Ch. 17: Musculoskeletal Injuries

Question 1

Types of musculoskeletal injuries (5):

Answer 1

1. Fracture
2. Sprains
3. Strains
4. Dislocations
5. Avulsions/Ruptures

Question 2

What is a fracture?

Answer 2

Break in bone

Question 3

What is a sprain?

Answer 3

Injury to ligament,

MOI: tension force

Question 4

Types of fractures:

Answer 4

1. Greenstick
2. Spiral
3. Comminuted
4. Transverse
5. Compound (Kevin Ware)

Question 5

Purpose of ligaments:

Answer 5

hold bones together

Question 6

What is a strain?

Answer 6

Injury to muscles and tendons

MOI: tension or contraction force

Question 7

Purpose of tendons:

Answer 7

Attach muscle to bones

Question 8

What is a dislocation?

Answer 8

Displacement of bones in a joint from normal position

Question 9

What is an avulsion/rupture?

Answer 9

Complete tear of tendon from bone

Question 10

What are some specific fractures?

Answer 10

1. Colles Fracture
2. Boxer’s Fracture
3. Pott’s Fracture

Question 11

What is a colles fracture?

Answer 11

1. Dinner fork bend in arm
2. MOI: FOOSH, fall on out stretched hand
3. Fracture of the distal radius with dorsal angulation

Question 12

What does angulation mean?

Answer 12

Bend formation

Question 13

What is a boxer’s fracture?

Answer 13

1. Fracture of 5th metacarpal

2. MOI: hitting object with fist

Question 14

What is a pott’s fracture?

Answer 14

1. Fracture of the medial and/or lateral malleolus

2. MOI: ankle fracture

Question 15

What are the different classifications for strains and sprains? (Grades)

Answer 15

1. Grade I Mild
2. Grade 2 Moderate
3. Grade 3 Severe

Question 16

Describe a Grade I strain/sprain:

Answer 16

Mild tear or stretch of tissue, still functions properly, full range of motion

Question 17

Describe a Grade 2 strain/sprain:

Answer 17

Partial tear of tissues, still intact, altered function

Question 18

Describe a Grade 3 strain/sprain:

Answer 18

Complete tear, loss of function

Question 19

What are some MOI of musculoskeletal injuries?

Answer 19

1. Compression
2. Tension
3. Shearing
4. Bending
5. Torsion

Question 20

When is the MOI determined when you are accessing a patient?

Answer 20

Learned during the H (history) of HOPS assessment

Question 21

What is a direct force?

Answer 21

Trauma applied at point of injury

Question 22

What is an indirect force?

Answer 22

Force transmits and injures other areas

Question 23

What is a twisting force?

Answer 23

One aspect fixed, other rotates

Question 24

What are the three forces of MOI:

Answer 24

1. Direct
2. Indirect
3. Twisting

Question 25

How to assess musculoskeletal injuries?

Answer 25

1. History 2. Position of body found 3. S&S 4. Check associated or collateral injuries

Question 26

S&S of musculoskeletal injuries:

Answer 26

1. Pain and Tenderness 2. Exposed bone 3. Grading or crepitus (rice krispy bones) 4. Loss of function 5. Joint locked into positions or dislocation 6. Deformity 7. Swelling/discoloration

Question 27

What is an associated or collateral injury?

Answer 27

Damage caused to other systems of the body

Question 28

How to care for bones and joints (9):

Answer 28

1. PPE 2. Monitor CAB (primary survey) 3. Check for spinal 4. Treat for shock 5. Control severe bleeding 6. Check pulse and capillary refill distal to injury 7. Check motor function 8. Splint 9. Assess for complications (compartment syndrome)

Question 29

What is compartment syndrome? Ex: Elephantitus

Answer 29

Increased pressure that compresses muscles, nerves, and blood vessels

Question 30

Is compartment syndrome a medical emergency?

Answer 30

Yes

Question 31

How do you assess for compartment syndrome? 5 P's

Answer 31

1. Pain 2. Pallor 3. Paresthesia 4. Paralysis 5. Pulselessness

Question 32

Benefits of immobilizing injuries (5):

Answer 32

1. Reduce pain/swelling 2. Prevent further injury 3. May reduce blood loss 4. Increase rate of healing 5. Prevents closed fractures from opening skin

Question 33

5 General Splinting Rules:

Answer 33

1. Immobilize critical patients with spine board firsts 2. Splint when in doubt 3. Splint before movement 4. Use padded splints 5. Remove clothing that impede treatment

Question 34

Other general rules of splinting:

Answer 34

1. Splint in position found 2. Immobilize above and below the injury 3. Immobilize entire length of bone 4. Check neurovascular function before and after splint (PMS) 5. Pulse, motor, and sensory functions 6. Wound care

Question 35

Post-splint application:

Answer 35

1. Check capillary refill/distal pulse 2. Check motor function 3. Check distal sensation 4. Transport

Question 36

Splinting considerations

Answer 36

1. Not too tight | 2. Not too loose

Question 37

Types of splints (8):

Answer 37

1. Rigid 2. Vacuum 3. Pneumatic (air) 4. Sling & Swathe 5. Traction 6. Plaster/fiberglass 7. Soft 8. Improvised

Question 38

When do you spine board?

Answer 38

1. Neck or back fracture, dislocation suspected 2. Spine injury with paralysis 3. Hip dislocation 4. Pelvic fracture 5. Need to transport

Question 39

When to ship to hospital?

Answer 39

1. Open fracture 2. Dislocations 3. Fracture results in shock 4. Fracture that can not be adequately immobilized 5. All suspected fractures and dislocations should be referred for x-ray