44 orthopedic trauma Flashcards
1
Q
When assessing musculoskeletal injuries, how should paramedics treat any injuries found?
A.
Make every attempt to diagnose the injury correctly.
B.
Do not be concerned with differentiating among sprains, strains, and fractures.
C.
Manage patients as though they have a fracture.
D.
Manage patients as though they have a strain.
A
C
2
Q
What is the most common anatomical site for a stress fracture? A. Hands C. Lower leg B. Spine D. Foot
A
D
3
Q
What is a break that occurs at an angle across a bone called? A. Open fracture C. Greenstick fracture B. Comminuted fracture D. Oblique fracture
A
D
4
Q
What does a fracture of a child’s bone at the epiphyseal plate commonly lead to? A. Infection B. Permanent angulation or deformity of the extremity C. Frequent breakage of bones in the future D. Torn ligaments and tendons
A
B
5
Q
Sprains are categorized according to what aspect? A. Type of tissue involved C. Number of cartilages damaged B. Type of tendons damaged D. Extent of ligament damage
A
D
6
Q
What does a second-degree sprain usually result in? A. An unstable joint C. A dislocated joint B. Swelling and ecchymosis D. Vascular compromise
A
B
7
Q
To reduce pain and swelling in the first 24 hours after a sprain, what should be provided?
A.
Ice
B.
Warm soaks
C.
Heat first, then ice once the muscles are warmed
D.
Heat and ice, alternating every 3 to 4 hours
A
A
8
Q
Which musculoskeletal injury may result in the avulsion of a bone from its attachment site? A. Strain C. Bursitis B. Sprain D. Arthriti
A
A
9
Q
Paramedics are called to the scene of an industrial injury. A19-year-old male injured his finger in a hydraulic press. The skin over the affected finger is still intact, but the finger has apparently been completely dislocated at the proximal joint. What is the term given to this type of dislocation? A. Luxation C. First-degree dislocation B. Subluxation D. Third-degree dislocation
A
A
10
Q
What is the most common type of arthritis? A. Osteoarthritis C. Gouty arthritis B. Rheumatoid arthritis D. Autoinflammatory arthritis
A
A
11
Q
Paramedics are treating a patient who has a history of rheumatoid arthritis. Why did the arthritis develop? A. Wear and tear on the joints C. Uric acid accumulation B. An autoimmune disorder D. A previous fracture
A
B
12
Q
What is an easy way to remember the various components of musculoskeletal injury assessment? A. The mnemonic ARM-LEGS B. The mnemonic TIC C. The six Ps of musculoskeletal assessment D. The four Ms of musculoskeletal assessment
A
C
13
Q
In the mnemonic memory device DCAP-BTLS, what does the “S” stand for? A. Severity C. Sensation B. Swelling D. Subluxation
A
B
14
Q
A 71-year-old female has fallen from a standing position. She is complaining of pain in her left leg. Her left leg is shortened and externally rotated. What is the most likely injury?
A.
Hip dislocation
B.
Fracture of the midshaft femur
C.
Hip fracture with a dislocated femur head
D.
Hip fracture at the femoral head and neck
A
D
15
Q
Which injury is most likely to be limb threatening? A. Fracture of the humerus C. Open tibia-fibula fracture B. Hip dislocation D. Subcondylar fracture of the elbow
A
D
16
Q
When should a fracture or dislocation be realigned? A. The patient reports extreme pain. C. The site is bleeding. B. Circulation is impaired. D. The lower leg is involved.
A
B
17
Q
In the prehospital setting, what should never be manipulated? A. Hip C. Shoulder B. Elbow D. Knee
A
B
18
Q
Once the decision has been made to realign a fracture site, what care should the paramedic undertake?
A.
Make only one attempt at realignment.
B.
Continue realignment attempts until distal pulses are present.
C.
Continue realignment attempts until the gross deformity has been reduced.
D.
Wait to perform the procedure and realign only if the patient loses distal circulation.
A
A
19
Q
As a rule, what is the standard of care for fractures and dislocated joints? A. Reduce in the field. C. Immobilize with a soft splint. B. Reposition in the field. D. Immobilize in the position of injury.
A
D
20
Q
A “silver-fork” fracture refers to what area of the body? A. Ribs C. Distal radius B. Mandible D. Proximal tibia
A
C
21
Q
A 73-year-old female has fallen getting out of the shower. When paramedics arrive, the patient is complaining of a considerable amount of left proximal leg pain. The affected leg is shortened and internally rotated. This presentation is typical of what type of injury? A. Distal femur fracture C. Dislocation of the knee B. Dislocation of the hip D. Proximal femur fracture
A
B
22
Q
A 19-year-old female who is complaining of a considerable amount of knee pain has minimal swelling and no gross deformity at the left lateral knee joint. The patient states that she twisted her knee stepping off of a 3-foot bleacher. Assuming this patient has injured only her ligaments, what is the most likely type of injury? A. Strain C. Fracture B. Sprain D. Bone avulsion
A
B
23
Q
Which statement is correct regarding the use of traction splints?
A.
Traction splints are used for isolated midshaft femur fractures.
B.
Traction splints are used for dislocations of the knee with associated femur fracture.
C.
Traction splints are used to reduce open, midshaft, long-bone fractures.
D.
Traction splints are used for proximal femur fractures or hip dislocations.
A
A
24
Q
Traction splints are designed specifically for what type of injuries? A. Knee dislocations C. Pelvic fractures B. Tibia fractures D. Femur fractures
A
D
25
```
A 42-year-old female fell from a second story balcony and landed on her outstretched right arm. There is a gross deformity at the shoulder. The patient is unconscious. How should paramedics address immobilization of the deformed right shoulder?
A.
Apply a sling.
B.
Apply a traction splint.
C.
Apply a sling and swathe.
D.
Immobilize the patient to a long backboard.
```
D
26
```
An elderly man complains of severe pain in his upper thigh and hip after a fall. The leg on the affected side is shortened and internally rotated. Which action would be appropriate?
A.
Apply a PASG and inflate the leg segments.
B.
Apply a traction splint.
C.
Attempt to reduce the dislocation.
D.
Pad behind the knee for comfort.
```
D
27
```
A 34-year-old male injures his shoulder while playing softball. There is swelling at the left shoulder where the clavicle meets the proximal humerus. If this is the patient’s only injury, what device should be used for immobilization?
A.
Rigid splint
C.
Short backboard
B.
Long backboard
D.
Sling and swathe
```
D
28
Paramedics are called to a local skating rink for a 42-year-old female who fell. She is complaining of severe elbow pain and is supporting the affected limb against her body. To manage this situation effectively, how should the paramedics care for the injury?
A.
Splint the arm in the position found, using a traction splint.
B.
Rotate the arm to 90 degrees and secure it with a rigid splint.
C.
Splint the arm in the position found, using a pillow or blanket.
D.
Rotate the arm to 90 degrees and secure it with a sling and swathe.
C
29
```
What does immobilization of an injured extremity require?
A.
Only one rescuer
C.
At least three rescuers
B.
At least two rescuers
D.
A full four-person crew
```
B
30
What doe the technique “buddy splinting” refer to?
A.
Arm is secured to a rigid splint.
B.
Arm is secured to a long backboard.
C.
Finger or toe is taped to an adjacent but uninjured finger or toe.
D.
Leg is secured by holding the injury in place against a long backboard.
C
31
A 17-year-old male has been involved in a motorcycle crash. Based on a physical assessment, the medical direction the physician advises paramedics to apply is both a traction splint and the pneumatic antishock garment (PASG). You should:
A.
Apply the traction splint first, then apply and inflate the PASG.
B.
Apply the PASG first, inflate the PASG, and then apply the traction splint.
C.
Apply the PASG first, then apply the traction splint, and, finally, inflate the PASG.
D.
Advise medical control that these two devices cannot be used together.
B
32
After consulting with medical direction, a decision has been made to attempt realignment of a badly angulated tibia-fibula fracture. While attempting to realign the bone fragments, paramedics observe obvious anatomical resistance. How should the paramedics proceed?
A.
Pull harder.
B.
Cease their efforts to realign and splint the limb in this position.
C.
Administer a muscle relaxant and reattempt realignment.
D.
Gently rotate the limb, reapply traction, and then splint the limb.
B
33
Before manipulating any injured extremity, what action must a paramedic implement first?
A.
Position the patient on a long backboard.
B.
Place the patient on high-flow oxygen.
C.
Assess distal pulses, sensation, and motor function.
D.
Administer intravenous analgesic per medical direction.
C
34
A 23-year-old male with a hand injury states that he hit a brick wall when he missed his intended target. The patient’s knuckles and the entire back of his hand are edematous and painful. His hand has very limited movement of the distal phalanges. His hand is open and his fingers are bent. What is the best way to immobilize this injury?
A.
Immobilize the hand in a position of function.
B.
Straighten the fingers and then immobilize the hand.
C.
Close the hand into a fist and then immobilize the hand.
D.
“Buddy splint” the fingers together.
A
35
```
A patient injured his hand while punching someone with a closed fist. Where should the paramedic anticipate his injury to be?
A.
Fifth metacarpal
C.
Second phalange
B.
First carpal
D.
Thumb
```
A
36
```
How much blood loss can be a result of a fractured femur?
A.
250 mL
C.
1000 mL
B.
500 mL
D.
2000 mL
```
C
37
```
Which fracture site can hold the most blood?
A.
Humerus
C.
Femur
B.
Tibia
D.
Pelvis
```
D
38
```
The fracture of this patient’s pelvis can result in how much blood loss?
A.
500 mL
C.
2000 mL
B.
1000 mL
D.
5000 mL
```
C
39
When assessing his pelvis, what should paramedics remember when doing a visual inspection?
A.
Does not require exposing the patient because most injuries will be obvious
B.
Should not be performed so as to protect the patient’s modesty
C.
Should be examined with the patient standing so that anatomical differences can be appreciated
D.
May not help identify injuries because of the amount of muscle and other tissues in this region
D
40
```
What are other injuries associated with this mechanism of injury?
A.
Ruptured spleen
C.
Urethral injury
B.
Lacerated kidney
D.
Tentorial contusion
```
C
41
```
What does immobilization of a suspected fractured pelvis require?
A.
A traction splint
C.
Two long rigid splints
B.
Two traction splints
D.
A padded, long spine board
```
D
42
A 43-year-old female injured her ankle while sliding into home base. There is a gross deformity at the joint that appears consistent with a severe dislocation. She is in a tremendous amount of pain and has extreme difficulty when trying to wiggle her toes. Her distal pulse is weak. Proper intervention would include analgesics and what other intervention?
A.
Splinting the injury in the position found, using a pillow or blanket
B.
Attempted realignment by pulling on the toes
C.
Attempted realignment by pulling on the talus
D.
Attempted realignment by taking the ankle through its full range of motion
C
43
```
What type of dressing is most appropriate to cover an open fracture site?
A.
Occlusive
B.
Dry, sterile gauze
C.
Moistened, sterile gauze
D.
Sterile gauze moistened with an antiseptic solution
```
B
44
If bone ends are exposed at a fracture site, how should the paramedic care for the injury?
A.
Covered with a dry sterile dressing and splinted
B.
Continuously irrigated with water to keep them from drying
C.
Splinted but not covered with dressings to avoid pushing the bone fragments back under the skin
D.
Replaced to their correct anatomical position, covered with a sterile moistened dressing, and splinted
A
45
A 12-year-old girl has fallen out of a tree from approximately 8 feet above the ground. Upon arrival, paramedics observe a portion of the ulna protruding through the patient’s forearm. Later, during reevaluation, the bone has retracted under the skin. How should the paramedics proceed?
A.
Attempt to re-expose the bone end for field debridement.
B.
Irrigate the wound thoroughly for at least 20 minutes.
C.
Cover the wound with an occlusive dressing.
D.
Report their observation to the receiving facility for subsequent surgical debridement.
D
46
What statement most accurately reflects open fractures?
A.
A bone end protruding through the skin
B.
Both ends of the bone protruding through the skin
C.
Visible bone but not necessarily protruding through the skin
D.
A break in the skin with or without presenting bone parts
D
47
```
What is a situation that warrants a paramedic to attempt manipulation of a dislocation or angulated fracture?
A.
To aid in transportation
C.
To assist in the comfort of the patient
B.
To apply a traction splint
D.
To aid on long backboarding
```
A
48
```
What joint injury should never be manipulated in the prehospital setting?
A.
Elbow
C.
Knee
B.
Wrist
D.
Shoulder
```
A
49
```
How many attempts at realignment can a paramedic perform with the aid of analgesics?
A.
One
C.
Three
B.
Two
D.
As many as needed
```
A
