine skull makes the temporomandibular joint a difficult area to evaluate radiographically. The goal of this study was to determine the optimal angle for a complementary radiographic projection of the equine temporomandibular joint based on a computed tomography (CT) cadaver study. CT was performed on six equine cadaver heads of horses that were euthanized for other reasons than temporomandibular joint disease. After the CT examination, 3D reconstruction of the equine skull was performed to subjectively determine the angle for a complementary radiographic projection of ...
Seroprevalence of toxoplasmosis in horses in Niğde Province of Turkey.
Tropical animal health and production    August 25, 2009   Volume 42, Issue 3 385-389 doi: 10.1007/s11250-009-9430-8
Karatepe B, Babür C, Karatepe M, Kiliç S.The present study was conducted to investigate the prevalence of Toxoplasma gondii specific antibodies in local horses from four districts of Niğde in the middle of Turkey, between April-June 2004. Serum samples were obtained a total of 125 horses which consisted of 81 (50 female, 31 male) 1-10 years old and 44 (25 female, 19 male) 11-20 years old and tested for antibodies to T. gondii using the Sabin Feldman Dye Test (SFDT). According to the results of the SFDT, antibodies to T. gondii were found by the SFDT in 9 (7.2%) of 125 sera with the titers of 1:16 (8 horses) and 1:64 (1 horse). Antib...
Magnetic resonance imaging anatomy of the normal equine larynx and pharynx. Pekarkova M, Kircher PR, Konar M, Lang J, Tessier C.The purpose of the present study was to describe normal magnetic resonance (MR) imaging anatomy of the equine larynx and pharynx and to present the optimal protocol, sequences, and possible limitations of this examination technique. Using a 0.3 T unit, the laryngeal and pharyngeal regions was imaged in two horses. The protocol consisted of sagittal and transverse T2-weighted (T2w) fast spin echo, transverse T1-weighted (T1w) spin echo, and dorsal high-resolution T1w gradient echo (both pre- and postcontrast enhancement) sequences. Euthanasia was performed at the end of the imaging procedure. M...
Magnetic resonance imaging findings in horses with recent onset navicular syndrome but without radiographic abnormalities. Sampson SN, Schneider RK, Gavin PR, Ho CP, Tucker RL, Charles EM.Seventy-two horses with recent onset of navicular syndrome and normal radiographs were assessed. Horses underwent magnetic resonance (MR) imaging of both front feet. All abnormalities were characterized and the most severe abnormality identified, if possible. Abnormal signal intensity in the navicular bone was the most severe abnormality in 24 (33%) horses. Pathologic change in the deep digital flexor tendon was the most severe abnormality in 13 (18%) horses. Pathologic change in the collateral sesamoidean ligament was the most severe abnormality in 11 (15%) horses. Pathologic change in the di...
Antibodies conjugated with new highly luminescent Eu3+ and Tb3+ chelates as markers for time resolved immunoassays. Application to simultaneous determination of clenbuterol and free cortisol in horse urine.
Talanta    August 22, 2009   Volume 80, Issue 2 954-958 doi: 10.1016/j.talanta.2009.08.019
Bacigalupo MA, Meroni G, Secundo F, Scalera C, Quici S.Highly luminescent Eu(3+) and Tb(3+) complexes of 10-[4-(3-isothiocyanatopropoxy)benzoylmethyl]-1,4,7,10-tetraazacyclododecane-1,4,7 triacetic acid Eu(3+) is a subset of 1 and Tb(3+) is a subset of 1 were conjugated with a goat anti-rabbit IgG and a rabbit anti-mouse IgG, respectively, and applied as markers in a time resolved immunoassay for simultaneous quantitative determination of anabolic compounds clenbuterol (CL) and hydrocortisone (HC). The assay was performed in horse urine, using a monoclonal antibody specific to CL and a rabbit polyclonal antibody specific to the free HC. These lant...
Identification and characterisation of an immunodiagnostic marker for cyathostomin developing stage larvae.
International journal for parasitology    August 22, 2009   Volume 40, Issue 3 265-275 doi: 10.1016/j.ijpara.2009.08.004
McWilliam HE, Nisbet AJ, Dowdall SM, Hodgkinson JE, Matthews JB.Parasitic nematodes of the group Cyathostominae are an important cause of disease in horses. This group consists of approximately 50 species, all of which have similar life cycles that involve encystment of larval stages in the large intestinal wall. Encysted larvae can persist for months to years and, occasionally, large numbers can accumulate and emerge synchronously to cause severe pathology, resulting in diarrhoea, weight loss, colic and/or oedema. This syndrome, known as larval cyathostominosis, can be fatal in up to 50% of cases, despite treatment. There is no diagnostic method that enab...
Coagulopathy of the critically ill equine patient.
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)    August 21, 2009   Volume 19, Issue 1 53-65 doi: 10.1111/j.1476-4431.2009.00390.x
Dallap Schaer BL, Epstein K.To review the hemostasis literature relevant to development of coagulopathy in the critically ill equine patient. Methods: Original scientific and review articles. Results: Inflammation plays a critical role in the activation and amplification of clot formation, as well as the impairment of physiologic anticoagulant mechanisms, and fibrinolysis. Earlier identification of coagulopathy in patients at risk and restoration of physiologic hemostasis may result in better outcome. Development of scoring systems based on information other than coagulation markers alone may better identify patients wit...
Thrombelastography in 26 healthy horses with and without activation by recombinant human tissue factor.
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)    August 21, 2009   Volume 19, Issue 1 96-101 doi: 10.1111/j.1476-4431.2008.00381.x
Epstein KL, Brainard BM, Lopes MA, Barton MH, Moore JN.To develop a standardized technique for thrombelastography (TEG) analysis in healthy adult horses, with and without the ex vivo addition of tissue factor (TF) as an activator. To determine reference intervals for TEG parameters in the horse, and to determine if traditional coagulation tests correlate with TEG. Methods: Prospective, observational. Methods: Veterinary teaching hospital. Methods: Twenty-six healthy adult horses. Methods: None. Results: Thrombelastography with (TF-TEG) and without (TEG) the addition of TF performed by 4 operators. Coagulation profiles (prothrombin time, activated ...
A technique for central venous pressure measurement in normal horses.
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)    August 21, 2009   Volume 19, Issue 3 241-246 doi: 10.1111/j.1476-4431.2009.00420.x
Wilsterman S, Hackett ES, Rao S, Hackett TB.To investigate a technique of central venous pressure (CVP) measurement using a newly developed catheter in healthy adult horses. Methods: Prospective experimental study. Methods: University research facility. Methods: Twenty healthy adult horses. Methods: An equine central venous catheter was inserted into the jugular vein to a length of approximately 80 cm from the mid-cervical region in an attempt to catheterize the pulmonary artery. Pulmonary arterial catheterization was confirmed by echocardiography. Insertion distance and pressure were measured at this location with a disposable manomete...
Lawsonia intracellularis: humoral immune response and fecal shedding in weanling foals following intra-rectal administration of frozen-thawed or lyophilized avirulent live vaccine.
Veterinary journal (London, England : 1997)    August 20, 2009   Volume 186, Issue 1 110-112 doi: 10.1016/j.tvjl.2009.07.008
Pusterla N, Jackson R, Mapes SM, Noland J, Stenbom RM, Gebhart C.The humoral immune response and fecal shedding of Lawsonia intracellularis was investigated in 20 weanling foals following intra-rectal administration of frozen-thawed or lyophilized avirulent live L. intracellularis vaccine. Foals received either 30 mL frozen-thawed or lyophilized vaccine intra-rectally, given twice, 4 weeks apart. Serum samples from each foal were collected every 4 weeks for 16 weeks following the first vaccination and tested for anti-L. intracellularis specific IgG by immunoperoxidase monolayer assay. Rectal swabs were collected every other day following the first vaccinati...
Acute phase response to surgery of varying intensity in horses: a preliminary study.
Veterinary surgery : VS    August 14, 2009   Volume 38, Issue 6 762-769 doi: 10.1111/j.1532-950X.2009.00564.x
Jacobsen S, Nielsen JV, Kjelgaard-Hansen M, Toelboell T, Fjeldborg J, Halling-Thomsen M, Martinussen T, Thoefner MB.To evaluate the postoperative inflammatory response of horses to elective surgery of varying intensity. Methods: Prospective longitudinal study. Methods: Horses referred to 2 hospitals for either arthroscopic removal of a unilateral osteochondritic lesion in the tibiotarsal joint (minimal surgical trauma, n=11), correction of recurrent laryngeal neuropathy by laryngoplasty and ventriculectomy (intermediate surgical trauma, n=10) or removal of an ovarian tumor by laparotomy (major surgical trauma, n=5). Methods: Horses had a thorough clinical examination every day. White blood cell (WBC) counts...
Effect of transvenous electrical cardioversion on plasma cardiac troponin I concentrations in horses with atrial fibrillation.
Journal of veterinary internal medicine    August 11, 2009   Volume 23, Issue 5 1103-1107 doi: 10.1111/j.1939-1676.2009.0369.x
Jesty SA, Kraus MS, Gelzer AR, Rishniw M, Moise NS.Whether electrical cardioversion of cardiac arrhythmias results in cardiomyocyte damage is unknown. Objective: To describe effect of transvenous electrical cardioversion (TVEC) on plasma cardiac troponin I (cTnI) concentration in horses. Methods: All horses presented to the Cornell University Hospital for Animals for cardioversion of atrial fibrillation between May 2006 and October 2008 were eligible for inclusion in the study. Owners of 14 horses elected for TVEC and each horse was then enrolled (16 procedures). Methods: Prospective observational study measuring concentrations of plasma cTnI ...
Methicillin-resistant Staphylococcus aureus in horses and horse personnel: an investigation of several outbreaks.
Veterinary microbiology    August 8, 2009   Volume 141, Issue 1-2 96-102 doi: 10.1016/j.vetmic.2009.08.009
van Duijkeren E, Moleman M, Sloet van Oldruitenborgh-Oosterbaan MM, Multem J, Troelstra A, Fluit AC, van Wamel WJ, Houwers DJ, de Neeling AJ....At the Veterinary Microbiological Diagnostic Center, the Netherlands, the percentage of methicillin-resistant Staphylococcus aureus (MRSA) isolates found in equine clinical samples increased from 0% in 2002 to 37% in 2008. MRSA of spa-type t064, belonging to MLST ST8 and spa-types t011 and t2123, both belonging to the livestock-associated MLST ST398, predominated. During an outbreak of post-surgical MRSA infections in horses at a veterinary teaching hospital in 2006/2007, MRSA isolates of spa-type t2123 were cultured from 7 horses and 4/61 personnel which indicated zoonotic transmission. After...
CE provides evidence of the stereoselective hydroxylation of norketamine in equines.
Electrophoresis    August 5, 2009   Volume 30, Issue 16 2912-2921 doi: 10.1002/elps.200900221
Schmitz A, Theurillat R, Lassahn PG, Mevissen M, Thormann W.CE with multiple isomer sulfated-CD as selector was used for the simultaneous analysis of the stereoisomers of ketamine, norketamine, 5,6-dehydronorketamine and hydroxylated metabolites of norketamine in liquid/liquid extracts of (i) in vitro incubations with ketamine or norketamine and equine liver microsomes and (ii) plasma and urine of ponies receiving a target-controlled infusion of ketamine under isoflurane anesthesia. Hydroxynorketamine metabolites with the hydroxy group at the cyclohexanone ring could be shown to be formed stereoselectively both in vitro and in vivo. Due to the lack of ...
Suture exostosis causing obstruction in the nasolacrimal duct in three horses.
New Zealand veterinary journal    August 4, 2009   Volume 57, Issue 4 229-234 doi: 10.1080/00480169.2009.36907
Carslake HB.Three horses were presented with facial swelling and epiphora. Results: All horses had facial swellings and radiographic findings consistent with exostosis at the lacrimomaxillary suture, and ipsilateral epiphora. Positive contrast dacryocystorhinography demonstrated that the site of obstruction of the nasolacrimal duct was located where the duct traverses the lacrimomaxillary suture. Methods: Lacrimomaxillary suture exostosis. Conclusions: Lacrimomaxillary suture exostosis should be considered as a differential diagnosis in cases of epiphora in horses. Dacryocystorhinography, preferably retro...
Equine herpesvirus-1 consensus statement.
Journal of veterinary internal medicine    August 4, 2009   Volume 23, Issue 3 450-461 doi: 10.1111/j.1939-1676.2009.0304.x
Lunn DP, Davis-Poynter N, Flaminio MJ, Horohov DW, Osterrieder K, Pusterla N, Townsend HG.Equine herpesvirus-1 is a highly prevalent and frequently pathogenic infection of equids. The most serious clinical consequences of infection are abortion and equine herpesvirus myeloencephalopathy (EHM). In recent years, there has been an apparent increase in the incidence of EHM in North America, with serious consequences for horses and the horse industry. This consensus statement draws together current knowledge in the areas of pathogenesis, strain variation, epidemiology, diagnostic testing, vaccination, outbreak prevention and control, and treatment.
Methods and reliability of tissue Doppler imaging for assessment of left ventricular radial wall motion in horses.
Journal of veterinary internal medicine    August 4, 2009   Volume 23, Issue 3 643-652 doi: 10.1111/j.1939-1676.2009.0287.x
Schwarzwald CC, Schober KE, Bonagura JD.Noninvasive assessment of left ventricular (LV) function is incompletely studied in horses. Objective: The goals of this study were to investigate the feasibility, techniques, and reliability of tissue Doppler imaging (TDI) for characterization of LV radial wall motion in healthy horses. Methods: Three Standardbreds, 3 Thoroughbreds; age 8-14 years; body weight 517-606 kg. Methods: Repeated echocardiographic examinations were performed by 2 observers in unsedated horses using TDI. Test reliability was determined by estimating measurement variability, within-day interobserver variability, and b...
Reproducibility of airway responsiveness in horses using flowmetric plethysmography and histamine bronchoprovocation.
Journal of veterinary internal medicine    August 4, 2009   Volume 23, Issue 3 631-635 doi: 10.1111/j.1939-1676.2009.0307.x
Nolen-Walston RD, Kuehn H, Boston RC, Mazan MR, Wilkins PA, Bruns S, Hoffman AM.Inflammatory airway disease has a high prevalence in horses, but is often a diagnostic challenge. Flowmetric plethysmography and histamine bronchoprovocation (FP/HBP) is a simple and effective tool for diagnosis, but reproducibility of these measurements made over time has not been established. Objective: We hypothesize that the measurement of airway responsiveness in horses using FP/HBP is consistent over both short and long periods of time. Methods: Twenty-nine healthy adult horses from 2 university herds. Methods: In this prospective experimental study, airway responsiveness was determined ...
Influence of the position of the foot on MRI signal in the deep digital flexor tendon and collateral ligaments of the distal interphalangeal joint in the standing horse.
Equine veterinary journal    August 1, 2009   Volume 41, Issue 5 498-503 doi: 10.2746/042516409x394472
Spriet M, Zwingenberger A.Hyperintense signal is sometimes observed in ligaments and tendons of the equine foot on standing magnetic resonance examination without associated changes in size and shape. In such cases, the presence of a true lesion or an artifact should be considered. A change in position of a ligament or tendon relative to the magnetic field can induce increased signal intensity due to the magic angle effect. Objective: To assess if positional rotation of the foot in the solar plane could be responsible for artifactual changes in signal intensity in the collateral ligaments of the distal interphalangeal ...
Stability of common biochemistry analytes in equine blood stored at room temperature.
Equine veterinary journal    August 1, 2009   Volume 41, Issue 5 428-432 doi: 10.2746/042516409x370928
Rendle DI, Heller J, Hughes KJ, Innocent GT, Durham AE.Time delays between collection of blood samples and biochemical analysis of equine blood are unavoidably common in equine practice. The effect that delays may have on the accuracy of results of blood biochemical analyses is not well established. Objective: Delays in processing of blood of up to 72 h results in alterations in measured levels of common biochemical analytes that are of potential clinical relevance. Separation of serum prior to storage is protective against the effects of time delays. Methods: Samples of clotted blood, separated serum and oxalate fluoride plasma from 20 horses wer...
Ultrasonographic assessment of the superficial digital flexor tendons of National Hunt racehorses in training over two racing seasons.
Equine veterinary journal    August 1, 2009   Volume 41, Issue 5 449-454 doi: 10.2746/042516409x391042
Avella CS, Ely ER, Verheyen KL, Price JS, Wood JL, Smith RK.It is important to ascertain the prevalence of superficial digital flexor tendon (SDFT) injuries and to improve methods of predicting injury in National Hunt (NH) racehorses. Objective: To establish: 1) the prevalence of SDFT tendinopathy in NH horses; 2) whether routine ultrasonography can be used to predict SDFT injuries; 3) whether previous tendinopathy predisposes to reinjury; 4) a normal range for the SDFT cross-sectional area (CSA); and 5) the effects of gender, age, background (ex-flat or ex-store), limb, training and rest periods on SDFT CSA. Methods: Routine ultrasound assessment of t...
Two- and three-dimensional computed tomographic anatomy of the enamel, infundibulae and pulp of 126 equine cheek teeth. Part 1: Findings in teeth without macroscopic occlusal or computed tomographic lesions.
Equine veterinary journal    August 1, 2009   Volume 41, Issue 5 433-440 doi: 10.2746/042516409x390214
Windley Z, Weller R, Tremaine WH, Perkins JD.Dental disorders are of major clinical importance in equine practice; however, the knowledge of normal dental anatomy, especially that of the pulp remains incomplete. Computed tomography (CT) is being used increasingly in the diagnosis of dental disease, although the normal 2- (2D) and 3-dimensional (3D) CT anatomy has not yet been fully described. Objective: To describe the 2D and 3D CT appearance of the enamel, infundibulae and pulp of normal equine cheek teeth. Methods: One-hundred-and-twenty-six cadaveric cheek teeth with eruption ages of 0.5-19 years were evaluated; CT scans of each tooth...
Two- and three-dimensional computed tomographic anatomy of the enamel, infundibulae and pulp of 126 equine cheek teeth. Part 2: Findings in teeth with macroscopic occlusal or computed tomographic lesions.
Equine veterinary journal    August 1, 2009   Volume 41, Issue 5 441-447 doi: 10.2746/042516409x391033
Windley Z, Weller R, Tremaine WH, Perkins JD.Dental disease often presents a diagnostic challenge in the horse. Computed tomography (CT) is increasingly used in the evaluation of head related disease in the horse, but the CT appearance of the most common dental diseases of horses has not yet been fully described. Objective: To describe the CT appearance of the peripheral enamel, pulp, infundibular enamel and cement in equine cheek teeth with macroscopic occlusal or CT lesions. Methods: In this study, 126 cadaveric cheek teeth with eruption ages of between 05 and 19 years were evaluated for lesions of their infundibulae, pulp and enamel u...