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Paramedic Care Volume 5 - Trauma > Chapter 7 - Orthopedic Trauma > Flashcards

Chapter 7 - Orthopedic Trauma Flashcards

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1
Q

Musculoskeletal injuries can include injury to

A

pg 151

bones.

muscles.

tendons.

ligaments.

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2
Q

Which of the following is NOT a function performed by the musculoskeletal system?

A. Vital organ protection
B. A portion of the immune response
C. Storage of material necessary for metabolism
D. Hemopoietic activities
E. Efficient movement against gravity

A

pg 152

B. A portion of the immune response

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3
Q

The bone cell responsible for maintaining bone tissue is the

A

pg 152

osteocyte.

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4
Q

The bone cell responsible for dissolving bone tissue is the

A

pg 152

osteoclast.

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5
Q

The central portion of a long bone is called the

A

pg 152

diaphysis.

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6
Q

The transitional area between the end and central portion of the long bone is called the

A

pg 153

metaphysis.

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7
Q

The type of bone tissue filling the end of the long bone is called the

A

pg 153

cancellous bone.

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8
Q

The covering of the shaft of the long bones that initiates the bone repair cycle is the

A

pg 153

periosteum.

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9
Q

Immovable joints such as those of the skull are termed

A

pg 153

synarthroses.

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10
Q

The smooth, flexible structures that act as the actual articular surface of joints are the

A

pg 153

cartilages.

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11
Q

The elbow is an example of which type of joint?

A

pg 154

Monaxial

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12
Q

Bands of strong material that stretch and hold the joint together while permitting movement
are the

A

pg 154

ligaments.

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13
Q

The small sacs filled with synovial fluid that reduce friction and absorb shock are the

A

pg 155

bursae.

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14
Q

The most commonly fractured bone in the body is the

A

pg 156

clavicle.

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15
Q

Which of the following is a bone of the upper arm?

A

pg 156

Humerus

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16
Q

Which of the following is a bone of the palm of the hand?

A

pg 156

Metacarpal

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17
Q

Which of the following is the bone of the thigh?

A

pg 156

Femur

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18
Q

Skeletal maturity is reached by age

A

pg 157

age 20

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19
Q

The muscular system consists of about how many muscle groups?

A

pg 157

600 muscle groups

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20
Q

The muscle attachment to the bone that moves when the muscle mass contracts is the

A

pg 160

insertion

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21
Q

T/F - More than half the energy created by muscle motion is in the form of heat energy.

A

pg 161

True

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22
Q

T/F - Contusion can account for significant fluid loss into the more massive muscles of the body.

A

pg 161

True

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23
Q

A specific sign associated with compartment syndrome is

A

pg 162

pain when flexing the foot.

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24
Q

The condition in which exercise draws down the supply of oxygen and energy reserves and
metabolic waste products accumulate, limiting the ability of a muscle group to perform is
called

A

pg 162

fatigue.

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25
Q

The tissue that is normally damaged in a sprain is the

A

pg 162

ligament.

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26
Q

The overstretching of a muscle that presents with pain is a

A

pg 162

strain.

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27
Q

What fractures are relatively stable?

A

pg 164

Hairline & Impacted

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28
Q

Which of the following fractures is most likely to be open?

A. Fibula D. Humerus
B. Tibia E. Ulna
C. Femur

A

pg 163

Tibia

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29
Q

T/F - In serious long-bone fractures, especially those that are manipulated after injury, there is the
possibility of fat embolizing and becoming lodged in the lungs.

A

pg 164

True

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30
Q

Which of the types of fracture is likely to occur only in the pediatric patient?

A

pg 165

Greenstick.

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31
Q

The bones of the elderly are likely to be

A. less flexible.
B. more brittle.
C. more easily fractured.
D. more slow to heal.
E. all of the above.

A

pg 165

E. all of the above.

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32
Q

T/F - The dislocation, or fracture, in the area of a joint is generally less significant than the
long-bone shaft fracture because it does not have as high an incidence of vascular and nervous
injury.

A

pg 166

False

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33
Q

T/F - The energy and degree of manipulation needed to cause further injury after a bone has broken
are much less than was initially needed to cause the fracture.

A

pg 166

True

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34
Q

The growth of bone that comes after a fracture and encapsulates the fracture site is called the

A

pg 166

callus.

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35
Q

What is caused by a buildup of uric acid crystals in the joints?

A

pg 167

Gout

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36
Q

An inflammation of the small synovial sacs that reduces friction and cushions tendons from
trauma is

A

pg 166

Bursitis.

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37
Q

Which of the following is an indication for fluid resuscitation in the patient with skeletal
injury?

A. Pelvic fracture D. Hip dislocation
B. Serious tibial fracture E. Both A and C
C. Femur fracture

A

pg 168

E. Both pelvic fracture & femur fracture

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38
Q

With which fractures should you consider immediate transport of the patient because
of possible internal blood loss?

A

pg 168

Both pelvic fracture & femur fractures

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39
Q

When assessing a limb for possible fracture, you should examine distally for

A

pg 169

sensation.

crepitus.

motor strength.

circulation.

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40
Q

A patient complains of a deep burning pain out of proportion with the apparent injury, and a
serious crushing-type mechanism has caused his calf to feel “almost board hard.” What injury
would you suspect?

A

pg 170

Compartment syndrome

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41
Q

An elderly patient who has suffered a fracture because of bone degeneration is expected to
experience what level of pain when compared to a traumatic fracture?

A

pg 170

Less pain

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42
Q

T/F - the effects of the fight-or-flight response wear off, the symptoms of fracture will become
less evident.

A

pg 170

False

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43
Q

It is essential to tell the patient that limb alignment will cause some increased pain because this
will help maintain his confidence in you.

A

pg 171

True

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44
Q

In general, long-bone shaft fractures should be splinted

A

pg 172

aligned, except if resistance is experienced.

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45
Q

T/F - Any fracture within 3 inches of the joint should be treated the same way as a dislocation.

A

pg 172

True

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46
Q

What position is ideal for the immobilization of most extremity injuries?

A

pg 172

Neutral

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47
Q

Ascending to altitude in a helicopter will cause the pressure in the air splint to

A

pg 174

increase

48
Q

The traction splint is designed to splint which musculoskeletal injury?

A

pg 174

Midshaft femur fracture

49
Q

Which of the following is a disadvantage of the vacuum splint when applying it
fractures?

A. It is difficult to apply.
B. It is bulky and heavy.
C. It shrinks slightly during application.
D. It takes more than two rescuers to apply.
E. All of the above.

A

pg 174

C. It shrinks slightly during application.

50
Q

Align a seriously angulated long-bone fracture unless

A

pg 76

you meet with resistance.

51
Q

If after moving a limb to alignment you notice the distal pulse is absent, you shoud

A

pg 176

gently move the limb to restore the pulse.

52
Q

T/F - With joint injury you should not move the limb, even to restore circulation or sensation.

A

pg 176

False

53
Q

Early reduction of a dislocation usually results in which of the following?

A

pg 176

Less stress on the ligaments

Better distal sensation

Less stress on the joint structure

Better distal circulation

54
Q

Signs that a reduction of a dislocation has been effective include

A

pg 176

feeling a “pop.”

less deformity of the joint.

patient reports of less pain.

greater mobility in the joint.

55
Q

Heat may be applied to a muscular injury

A

pg 176

after 48 hours.

56
Q

The splinting device recommended for a painful and isolated fracture of the femur is

A

pg 178

the traction splint.

57
Q

The splinting device recommended for a painful and isolated fracture of the tibia is the

A

pg 178

padded board splint.

58
Q

The splinting device(s) recommended for an isolated fracture of the humerus is (are) the

A

pg 179

sling and swathe & the padded board splint.

59
Q

The fracture of the forearm close to the wrist that presents with the “silver fork” deformity is
called:

A

pg 179

Colles’ fracture.

60
Q

An anterior hip dislocation normally presents with the

A

pg 179

foot turned outward.

61
Q

T/F - In general, anterior dislocations of the hip can be reduced in the prehospital setting.

A

pg 180

False

62
Q

Which of the following is NOT a sign of patellar dislocation?

A. Knee in the flexed position

B. Significant joint deformity

C. Extremity drops at the knee

D. Lateral displacement of the patella

A

pg 180

Extremity drops at the knee

63
Q

If a patient presents with an ankle deformed with the foot turned to the side, you would suspect
which type of ankle dislocation?

A

pg 181

Lateral ankle dislocation

64
Q

If a patient presents with an ankle deformed with the foot pointing upward, you should suspect
which type of ankle dislocation?

A

pg 181

Anterior ankle dislocation

65
Q

When a patient’s shoulder appears “squared-off,” the patient complains of severe pain, and she
cannot move her arm, you should suspect what type of shoulder dislocation?

A

pg 181

Anterior shoulder dislocation

66
Q

T/ F - The elbow dislocation is a simple injury but one that is essential to reduce in the field.

A

pg 181

False

67
Q

Which injuries can be adequately splinted by using the short padded board
splint, placing the hand in the position of function, and slinging and swathing the extremity?

A

pg 182

Radial fractures

Finger fractures

Ulnar fractures

Wrist fractures

68
Q

Morphine in the prehospital setting

A. reduces anxiety.

B. reduces the perception of pain.

C. sedates the patient.

D. may cause respiratory depression

E. all of the above.

A

pg 183

E. all of the above.

69
Q

Which of the following is NOT an analgesic that is used to control the pain of musculoskeletal
injuries?

A. Meperidine D. Diazepam
B. Morphine E. Astramorph
C. Nalbuphine

A

pg 183

D. Diazepam

70
Q

The “I” within the acronym RICE used by athletic trainers stands for

A

pg 183

Ice for the first 48 hours.

71
Q

What percentage of multisystem trauma patients has significant musculoskeletal injuries?

A

pg 151

80 percent

72
Q

The bone cell responsible for laying down new bone tissue is the

A

pg 152

osteoblast.

73
Q

The widened end of a long bone is called the

A

pg 153

epiphysis.

74
Q

The bone tissue making up the central portion of the long bone is called the

A

pg 152

compact bone.

75
Q

The penetration through the compact bone that permits blood vessels to enter and exit the shaft of
the long bones is the

A

pg 152

perforating canal.

76
Q

The body joints that permit free movement are termed

A

pg 153

synovial joints and diarthroses.

77
Q

The shoulder and hip are examples of which type of joint?

A

pg 154

Triaxial joints

78
Q

What are the bones of the forearm?

A

pg 156

Radius & Ulna

79
Q

What is the bump of the elbow?

A

pg 156

Olecranon

80
Q

What is the major bone of the lower leg?

A

pg 157

Tibia

81
Q

At what age does the degeneration of bone tissue generally begin?

A

pg 157

40 years old

82
Q

Which of the following is NOT a classification of muscle tissue?

A. Cardiac D. Involuntary
B. Smooth E. Contractile
C. Voluntary

A

pg 160

Contractile

83
Q

The strong bands of connective tissue securing muscle to bone are the

A

pg 160

tendons.

84
Q

The muscle attachment to the bone that does NOT move when the muscle mass contracts is the

A

pg 160

origin.

85
Q

The condition that is caused by overstretching of some muscle fibers and that produces pain in
the affected muscle group is called

A

pg 162

strain.

86
Q

The partial displacement of a bone end from its location within a joint capsule is a

A

pg 162

subluxation.

87
Q

Which of the following fractures is caused by a rotational injury mechanism

A. Hairline D. Comminuted
B. Oblique E. Spiral
C. Transverse

A

pg 164

Spiral

88
Q

T/F - The greenstick fracture is an incomplete fracture that occasionally must be completely broken to
permit proper healing.

A

pg 165

True

89
Q

A common and serious type of fracture occurring in the pediatric patient that may prevent normal
bone growth is the

A

pg 165

epiphyseal.

90
Q

A chronic, systemic, and progressive deterioration of the connective tissue in the peripheral joints
describes

A

pg 167

rheumatoid arthritis.

91
Q

A degenerative disease related to the normal wear and tear of the joint tissue describes:

A

pg 167

osteoarthritis.

92
Q

If a fracture of the pelvis or bilateral femurs is suspected and patient vital signs are stable, the
PASG should be

A

pg 168

inflated until immobilization is achieved.

93
Q

What are signs reflective of a fracture?

A

pg 169

Distal pulse loss

Deformity

Crepitus

False motion

94
Q

An elderly patient who has suffered a fracture due to bone degeneration is expected to experience
what level of pain when compared to the traumatic fracture pain experienced by a younger adult
patient?

A

pg 170

Less pain

95
Q

T/F - Musculoskeletal injuries associated with sports are generally less severe than trauma-induced
injuries and should merit a quick return to competition if possible.

A

pg 171

False

96
Q

T/F - Only attempt manipulation of a dislocation if a neurovascular deficit is noted.

A

pg 172

True

97
Q

T/F - In general, most fractures should be left in the position found because the splints of today are
very effective in immobilizing a limb in that position.

A

pg 172

False

98
Q

Descending in altitude in a helicopter will cause the pressure in the air splint to

A

pg 174

decrease.

99
Q

The traction splint is designed to splint which musculoskeletal injury?

A

pg 174

Femur fracture

100
Q

Align an angulated long-bone fracture unless

A

pg 176

there is a significant increase in pain.

101
Q

If after moving a limb to alignment you notice distal sensation is absent, you should

A

pg 176

gently move the limb to restore the pulse.

102
Q

List some signs that a reduction of a dislocation has been effective?

A

pg 176

Feeling a “pop”
Patient reports less pain
Joint becomes more mobile
Joint deformity lessens

103
Q 
T/F - If the reduction is successful and pulses and sensation are intact, splint the limb in the position of
 function and transport.
A

pg 176

True

104
Q

The splinting device recommended for a pelvic fracture is the

A

pg 177

pelvic sling.

105
Q

The traction splint is recommended for treatment of the

A

pg 178

midshaft femur fracture.

106
Q

The splinting device recommended for an isolated fracture of the clavicle is the

A

pg 179

sling and swathe.

107
Q

A posterior hip dislocation normally presents with the

A

pg 179

knee turned inward.

foot turned inward.

knee flexed.

108
Q

The ankle is deformed with the foot pointing downward. Which type of ankle dislocation do you
suspect?

A

pg 181

Posterior ankle dislocation.

109
Q

The patient’s arm is internally rotated and the elbow and forearm are held away from the chest.
What type of dislocation of the shoulder should you suspect?

A

pg 181

Posterior Shoulder dislocation

110
Q

The arm is held locked above the head. What type of dislocation of the shoulder do you suspect?

A

pg 181

Inferior shoulder dislocation

111
Q

T/F - The elbow dislocation should NOT be reduced in the field.

A

pg 181

True

112
Q

Which of the following injuries can be adequately splinted using the full-arm air splint and
placing the hand in the position of function?

A. Radial fracture D. Finger fracture
B. Ulnar fracture E. All of the above
C. Wrist fracture

A

pg 182

E. All of the above

113
Q

The normal initial dose of fentanyl for pain is

A

pg 183

25 to 50 mcg.

114
Q

For which of the following will naloxone reverse the drug effects?

A. Fentanyl

B. Morphine

C. Nalbuphine

D. Diazepam

E. A, B, and C

A

pg 183

E. A, B, and C

115
Q

The “C” in the acronym RICE used by athletic trainers stands for

A

pg 183

compression.

Paramedic Care Volume 5 - Trauma (11 decks)

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