CH 32 Musculoskeletal Trauma Flashcards
H-1) In a greenstick fracture, the break is: A. incomplete. B. straight through the bone. C. through the skin. D. in several places.
A. incomplete
H-2) A muscle injury resulting from overstretching or overexertion of the muscle is a: A. dislocation. B. fracture. C. sprain. D. strain.
D. strain.
H-3) When the end of a bone is involved in forming a ball-and-socket joint, it will be: A. rounded. B. angled. C. sharp. D. flat.
A. rounded.
When the end of a bone is involved in forming a ball-and-socket joint, it will be rounded to allow for rotational movement. This rounded end, called the head of the bone, is connected to the shaft by the neck.
H-4) The muscles that are of chief concern in trauma and musculoskeletal injury are the \_\_\_\_\_\_\_\_, or voluntary, muscles. A. cardiac B. involuntary C. skeletal D. smooth
C. skeletal
The muscles that are of chief concern in trauma and musculoskeletal injury are the skeletal, or voluntary, muscles. These muscles control all conscious or deliberate motions. The skeletal or voluntary muscles include all the muscles that are connected to bones, as well as the muscles in the tongue, pharynx, and upper esophagus.
H-5) Your patient fell from the roof of a one-story building and landed flat-footed. Damage to the patient's knees would most likely be the result of: A. direct force. B. rotational force. C. indirect force. D. twisting force.
C. indirect force
In this case, injuries to the patient’s knees as well as femurs, pelvis, and spine would be the result of indirect force from the impact with the ground, whereas direct force would likely cause injuries to the feet and ankles.
H-6) Most injuries to the upper extremities are caused by:
A. assault or abuse.
B. athletic injuries.
C. forces applied to an outstretched arm.
D. penetrating trauma.
C. forces applied to an outstretched arm
Forces applied to an outstretched arm are the most common cause of upper extremity injuries
H-7) You are summoned to the aid of a 45-year-old male who was hunting and fell from a tree stand. When you arrive, he is experiencing severe pain in his lower right thigh. On examination, you find that an area about three inches above his right knee has an open wound about one inch in diameter that is bleeding minimally. There are no exposed bones, but you palpate crepitus and see swelling that makes you suspect bone fracture. You would you classify this as a(n): A. open extremity injury. B. sprain. C. closed extremity injury. D. dislocation.
A. open extremity injury
This would be classified as an open extremity injury, which is an extremity injury in which the skin has been broken or torn through from the inside by an injured bone or from the outside by something that has caused a penetrating wound with associated injury to the bone
H-8) A patient has been exercising too much, which has led to a muscle injury in his right shoulder due to too much strenuous activity involving that muscle. This is a: A. sprain. B. fracture. C. strain. D. dislocation.
C. strain
H-9) Your patient fractured her right wrist in a motor vehicle collision. You notice swelling, redness, and tenderness distal to the site. The patient is wearing a ring and a bracelet. The ring slides off her finger easily but the bracelet is tight against the swelling. You should:
A. slide off the ring and cut off the bracelet.
B. leave both the ring and bracelet in place.
C. cut off the bracelet but leave the ring in place.
D. slide off the ring but leave the bracelet in place.
A. slide off the ring and cut off the bracelet
When bones break and soft tissue is torn, bleeding causes swelling that may increase the proportions of a deformity. Rings, watches, and other jewelry can easily constrict and injure underlying tissue. Therefore, slide or cut them off as soon as possible if swelling is likely to occur.
H-10) Which of the following is one of the "six Ps" of assessing compromise to an extremity when a musculoskeletal injury is suspected? A. Putrescence B. Pressure C. Proximity D. Probability
B. Pressure
Pressure is one of the “six Ps” of assessing compromise to an extremity when a musculoskeletal injury is suspected. The others are pain, pallor, paresthesia, pulses, and paralysis.
H-11) When treating a patient with musculoskeletal injuries, after addressing any life-threatening conditions, splint:
A. injuries to the legs.
B. injuries to the arms.
C. any suspected extremity fracture.
D. any fracture that has broken the skin.
C. any suspected extremity fracture
H-12) Why should you not let a grotesque but relatively minor extremity injury sidetrack you or the patient when assessing a patient with musculoskeletal injuries?
A. The pain or terrible appearance of an extremity injury may distract the patient and you from awareness of other injuries or symptoms.
B. It’s important to remember where you are in the assessment process to make sure you follow the steps correctly.
C. You will treat any musculoskeletal injury the same way, and so it’s wrong to assign importance to injuries based on appearance.
D. The more apparently gruesome an injury is, the less likely it is to actually be serious.
A. The pain or terrible appearance of an extremity injury may distract the patient and you from awareness of other injuries or symptoms
In cases of severe extremity trauma, injuries can be very obvious. However, when treating trauma patients, your priority must be to rapidly identify and treat life-threatening conditions first. Do not let a grotesque but relatively minor extremity injury sidetrack you - or the patient. The pain or terrible appearance of an extremity injury may distract the patient from awareness of other injuries or symptoms, such as abdominal pain from internal bleeding. Be sure to assess the patient fully and ask appropriate questions to avoid missing other injuries.
H-13) As you care for a patient with a possible lower leg injury, you should assess the distal pulse, motor function, and sensation:
A. only before applying a splint to the leg.
B. both before and after applying a splint to the leg.
C. every 5 minutes until arrival at the hospital.
D. only after the application of a splint to the leg.
B. both before and after applying a splint to the leg
It is important for the EMT to check the patient’s distal pulses, motor function, and sensation both before and after splinting bone and joint injuries. Document your findings in the prehospital care report.
H-14) If the primary assessment reveals an unstable patient, splinting of individual extremity injuries:
A. must be done with a traction splint applied to all injured extremities as soon as possible.
B. becomes a low priority.
C. must be done for each individual injury site before transport.
D. is done during the assessment of circulation during the primary assessment.
B. becomes a low priority
If the primary assessment reveals that the patient is unstable, management of individual extremity injuries becomes a low priority. Do not waste time splinting each injury individually. Wasting time splinting individual injuries is often called “splinting the patient to death.”
H-15) You are treating a 17-year-old female who fell while playing basketball. Her right thigh is painful, swollen, and deformed. She is in considerable pain. The most appropriate device for splinting her injury would be a: A. inflatable splint. B. pneumatic anti-shock garment. C. traction splint. D. pair of long board splints.
C. traction splint
When a patient has a suspected isolated femur fracture (painful, swollen, and deformed thigh, and a leg that is flexed and will not straighten), the most appropriate splint is the traction splint
H-16) If a commercial pelvic splint is not available, the next best alternative is:
A. backboard straps and a long wooden splint.
B. a pelvic wrap improvised from a sheet.
C. a sling and swathe.
D. cot straps and a backboard.
B. a pelvic wrap improvised from a sheet
If a commercial pelvic splint is not available, an improvised pelvic wrap may be applied using a sheet.
PT-1) To stabilize a hip fracture, how should you bind the legs together?
A. Place a folded blanket between the patient’s legs and bind the legs together with wide straps, Velcro-equipped straps, or wide cravats.
B. Secure the patient to a long spine board and then bind the patient’s ankles together with a wide strap or Velcro-equipped strap.
C. Place the patient on a long spine board and bind the patient’s legs against the board with wide cravats or straps.
D. Place the patient on an orthopedic stretcher and then bind the ankles and thighs to the stretcher with wide straps.
A. Place a folded blanket between the patient’s legs and bind the legs together with wide straps, Velcro-equipped straps, or wide cravats.
PT-2) For a high-priority, unstable patient with musculoskeletal injuries, you should:
A. apply a cervical collar and then splint specific injuries before transport.
B. splint specific injuries before transport.
C. position the patient on the less injured side and then “load and go.”
D. immobilize the whole body on a long spine board and “load and go.”
D. immobilize the whole body on a long spine board and “load and go.”
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PT-3) The humerus is an example of a(n): A. appendicular bone. B. irregular bone. C. axial bone. D. flat bone.
A. appendicular bone
PT-4) What is the primary concern about a splint that is applied too loosely?
A. It could cause pressure sores to develop from skin rubbing against the splint.
B. It could allow the bone fragments to move, which could cause further damage.
C. The splint will cut off distal circulation.
D. The patient will lose motor function in that extremity.
B. It could allow the bone fragments to move, which could cause further damage.
PT-5) The first step in the progression of compartment syndrome is that:
A. cellular damage occurs and causes additional swelling.
B. pressure and swelling caused by bleeding within a muscle compartment become so great that the body can no longer perfuse the tissues against the pressure.
C. a fracture or crush injury causes bleeding or swelling in an extremity.
D. blood flow to the area is lost, and the limb itself may be lost if the pressure is not relieved.
C. a fracture or crush injury causes bleeding or swelling in an extremity.
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PT-6) A fracture that results in multiple bone pieces at the fracture site is termed a: A. crush fracture. B. spiral fracture. C. fracture dislocation. D. comminuted fracture.
D. comminuted fracture.
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PT-7) Which of the following is the best sign of a pelvic injury?
A. Pain in the pelvis, significant mechanism of injury, obvious deformity
B. Significant mechanism of injury, pain in the back, no obvious deformity
C. Rotational injury to the spine, no pain in the pelvis or obvious deformity
D. Pain in the pelvis, no significant mechanism of injury
A. Pain in the pelvis, significant mechanism of injury, obvious deformity
PT-8) To see the effect of direct force, you would look at:
A. areas adjacent to the point of impact.
B. all areas of the patient’s body.
C. the area of the point of impact.
D. any part of the patient that could have rotated from the impact.
C. the area of the point of impact.
PT-9) The first effects of a bone injury are swelling of soft tissue and:
A. tearing of cartilage connected to the bone.
B. strain of muscles and sprain of ligaments associated with the bone.
C. referred pain from the injury to associated muscle and bone groups.
D. the formation of a blood clot in the area of the fracture.
D. the formation of a blood clot in the area of the fracture.
P-10) A 22-year-old female patient slipped running down stairs, and has injured her right tibia and fibula. You have used an air splint to splint the injury. To test the splint, you can:
A. drum your fingers briefly on the side of the splint.
B. gently brush the length of the split with your fingertips.
C. see if you can cause a slight dent in the plastic with fingertip pressure.
D. ask the patient if the splint is tight enough without being painful.
C. see if you can cause a slight dent in the plastic with fingertip pressure.
P-11) When palpating a fracture site on a patient's mid-thigh, you notice a grating sensation. This is known as: A. crepitus. B. stridor. C. bone grind. D. thrill.
A. crepitus
PT-12) A fracture may be classified as: A. common or uncommon. B. simple or complex. C. total or partial. D. open or closed.
D. open or closed.
PT-13) If you see angulation when assessing a patient, then:
A. the patient is bending the knees or arms.
B. a bone or bones are out of anatomical position.
C. the patient’s distal pulse must be reassessed.
D. splinting is unlikely to be of assistance.
B. a bone or bones are out of anatomical position.
PT-14) In a dislocation, what structures other than the joint capsule are likely to be injured? A. Muscles B. Ligaments C. Skin and subcutaneous tissue D. Tendons
B. Ligaments
PT-15) When treating a patient with an open musculoskeletal injury to the thigh, how would you best treat the open wound?
A. Cover the open wound with a sterile dressing, pack it with ice, and wrap it with self-adhesive bandages.
B. Cover the open wound with a sterile dressing, elevate the extremity, and apply a cold pack to the area to help reduce swelling.
C. Cover the wound with bulky dressings, keep the extremity level, and transport immediately.
D. Splint the wound, cover it with compression bandages, and transport as soon as possible.
B. Cover the open wound with a sterile dressing, elevate the extremity, and apply a cold pack to the area to help reduce swelling.
