Chapter 29 Orthopaedic Injuries

Which of the following statements regarding compartment syndrome is correct? A. Most cases of compartment syndrome occur following a severe fracture of the pelvis. B. In most cases, compartment syndrome develops within a few minutes after an injury. C. Compartment syndrome typically develops within 6 to 12 hours after an injury. D. Compartment syndrome occurs because of increased pressure within the bone cavity.

The correct answer is: Compartment syndrome typically develops within 6 to 12 hours after an injury.

Which of the following statements regarding shoulder dislocations is MOST correct? A. They are caused by forced arm adduction. B. Most shoulder dislocations occur anteriorly. C. Posterior dislocations are most common. D. They involve the acromion process and humerus.

The correct answer is: Most shoulder dislocations occur anteriorly.

A subluxation occurs when: A. a bone develops a hairline fracture. B. ligaments are partially severed. C. a joint is incompletely dislocated. D. a fracture and a dislocation exist.

The correct answer is: a joint is incompletely dislocated.

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. make two or three attempts to restore distal circulation by manipulating the elbow. B. apply gentle manual traction in line with the limb and reassess for a pulse. 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.

The correct answer is: apply gentle manual traction in line with the limb and reassess for a pulse.

In moving joints, the ends of the bones are covered with: A. articular cartilage. B. muscular fascia. C. synovial tendons. D. gliding cartilage.

The correct answer is: articular cartilage.

A 21-year-old male was thrown over the handlebars of his motorcycle when he rear-ended a car that was stopped at a red light. He was wearing a helmet, which he removed prior to your arrival. He is conscious, but restless, and has closed deformities to both of his femurs. His skin is pale, his heart rate is rapid and weak, and his respirations are rapid and shallow. In addition to applying high-flow oxygen and protecting his spine, you should: A. splint each of his deformed femurs with long board splints and transport immediately. B. apply traction splints to both of his legs, keep him warm, and transport without delay. C. bind his legs together on the backboard, keep him warm, and transport without delay. D. apply the PASG to stabilize his femurs and transport at once.

The correct answer is: bind his legs together on the backboard, keep him warm, and transport without delay.

The musculoskeletal system refers to the: A. involuntary muscles of the nervous system. B. bones and voluntary muscles of the body. C. connective tissue that supports the skeleton. D. nervous system's control over the muscles.

The correct answer is: bones and voluntary muscles of the body.

When caring for a patient with a possible fracture of the scapula, the EMT should: A. apply rigid board splints across the chest and back. B. recognize that scapular fractures are life threatening. C. carefully assess the patient for breathing problems. D. assume that minimal force was applied to the back.

The correct answer is: carefully assess the patient for breathing problems.

The MOST significant hazard associated with splinting is: A. delaying transport of a critically injured patient. B. reduction in circulation distal to the injury site. C. compression of nerves, tissues, and vasculature. D. aggravation of the injury or worsened pain.

The correct answer is: delaying transport of a critically injured patient.

The disruption of a joint in which the bone ends are no longer in contact is called a: A. strain. B. sprain. C. dislocation. D. fracture.

The correct answer is: dislocation.

Which of the following musculoskeletal injuries would MOST likely result in deformity? A. hairline fracture B. severe strain C. moderate sprain D. displaced fracture

The correct answer is: displaced fracture

A Colles fracture involves a fracture of the: A. proximal radius. B. distal radius. C. radius and ulna. D. distal ulna.

The correct answer is: distal radius.

A(n) __________ fracture occurs in the growth section of a child's bone and may lead to bone growth abnormalities. A. metaphyseal B. greenstick C. diaphyseal D. epiphyseal

The correct answer is: epiphyseal

Assessing a person's neurovascular status following a musculoskeletal injury includes all of the following, EXCEPT: A. assessing sensory function. B. determining capillary refill. C. assessing motor function. D. evaluating proximal pulses.

The correct answer is: evaluating proximal pulses.

A 17-year-old football player collided with another player and has pain to his left clavicular area. 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: A. immobilize the injury with a sling and swathe. B. perform a rapid secondary assessment. C. straighten his arm and apply a board splint. D. place a pillow under his arm and apply a sling.

The correct answer is: immobilize the injury with a sling and swathe.

When splinting a possible fracture of the foot, it is MOST important for the EMT to: A. use a pillow as a splint. B. leave the toes exposed. C. apply a pneumatic splint. D. observe for tissue swelling.

The correct answer is: leave the toes exposed.

Atrophy is a condition that occurs when: A. the tendons that attach muscle to bone become stretched or injured. B. increased use of skeletal muscle causes an increase in its strength. C. carbon dioxide, lactic acid, and other wastes accumulate in the muscle. D. muscle decreases in size and function because of disease or trauma.

The correct answer is: muscle decreases in size and function because of disease or trauma.

Of the following musculoskeletal injuries, which is considered to be the LEAST severe? A. an amputation of an extremity B. multiple closed long bone fractures C. nondisplaced pelvic fracture D. open fractures of a long bone

The correct answer is: nondisplaced pelvic fracture

Which of the following fractures has the greatest potential for internal blood loss and shock? A. humerus B. hip C. femur D. pelvis

The correct answer is: pelvis

A 77-year-old woman slipped and fell on a throw rug and landed on her left hip. She denies striking her head or losing consciousness. Assessment of her left leg reveals that it is shortened and externally rotated. Distal pulses, sensory, and motor functions are intact. You should: A. manually stabilize her left leg, apply a traction splint, and then secure her to a long backboard or scoop. B. carefully slide a long backboard underneath her, keep her in a supine position, and apply a splint to her leg. C. bind both of her legs together with triangular bandages and carefully secure her onto the ambulance stretcher. D. place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps.

The correct answer is: place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps.

The MOST reliable indicator of an underlying fracture is: A. severe swelling. B. point tenderness. C. obvious bruising. D. guarding.

The correct answer is: point tenderness.

Crepitus and false motion are: A. indicators of a severe sprain. B. most common with dislocations. C. only seen with open fractures. D. positive indicators of a fracture.

The correct answer is: positive indicators of a fracture.

A "hip" fracture is actually a fracture of the: A. femoral shaft. B. proximal femur. C. pubic symphysis. D. pelvic girdle.

The correct answer is: proximal femur.

The PASG is absolutely contraindicated in patients who have: A. pelvic fractures. B. bilateral femur fractures. C. pulmonary edema. D. any trauma below the pelvis.

The correct answer is: pulmonary edema.

Applying ice to and elevating an injured extremity are performed in order to: A. prevent further injury. B. reduce pain and swelling. C. enhance tissue circulation. D. maintain extremity perfusion.

The correct answer is: reduce pain and swelling.

Which of the following joints allows no motion? A. shoulder joint B. skull sutures C. sacroiliac joint D. sternoclavicular joint

The correct answer is: skull sutures

A 31-year-old male fell and landed on his left elbow. Your assessment reveals that the elbow is grossly deformed, his forearm is cool and pale, and the distal pulse on the side of the injury is barely palpable. His vital signs are stable and he denies any other injuries. Your transport time to the closest appropriate hospital is approximately 15 minutes. You should: A. apply a heat pack to the elbow to reduce swelling. B. gently manipulate the elbow to improve circulation. C. gently straighten the elbow and apply an air splint. D. splint the elbow in the position found and transport.

The correct answer is: splint the elbow in the position found and transport.

A ____________ is a musculoskeletal injury in which there is partial or temporary separation of the bone ends as well as partial stretching or tearing of the supporting ligaments. A. fracture B. sprain C. strain D. dislocation

The correct answer is: sprain

Deformity caused by a fracture would MOST likely be masked by: A. crepitus. B. guarding. C. swelling. D. ecchymosis.

The correct answer is: swelling.

An open fracture is MOST accurately defined as a fracture in which: A. the overlying skin is no longer intact. B. a large laceration overlies the fracture. C. bone ends protrude through the skin. D. a bullet shatters the underlying bone.

The correct answer is: the overlying skin is no longer intact.