Chapter 32 - Orthopedic Injuries Flashcards
A “hip” fracture is actually a fracture of the:
Select one:
A. pelvic girdle.
B. femoral shaft.
C. proximal femur.
D. pubic symphysis.
C. proximal femur.
A 17-year-old female dislocated her patella while playing soccer. Her knee is flexed and she complains of severe pain.
You should:
A. make one attempt to return the patella to its normal position.
B. gently straighten her knee and apply a padded board splint.
C. keep her knee flexed and secure it with padded board splints.
D. flex her knee slightly more and assess for distal circulation.
C. keep her knee flexed and secure it with padded board splints.
A 22-year-old female was ejected from her car after striking a tree head-on. As you approach her, you note obvious closed deformities to both of her femurs. She is not moving and does not appear to be conscious.
You should:
A. stabilize her head and perform a primary assessment.
B. assess for a carotid pulse and assist her ventilations.
C. apply manual stabilization to both of her femurs.
D. administer oxygen and perform a rapid assessment.
A. stabilize her head and perform a primary assessment.
A 54-year-old male accidentally shot himself in the leg while cleaning his gun. Your assessment reveals a small entrance wound to the medial aspect of his right leg. The exit wound is on the opposite side of the leg and is actively bleeding. The patient complains of numbness and tingling in his right foot.
You should:
A. gently manipulate the injured leg until the numbness dissipates.
B. control the bleeding and cover the wound with a sterile dressing.
C. assess distal pulses as well as sensory and motor functions.
D. manually stabilize the leg above and below the site of injury.
B. control the bleeding and cover the wound with a sterile dressing.
A fracture is MOST accurately defined as a(n):
Select one:
A. break in the continuity of the bone.
B. total loss of function in a bone.
C. abnormality in the structure of a bone.
D. disruption in the midshaft of a bone.
A. break in the continuity of the bone.
A supracondylar or intercondylar fracture is also known as a fracture of the:
Select one:
A. proximal radius.
B. distal humerus.
C. olecranon process.
D. radial head.
B. distal humerus.
An open fracture is MOST accurately defined as a fracture in which:
Select one:
A. a bullet shatters the underlying bone.
B. bone ends protrude through the skin.
C. a large laceration overlies the fracture.
D. the overlying skin is no longer intact.
D. the overlying skin is no longer intact.
Crepitus and false motion are:
Select one:
A. most common with dislocations.
B. positive indicators of a fracture.
C. indicators of a severe sprain.
D. only seen with open fractures.
B. positive indicators of a fracture.
During your assessment of a 29-year-old female with significant deformity to her left elbow, you are unable to palpate a radial pulse. Your transport time to the hospital is approximately 40 minutes.
You should:
A. apply gentle manual traction in line with the limb and reassess for a pulse.
B. make two or three attempts to restore distal circulation by manipulating the elbow.
C. splint the elbow in the position of deformity and transport immediately.
D. carefully straighten the injured arm and secure it with padded board splints.
A. apply gentle manual traction in line with the limb and reassess for a pulse.
During your secondary assessment of a 30-year-old male who fell 25 feet, you note crepitus when palpating his pelvis. Your partner advises you that the patient’s blood pressure is 80/50 mm Hg and his heart rate is 120 beats/min and weak. After completing your assessment, you should:
Select one:
A. stabilize the pelvis with a pelvic binder and protect the spine.
B. perform a focused physical exam with emphasis on the pelvis.
C. log roll the patient onto a long backboard and transport at once.
D. defer spinal immobilization and transport to a trauma center.
A. stabilize the pelvis with a pelvic binder and protect the spine.
In general, musculoskeletal injuries should be splinted before moving the patient unless:
Select one:
A. transport time is less than 15 minutes.
B. the patient is clinically unstable.
C. deformity and swelling are present.
D. the patient is in severe pain.
B. the patient is clinically unstable.
In which of the following situations should the EMT splint an injured limb in the position of deformity?
Select one:
A. When distal circulation and neurological functions are absent
B. If resistance is encountered or the patient experiences severe pain
C. If transport time to the hospital is greater than 20 to 30 minutes
D. If a traction splint will be used to immobilize the injured extremity
B. If resistance is encountered or the patient experiences severe pain
Skeletal muscle is attached to the bone by tough, ropelike, fibrous structures called:
Select one:
A. fascia.
B. tendons.
C. ligaments.
D. cartilage.
B. tendons.
The MOST significant hazard associated with splinting is:
Select one:
A. compression of nerves, tissues, and vasculature.
B. reduction in circulation distal to the injury site.
C. aggravation of the injury or worsened pain.
D. delaying transport of a critically injured patient.
D. delaying transport of a critically injured patient.
The musculoskeletal system refers to the:
Select one:
A. involuntary muscles of the nervous system.
B. nervous system’s control over the muscles.
C. bones and voluntary muscles of the body.
D. connective tissue that supports the skeleton.
C. bones and voluntary muscles of the body.
When caring for a patient with a possible fracture of the scapula, the EMT should:
Select one:
A. apply rigid board splints across the chest and back.
B. assume that minimal force was applied to the back.
C. recognize that scapular fractures are life threatening.
D. carefully assess the patient for breathing problems.
D. carefully assess the patient for breathing problems.
Which of the following musculoskeletal injuries would MOST likely result in deformity?
Select one:
A. Severe strain
B. Moderate sprain
C. Displaced fracture
D. Hairline fracture
C. Displaced fracture
Which of the following musculoskeletal injuries would pose the greatest threat to a patient’s life?
Select one:
A. Pelvic fracture with hypotension
B. Bilateral femur fractures
C. An amputated extremity
D. Nondisplaced long bone fractures
A. Pelvic fracture with hypotension
Which of the following statements regarding compartment syndrome is correct?
Select one:
A. Compartment syndrome occurs because of increased pressure within the bone cavity.
B. Most cases of compartment syndrome occur following a severe fracture of the pelvis.
C. In most cases, compartment syndrome develops within a few minutes after an injury.
D. Compartment syndrome typically develops within 6 to 12 hours after an injury.
D. Compartment syndrome typically develops within 6 to 12 hours after an injury.
With regard to musculoskeletal injuries, the zone of injury is defined as the:
Select one:
A. part of the body that sustained secondary injury.
B. area of obvious deformity over the site of impact.
C. area of soft-tissue damage surrounding the injury.
D. exact part of the bone or joint that was disrupted.
C. area of soft-tissue damage surrounding the injury.
Which of the following fractures has the greatest potential for internal blood loss and shock?
A.hip
B.femur
C.pelvis
D.humerus
C.pelvis
A 17-year-old football player collided with another player and has pain to his left clavicle. He is holding his arm against his chest and refuses to move it. Your assessment reveals obvious deformity to the midshaft clavicle. After assessing distal pulse, sensory, and motor functions, you should:
perform a rapid secondary assessment.
straighten his arm and apply a board splint.
immobilize the injury with a sling and swathe.
place a pillow under his arm and apply a sling.
immobilize the injury with a sling and swathe.
A construction worker’s arm was severed just above the elbow when a steel girder fell on it. The stump is covered with a blood-soaked towel. The patient’s skin is cool, clammy, and pale. The EMT should:
administer high-flow oxygen to the patient.
remove the towel and inspect the wound.
apply a tourniquet just below the shoulder.
wrap the severed arm in a sterile dressing.
apply a tourniquet just below the shoulder.
The primary purpose for splinting a musculoskeletal injury is to:
prevent further injury.
maximize distal circulation.
make the patient comfortable.
facilitate ambulance transport.
prevent further injury.
Of the following musculoskeletal injuries, which is considered to be the LEAST severe?
Nondisplaced pelvic fracture
Open fractures of a long bone
An amputation of an extremity
Multiple closed long bone fractures
Nondisplaced pelvic fracture
You have applied a zippered air splint to a patient’s left arm. During transport, the patient complains of increased numbness and tingling in his left hand. You reassess distal circulation and note that it remains present. Your MOST appropriate action should be to:
elevate the injured arm and reassess distal sensory function.
inflate the splint with more air until the patient is comfortable.
assess the amount of air in the splint and let air out as necessary.
remove the air splint and reimmobilize with padded board splints.
assess the amount of air in the splint and let air out as necessary.
The pectoral girdle consists of the:
scapulae and clavicles.
clavicles and rib cage.
sternum and scapulae.
acromion and clavicles.
scapulae and clavicles.
The MOST reliable indicator of an underlying fracture is:
guarding.
severe swelling.
obvious bruising.
point tenderness.
point tenderness.
Which of the following structures is regulated by smooth muscle?
Heart
Skeleton
Blood vessels
Diaphragm
Blood vessels
A 76-year-old male experienced sudden pain to his left thigh when he was standing in line at the grocery store. Your assessment reveals ecchymosis and deformity to the distal aspect of his left femur, just above the knee. Distal circulation and sensory and motor functions are intact. You should:
apply a traction splint to realign the deformity.
flex the knee slightly and apply a formable splint.
apply padded board splints to both sides of the leg.
bind the legs together and elevate them 6 to 8 inches.
apply padded board splints to both sides of the leg.
