chapter 9 extended

Question 1

Which of the following is NOT part of the axial skeleton?
A) Sacrum
B) Pubis
C) Sternum
D) Mandible

Answer 1

pubis

Question 2

Your patient is a 27-year-old male ice skater whose left skate was planted when he was struck
and knocked down by another skater. He is agitated and complaining of severe pain in his leg.
Your examination reveals an open fracture 6 inches proximal to the ankle joint. Which of the
following describes the most appropriate management of this patient?
A) Focused exam, oxygen, spinal immobilization, splint from the foot to above the knee, begin
transport, start a large-bore IV, and request orders for analgesia
B) Focused exam, cover the open wound, apply a lower extremity traction splint, begin transport,
start an IV, and request orders for analgesia
C) Focused exam, cover the open wound, splint from the foot to above the knee, begin transport,
start an IV, and request orders for analgesia
D) Rapid trauma exam, high-concentration oxygen, cervical spine immobilization, cover the
open wound, use the long backboard for initial splinting, initiate transport, start a large-bore IV,
perform a detailed examination, use padded board splints to immobilize from the ankle to above
the knee, and reassess the patient every 5 minutes

Answer 2

focused exam cover the open wound splint form the foot to above the knee, begin transport, start an IV , and request orders for analgesia

Question 3

Your patient is a football player who had his right foot planted and was tackled from the left
rear, causing his body to rotate around the axis of his right lower extremity. This mechanism is
most consistent with which of the following types of fractures?
A) Oblique
B) Spiral
C) Impacted
D) Comminuted

Answer 3

spiral

Question 4

) Which of the following is the highest priority when managing a patient with bilateral closed
femur fractures?
A) Assessing distal neurovascular function
B) Anticipating hypovolemia
C) Providing analgesia
D) Anticipating pulmonary embolism as a complication

Answer 4

anticipating hypovolemia

Question 5

Upon assessing a patient with a hip injury, you find that his right lower extremity is moved
away from the midline of the body. You should describe the right lower extremity as being:
A) abducted.
B) externally rotated.
C) angulated.
D) adducted.

Answer 5

abducted

Question 6

Which of the following is a consideration in preventing orthopedic injury?
A) Proper footwear
B) Well-designed railings
C) Appropriate stepladder use
D) All of the above

Answer 6

all of the above

Question 7

Your patient is a 20-year-old woman complaining of ankle pain after stepping off a curb. She
states that she is concerned because she had a grade III sprain a year and a half ago that required
extensive treatment and rehabilitation. Which of the following most accurately describes the
patient’s previous injury?
A) The ankle ligaments were stretched but not torn.
B) The ankle ligaments had a minor tear.
C) The ankle ligaments were torn but not all the way.
D) The ankle ligaments were completely torn.

Answer 7

the ankle ligaments are completely torn

Question 8

Tendons connect \_\_\_\_\_\_\_\_ to \_\_\_\_\_\_\_\_.
A) muscles; bones
B) bones; bones
C) cartilage; bones
D) muscles; fascia

Answer 8

muscles, bones

Question 9

The use of a binder is indicated in the treatment of which of the following musculoskeletal 
injuries?
A) Bilateral tibia/fibula fractures
B) Knee dislocation
C) Lumbar vertebral compression fracture
D) Pelvic fracture

Answer 9

pelvic fracture

Question 10

Which of the following supplies articular cartilage with oxygen and nutrients?
A) Bursae
B) Capillary beds
C) Synovial fluid
D) The Haversian system

Answer 10

capillary beds

Question 11

A partial displacement of a bone end from its position in the joint is called a:
A) sprain.
B) dislocation.
C) subluxation.
D) contractur

Answer 11

subluxation

Question 12

A fracture in which significant energy exchange shatters or splinters bone, creating many
fragments, is called a(n) ________ fracture.
A) impacted
B) comminuted
C) oblique
D) spiral

Answer 12

comminuted

Question 13

Your patient is a seven-year-old boy with a fracture of the proximal tibia. Which of the
following is the MOST likely and serious complication of this injury?
A) Juvenile onset arthritis
B) Formation of a bone callus
C) Disruption of the epiphyseal plate
D) Fat embolism

Answer 13

disruption of the emohyseal plate

Question 14

Which of the following best describes the function of cancellous bone of the medullary
canal?
A) It produces erythrocytes.
B) It acts as a growth plate in long bones.
C) Its dense, compact structure is well adapted to weight bearing.
D) It contains yellow bone marrow

Answer 14

it produces erythrocytes

Question 15

A dislocated knee is MOST likely to damage which of the following vascular structures?
A) Femoral vein
B) Popliteal artery
C) Femoral artery
D) Great saphenous vein

Answer 15

popliteal artery

Question 16

Which of the following types of fractures occurs in pediatric age groups but not in adults?
A) Oblique
B) Transverse
C) Greenstick
D) Impacted

Answer 16

greenstick

Question 17

) Your patient is a 50-year-old motorcyclist who received a lateral impact from an automobile
as he went through an intersection. He has an open right tibia/fibula fracture. He also has a
fracture of his left forearm and some abrasions. He was wearing a helmet and suffered no loss of
consciousness. He currently has a strong radial pulse of 100, his skin is warm and moist, and he
has adequate respirations at 20 per minute. Assuming no significant findings during a rapid
trauma exam and intact distal neurovascular status, which of the following is the best way to
manage this patient’s lower extremity trauma?
A) Use anatomical splinting provided by placing the patient on a long backboard.
B) Secure padded long board splints laterally and medially.
C) Apply PASG.
D) Apply a traction splint.

Answer 17

secure padded long board splints laterally and medially

Question 18

Not considering other injuries, which of the following musculoskeletal findings warrants 
immediate transport of your patient?
A) Unstable pelvis
B) Clavicle fracture
C) Posterior shoulder dislocation
D) Open fracture of the tibia and fibula

Answer 18

unstable pelvis

Question 19

Your patient is an 80-year-old woman who fractured a vertebra while coughing. This type of
fracture is best described as a(n) ________ fracture.
A) pathological
B) greenstick
C) epiphyseal
D) comminuted

Answer 19

pathological

Question 20

When assessing a long bone injury, you should assume that you are dealing with a joint
injury when the site of injury is within ________ inch(es) of the joint.
A) 3
B) 2
C) 1
D) 6

Answer 20

3

Question 21

One of the earliest indications that compartment syndrome is developing in an injured 
extremity is:
A) burning pain.
B) pallor of the overlying skin.
C) loss of distal pulses.
D) sensation of pressure in the limb.

Answer 21

burning pain

Question 22

) A sprain is an injury best defined as which of the following?
A) Bone ends not anatomically aligned
B) Muscle fibers stretched and torn
C) Partial or complete tearing of the ligaments of the joint capsule
D) A violent muscle spasm that tears away a small piece of bone

Answer 22

partial or complete tearing of the ligaments of the joint capsule

Question 23

Your patient has an abrasion on the bony prominence on the inside of her right ankle. This
abrasion should be described as being over which of the following structures?
A) Thenar eminence
B) Medial malleolus
C) Lateral malleolus
D) Styloid process

Answer 23

medial malleolus

Question 24

) The pain associated with skeletal fractures is transmitted by nerves in the:
A) epiphysis.
B) yellow bone marrow.
C) osteoclasts.
D) periosteum.

Answer 24

periosteum

Question 25

Your patient complains of elbow pain and states his doctor told him he had “the bursitis” in
his elbow. The patient’s condition is characterized by inflammation of the:
A) articular cartilage.
B) synovial sacs.
C) tendons.
D) bone.

Answer 25

synovial sacs

Question 26

Your patient is a 21-year-old football player who was struck in the lateral aspect of the left
knee by another player’s shoulder. The patient is in extreme pain, and the knee is significantly
deformed and swollen. The pedal pulse is weak, but present, and capillary refill is less than 2
seconds. The patient is screaming at you to “fix” his knee. You are 10 minutes from the
emergency department. You should:
A) splint the knee as found, start an IV, consider narcotic analgesia.
B) apply gentle axial traction and realign the limb, splint in alignment.
C) flex the knee to a 45-degree angle, splint in position of function.
D) start an IV, administer narcotic analgesia, apply firm axial traction until the pulse returns to
normal or resistance is met, then splint.

Answer 26

splint the knee as found start an IV consider narcotic analgesia