(15) Musculoskeletal Injuries

Question 1

When performing a physical examination on a patient with a musculoskeletal​ injury, remember​ that:

A. capillary refill is important to​ check, especially in adult patients.
B. pulselessness and cyanosis in the injured extremity are common and should not alter your assessment and transport priorities.
C.it is necessary to assess the joints above and below any bone​ injury, and you should assess the bones above and below any joint injury only if those areas have obvious trauma.
D. it is important to obtain a SAMPLE history during or after your physical examination.

Answer 1

D. it is important to obtain SAMPLE Hx during or after the physical exam

Question 2

During your ongoing assessment of a patient with a bone or joint injury while en route to the​ hospital, be sure​ to:

A. recheck the​ patient’s vital signs every 20 minutes if the patient is stable.
B. remove and reapply any splints if the​ patient’s distal​ pulses, motor​ function, or sensation have deteriorated.
C. palpate the injury site several times to assess if the site is still painful.
D. elevate the extremity if spinal injury is not suspected.

Answer 2

D. elevate the extremity if spinal injury is not suspected

Question 3

articular cartilage

Answer 3

hyalin cartilage that lines the ends of bones with movable joints

Question 4

displaced fracture

Answer 4

fracture in which the peices are no longer in normal alignment

Question 5

glenoid fossa

Answer 5

part of the scapula, is the curve that accepts the head of the humerus

Question 6

reduce

Answer 6

to put back into normal alignment

Question 7

traction

Answer 7

to pull along its length

Question 8

zone of injury

Answer 8

possible area of soft tissue injury that surrounds the point tenderness of a fracture

Question 9

the best indicator of an underlying fracture is

Answer 9

point tenderness

Question 10

comminuted fracture

Answer 10

fracture with more than 2 peices

Question 11

oblique fracture

Answer 11

fracture at an angle across the bone

Question 12

transverse fracture

Answer 12

fracture straight across the bone

Question 13

subluxation

Answer 13

partial dislocation

Question 14

sprain

Answer 14

stretching or tearing of ligaments of a joint

Question 15

strain

Answer 15

stretching or tearing of muscle fibers

Question 16

splint an ankle with SAM splint

Answer 16

Figure 8 then a second SAM in U

Question 17

Your patient has a severe angulated femur fracture. On your initial assessment of the injury site, you note that the patient has diminished sensation distally and weak pulses. The patient is in extreme pain and screaming loudly. You apply manual traction to the leg and straighten the injured leg out as much as you can. The patient notes some relief with this maneuver. Just before placing the hare traction splint, your partner notes that the patient has no feeling in her toes and the dorsalis pulse has disappeared. Your NEXT action should be to:

A. rotate the leg medially, attempting to take pressure off the femoral artery.
B. finish applying the traction splint, as that will free your hands up.
C. rotate the leg laterally, as the fractured bone may be pinching the femoral artery off.
D. attempt to reposition the leg manually by adding additional traction, thus attempting to pull the fractured bone heads apart and placing the leg in its natural position.

Answer 17

D. attempt to reposition the leg manually by adding additional traction, thus attempting to pull the fractured bone heads apart and placing the leg in its natural position.

Question 18

Aside from the pain it causes, when is a dislocation of MOST concern?

A. When it involves tear of blood vessels
B. When a bone has come through the skin
C. When it involves the shoulder
D. When it involves the elbow

Answer 18

A. when it involves the tearing of blood vessels

Question 19

A​ 57-year-old male fell 20 feet while setting up holiday lights on his roof. He impacted the ground feet first and has suffered open fractures to both​ tibias, with both bones protruding through the skin. Your assessment reveals him to be responsive to painful stimuli. His airway is​ open, his breathing is​ rapid, and his radial pulse is weak. The skin is cool and diaphoretic. Vital signs are pulse 132​ beats/min, respirations 24​ breaths/min, and blood pressure​ 106/90 mmHg. According to​ family, the patient has no pertinent medical history. Your partner is providing positive pressure ventilation. At this point in the​ patient’s care, it is a priority for you​ to:

A. Look for other injuries
B. Immobilize the fractures
C. Notify the hospital
D. Cover the patient with a blanket

Answer 19

A. look for other injuries

Question 20

A female lifeguard fell 10 feet from her chair and now has​ deformity, swelling, and ecchymosis to her right lower leg. The leg also is rotated medially. Another lifeguard has taken and is maintaining manual cervical spine motion restriction. As your partner conducts the primary assessment and finds no life threats or disturbances in her mental​ status, you should perform which action​ first?

A. Manually stabilize the lower right leg
B. Ready the traction splint for application
C. Align the leg in a neutral position
D. Check the right foot for pulses and motor ability

Answer 20

A. Manually stabilize the lower leg

Question 21

An alert and oriented auto mechanic had his right thigh pinned between the bumpers of two cars. Assessment findings include deformity and swelling to the right hip area and​ mid-thigh, along with ecchymosis and swelling to the right knee. The patient complains of excruciating pain to the right leg. Which set of instructions given to other EMTs on the scene would be​ appropriate?

A.​”Check for a pedal pulse and then carefully move the patient to the stretcher for​ transport.”
B. ​”We need to wrap the right leg in a pressure dressing and then elevate it for​ transport.”
C. “Let’s provide spine motion restriction precautions​ now, get the patient in the​ ambulance, and then provide more care to the leg en​ route.”
D. ​”Let’s put his leg in the traction splint to help align the femur and reduce​ pain.”

Answer 21

C. “Let’s provide spine motion restriction precautions​ now, get the patient in the​ ambulance, and then provide more care to the leg en​ route.