Chapter 7 - Orthopedic Trauma Flashcards
1
Q
Musculoskeletal injuries can include injury to
A
pg 151
bones.
muscles.
tendons.
ligaments.
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
3
Q
The bone cell responsible for maintaining bone tissue is the
A
pg 152
osteocyte.
4
Q
The bone cell responsible for dissolving bone tissue is the
A
pg 152
osteoclast.
5
Q
The central portion of a long bone is called the
A
pg 152
diaphysis.
6
Q
The transitional area between the end and central portion of the long bone is called the
A
pg 153
metaphysis.
7
Q
The type of bone tissue filling the end of the long bone is called the
A
pg 153
cancellous bone.
8
Q
The covering of the shaft of the long bones that initiates the bone repair cycle is the
A
pg 153
periosteum.
9
Q
Immovable joints such as those of the skull are termed
A
pg 153
synarthroses.
10
Q
The smooth, flexible structures that act as the actual articular surface of joints are the
A
pg 153
cartilages.
11
Q
The elbow is an example of which type of joint?
A
pg 154
Monaxial
12
Q
Bands of strong material that stretch and hold the joint together while permitting movement
are the
A
pg 154
ligaments.
13
Q
The small sacs filled with synovial fluid that reduce friction and absorb shock are the
A
pg 155
bursae.
14
Q
The most commonly fractured bone in the body is the
A
pg 156
clavicle.
15
Q
Which of the following is a bone of the upper arm?
A
pg 156
Humerus
16
Q
Which of the following is a bone of the palm of the hand?
A
pg 156
Metacarpal
17
Q
Which of the following is the bone of the thigh?
A
pg 156
Femur
18
Q
Skeletal maturity is reached by age
A
pg 157
age 20
19
Q
The muscular system consists of about how many muscle groups?
A
pg 157
600 muscle groups
20
Q
The muscle attachment to the bone that moves when the muscle mass contracts is the
A
pg 160
insertion
21
Q
T/F - More than half the energy created by muscle motion is in the form of heat energy.
A
pg 161
True
22
Q
T/F - Contusion can account for significant fluid loss into the more massive muscles of the body.
A
pg 161
True
23
Q
A specific sign associated with compartment syndrome is
A
pg 162
pain when flexing the foot.
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.
25
The tissue that is normally damaged in a sprain is the
pg 162
ligament.
26
The overstretching of a muscle that presents with pain is a
pg 162
strain.
27
What fractures are relatively stable?
pg 164
Hairline & Impacted
28
Which of the following fractures is most likely to be open?
## Footnote
A. Fibula D. Humerus
B. Tibia E. Ulna
C. Femur
pg 163
Tibia
29
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.
pg 164
True
30
Which of the types of fracture is likely to occur only in the pediatric patient?
pg 165
Greenstick.
31
The bones of the elderly are likely to be
## Footnote
A. less flexible.
B. more brittle.
C. more easily fractured.
D. more slow to heal.
E. all of the above.
pg 165
E. all of the above.
32
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.
pg 166
False
33
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.
pg 166
True
34
The growth of bone that comes after a fracture and encapsulates the fracture site is called the
pg 166
callus.
35
What is caused by a buildup of uric acid crystals in the joints?
pg 167
Gout
36
An inflammation of the small synovial sacs that reduces friction and cushions tendons from
trauma is
pg 166
Bursitis.
37
Which of the following is an indication for fluid resuscitation in the patient with skeletal
injury?
## Footnote
A. Pelvic fracture D. Hip dislocation
B. Serious tibial fracture E. Both A and C
C. Femur fracture
pg 168
E. Both pelvic fracture & femur fracture
38
With which fractures should you consider immediate transport of the patient because
of possible internal blood loss?
pg 168
Both pelvic fracture & femur fractures
39
When assessing a limb for possible fracture, you should examine distally for
pg 169
sensation.
crepitus.
motor strength.
circulation.
40
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?
pg 170
Compartment syndrome
41
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?
pg 170
Less pain
42
T/F - the effects of the fight-or-flight response wear off, the symptoms of fracture will become
less evident.
pg 170
False
43
It is essential to tell the patient that limb alignment will cause some increased pain because this
will help maintain his confidence in you.
pg 171
True
44
In general, long-bone shaft fractures should be splinted
pg 172
aligned, except if resistance is experienced.
45
T/F - Any fracture within 3 inches of the joint should be treated the same way as a dislocation.
pg 172
True
46
What position is ideal for the immobilization of most extremity injuries?
pg 172
Neutral
47
Ascending to altitude in a helicopter will cause the pressure in the air splint to
pg 174
increase
48
The traction splint is designed to splint which musculoskeletal injury?
pg 174
Midshaft femur fracture
49
Which of the following is a disadvantage of the vacuum splint when applying it
fractures?
## Footnote
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.
pg 174
C. It shrinks slightly during application.
50
Align a seriously angulated long-bone fracture unless
pg 76
you meet with resistance.
51
If after moving a limb to alignment you notice the distal pulse is absent, you shoud
pg 176
gently move the limb to restore the pulse.
52
T/F - With joint injury you should not move the limb, even to restore circulation or sensation.
pg 176
False
53
Early reduction of a dislocation usually results in which of the following?
pg 176
Less stress on the ligaments
Better distal sensation
Less stress on the joint structure
Better distal circulation
54
Signs that a reduction of a dislocation has been effective include
pg 176
feeling a "pop."
less deformity of the joint.
patient reports of less pain.
greater mobility in the joint.
55
Heat may be applied to a muscular injury
pg 176
after 48 hours.
56
The splinting device recommended for a painful and isolated fracture of the femur is
pg 178
the traction splint.
57
The splinting device recommended for a painful and isolated fracture of the tibia is the
pg 178
padded board splint.
58
The splinting device(s) recommended for an isolated fracture of the humerus is (are) the
pg 179
sling and swathe & the padded board splint.
59
The fracture of the forearm close to the wrist that presents with the "silver fork" deformity is
called:
pg 179
Colles' fracture.
60
An anterior hip dislocation normally presents with the
pg 179
foot turned outward.
61
T/F - In general, anterior dislocations of the hip can be reduced in the prehospital setting.
pg 180
False
62
Which of the following is NOT a sign of patellar dislocation?
## Footnote
A. Knee in the flexed position
B. Significant joint deformity
C. Extremity drops at the knee
D. Lateral displacement of the patella
pg 180
Extremity drops at the knee
63
If a patient presents with an ankle deformed with the foot turned to the side, you would suspect
which type of ankle dislocation?
pg 181
Lateral ankle dislocation
64
If a patient presents with an ankle deformed with the foot pointing upward, you should suspect
which type of ankle dislocation?
pg 181
Anterior ankle dislocation
65
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?
pg 181
Anterior shoulder dislocation
66
T/ F - The elbow dislocation is a simple injury but one that is essential to reduce in the field.
pg 181
False
67
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?
pg 182
Radial fractures
Finger fractures
Ulnar fractures
Wrist fractures
68
Morphine in the prehospital setting
## Footnote
A. reduces anxiety.
B. reduces the perception of pain.
C. sedates the patient.
D. may cause respiratory depression
E. all of the above.
pg 183
E. all of the above.
69
Which of the following is NOT an analgesic that is used to control the pain of musculoskeletal
injuries?
## Footnote
A. Meperidine D. Diazepam
B. Morphine E. Astramorph
C. Nalbuphine
pg 183
D. Diazepam
70
The "I" within the acronym RICE used by athletic trainers stands for
pg 183
Ice for the first 48 hours.
71
What percentage of multisystem trauma patients has significant musculoskeletal injuries?
pg 151
80 percent
72
The bone cell responsible for laying down new bone tissue is the
pg 152
osteoblast.
73
The widened end of a long bone is called the
pg 153
epiphysis.
74
The bone tissue making up the central portion of the long bone is called the
pg 152
compact bone.
75
The penetration through the compact bone that permits blood vessels to enter and exit the shaft of
the long bones is the
pg 152
perforating canal.
76
The body joints that permit free movement are termed
pg 153
synovial joints and diarthroses.
77
The shoulder and hip are examples of which type of joint?
pg 154
Triaxial joints
78
What are the bones of the forearm?
pg 156
Radius & Ulna
79
What is the bump of the elbow?
pg 156
Olecranon
80
What is the major bone of the lower leg?
pg 157
Tibia
81
At what age does the degeneration of bone tissue generally begin?
pg 157
40 years old
82
Which of the following is NOT a classification of muscle tissue?
## Footnote
A. Cardiac D. Involuntary
B. Smooth E. Contractile
C. Voluntary
pg 160
Contractile
83
The strong bands of connective tissue securing muscle to bone are the
pg 160
tendons.
84
The muscle attachment to the bone that does NOT move when the muscle mass contracts is the
pg 160
origin.
85
The condition that is caused by overstretching of some muscle fibers and that produces pain in
the affected muscle group is called
pg 162
strain.
86
The partial displacement of a bone end from its location within a joint capsule is a
pg 162
subluxation.
87
Which of the following fractures is caused by a rotational injury mechanism
## Footnote
A. Hairline D. Comminuted
B. Oblique E. Spiral
C. Transverse
pg 164
Spiral
88
T/F - The greenstick fracture is an incomplete fracture that occasionally must be completely broken to
permit proper healing.
pg 165
True
89
A common and serious type of fracture occurring in the pediatric patient that may prevent normal
bone growth is the
pg 165
epiphyseal.
90
A chronic, systemic, and progressive deterioration of the connective tissue in the peripheral joints
describes
pg 167
rheumatoid arthritis.
91
A degenerative disease related to the normal wear and tear of the joint tissue describes:
pg 167
osteoarthritis.
92
If a fracture of the pelvis or bilateral femurs is suspected and patient vital signs are stable, the
PASG should be
pg 168
inflated until immobilization is achieved.
93
What are signs reflective of a fracture?
pg 169
Distal pulse loss
Deformity
Crepitus
False motion
94
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?
pg 170
Less pain
95
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.
pg 171
False
96
T/F - Only attempt manipulation of a dislocation if a neurovascular deficit is noted.
pg 172
True
97
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.
pg 172
False
98
Descending in altitude in a helicopter will cause the pressure in the air splint to
pg 174
decrease.
99
The traction splint is designed to splint which musculoskeletal injury?
pg 174
Femur fracture
100
Align an angulated long-bone fracture unless
pg 176
there is a significant increase in pain.
101
If after moving a limb to alignment you notice distal sensation is absent, you should
pg 176
gently move the limb to restore the pulse.
102
List some signs that a reduction of a dislocation has been effective?
pg 176
## Footnote
Feeling a "pop"
Patient reports less pain
Joint becomes more mobile
Joint deformity lessens
103
```
T/F - If the reduction is successful and pulses and sensation are intact, splint the limb in the position of
function and transport.
```
pg 176
True
104
The splinting device recommended for a pelvic fracture is the
pg 177
pelvic sling.
105
The traction splint is recommended for treatment of the
pg 178
midshaft femur fracture.
106
The splinting device recommended for an isolated fracture of the clavicle is the
pg 179
sling and swathe.
107
A posterior hip dislocation normally presents with the
pg 179
knee turned inward.
foot turned inward.
knee flexed.
108
The ankle is deformed with the foot pointing downward. Which type of ankle dislocation do you
suspect?
pg 181
Posterior ankle dislocation.
109
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?
pg 181
Posterior Shoulder dislocation
110
The arm is held locked above the head. What type of dislocation of the shoulder do you suspect?
pg 181
Inferior shoulder dislocation
111
T/F - The elbow dislocation should NOT be reduced in the field.
pg 181
True
112
Which of the following injuries can be adequately splinted using the full-arm air splint and
placing the hand in the position of function?
## Footnote
A. Radial fracture D. Finger fracture
B. Ulnar fracture E. All of the above
C. Wrist fracture
pg 182
E. All of the above
113
The normal initial dose of fentanyl for pain is
pg 183
25 to 50 mcg.
114
For which of the following will naloxone reverse the drug effects?
## Footnote
A. Fentanyl
B. Morphine
C. Nalbuphine
D. Diazepam
E. A, B, and C
pg 183
E. A, B, and C
115
The "C" in the acronym RICE used by athletic trainers stands for
pg 183
compression.
