Chapter 29 orthopedic emergencies
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: Select one: A. stabilize her head and perform a primary assessment. B. administer oxygen and perform a rapid assessment. C. apply manual stabilization to both of her femurs. D. assess for a carotid pulse and assist her ventilations
A
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: Select one: A. control the bleeding and cover the wound with a sterile dressing. B. gently manipulate the injured leg until the numbness dissipates. C. assess distal pulses as well as sensory and motor functions. D. manually stabilize the leg above and below the site of injury.
A
A supracondylar or intercondylar fracture is also known as a fracture of the: Select one: A. distal humerus. B. radial head. C. olecranon process. D. proximal radius.
A
Femoral shaft fractures can result in up to _____ mL of internal blood loss. Select one: A. 1,000 B. 2,000 C. 1,500 D. 4,000
A
Skeletal muscle is also referred to as __________ muscle. Select one: A. striated B. smooth C. connective D. involuntary
A
The PASG is absolutely contraindicated in patients who have: Select one: A. pulmonary edema. B. pelvic fractures. C. any trauma below the pelvis. I D. bilateral femur fractures.
A
The primary purpose for splinting a musculoskeletal injury is to: Select one: A. prevent further injury. B. make the patient comfortable. C. facilitate ambulance transport. D. maximize distal circulation.
A
When assessing a patient with a possible fracture of the leg, the EMT should: Select one: A. compare it to the uninjured leg. B. ask the patient to move the injured leg. C. assess proximal circulation. D. carefully move it to elicit crepitus.
A
A fracture caused by minimal force that is associated with diseases such as cancer and osteoporosis is called a __________ fracture. Select one: A. transverse B. pathologic C. greenstick D. comminuted
B
A fracture is MOST accurately defined as a(n): Select one: A. total loss of function in a bone. B. break in the continuity of the bone. C. disruption in the midshaft of a bone. D. abnormality in the structure of a bone.
B
A subluxation occurs when: Select one: A. ligaments are partially severed. B. a joint is incompletely dislocated. C. a bone develops a hairline fracture. D. a fracture and a dislocation exist.
B
Assessing a person's neurovascular status following a musculoskeletal injury includes all of the following, EXCEPT: Select one: A. determining capillary refill. B. evaluating proximal pulses. C. assessing motor function. D. assessing sensory function.
B
Bone marrow produces: Select one: A. platelets. B. blood cells. C. electrolytes. D. lymphocytes
B
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: Select one: A. carefully straighten the injured arm and secure it with padded board splints. 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. make two or three attempts to restore distal circulation by manipulating the elbow.
B
During your rapid secondary assessment of a 19-year-old female with multiple trauma, you note bilateral humeral deformities and a deformity to the left midshaft femur. Her skin is diaphoretic and her pulse is rapid and weak. Your partner has appropriately managed her airway and is maintaining manual stabilization of her head. The MOST appropriate treatment for this patient includes: Select one: A. carefully splinting each of her deformed extremities. B. immobilizing her to a backboard and rapidly transporting. C. applying and inflating the pneumatic antishock garment (PASG) and transporting. D. applying a traction splint to immobilize her femur.
B
In general, musculoskeletal injuries should be splinted before moving the patient unless: Select one: A. the patient is in severe pain. B. the patient is clinically unstable. C. transport time is less than 15 minutes. D. deformity and swelling are present.
B
Skeletal muscle is attached to the bone by tough, ropelike fibrous structures called: Select one: A. ligaments. B. tendons. C. cartilage. D. fascia.
B
The MOST reliable indicator of an underlying fracture is: Select one: A. guarding. B. point tenderness. C. severe swelling. D. obvious bruising.
B
The disruption of a joint in which the bone ends are no longer in contact is called a: Select one: A. fracture. B. dislocation. C. strain. D. sprain.
B
Which of the following types of muscle is under direct voluntary control of the brain? Select one: A. cardiac B. skeletal C. autonomic D. smooth
B
With regard to musculoskeletal injuries, the zone of injury is defined as the: Select one: A. exact part of the bone or joint that was disrupted. B. area of soft-tissue damage surrounding the injury. C. area of obvious deformity over the site of impact. D. part of the body that sustained secondary injury.
B
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: Select one: A. elevate the injured arm and reassess distal sensory function. B. assess the amount of air in the splint and let air out as necessary. C. inflate the splint with more air until the patient is comfortable. D. remove the air splint and reimmobilize with padded board splints.
B
A(n) __________ fracture occurs in the growth section of a child's bone and may lead to bone growth abnormalities. Select one: A. greenstick B. diaphyseal C. epiphyseal D. metaphyseal
C
Crepitus and false motion are: Select one: A. most common with dislocations. B. only seen with open fractures. C. positive indicators of a fracture. D. indicators of a severe sprain.
C
Deformity caused by a fracture would MOST likely be masked by: Select one: A. guarding. B. crepitus. C. swelling. D. ecchymosis.
C
Following direct trauma to the left upper back, a 44-year-old male presents with diaphoresis and restlessness. His blood pressure is 100/50 mm Hg, his pulse rate is 120 beats/min and weak, and his respirations are 24 breaths/min and labored. Your assessment reveals abrasions and contusions over the left scapula. You should: Select one: A. apply high-flow oxygen, perform a detailed secondary assessment, and transport. B. focus your assessment on his scapulae and clavicles and apply high-flow oxygen. C. apply high-flow oxygen, consider spinal precautions, and transport without delay. D. hyperventilate him with a bag-mask device and monitor his oxygen saturation.
C
In which of the following situations should the EMT splint an injured limb in the position of deformity? Select one: A. if a traction splint will be used to immobilize the injured extremity B. when distal circulation and neurological functions are absent C. if resistance is encountered or the patient experiences severe pain D. if transport time to the hospital is greater than 20 to 30 minutes
C
The MOST significant hazard associated with splinting is: Select one: A. aggravation of the injury or worsened pain. B. compression of nerves, tissues, and vasculature. C. delaying transport of a critically injured patient. D. reduction in circulation distal to the injury site.
C
When splinting an injury of the wrist, the hand should be placed: Select one: A. in a straight position. B. into a fist. C. in a functional position. D. in an extended position.
C
Which of the following fractures has the greatest potential for internal blood loss and shock? Select one: A. humerus B. hip C. pelvis D. femur
C
Which of the following joints allows no motion? Select one: A. sacroiliac joint B. shoulder joint C. skull sutures D. sternoclavicular joint
C
Which of the following scenarios is an example of a direct injury? Select one: A. A child dislocates his elbow after falling on his outstretched arm. B. A skier dislocates his knee after a twisting injury to the ankle. C. A passenger fractures her patella after it strikes the dashboard. D. A person lands on his or her feet and fractures the lumbar spine.
C
You receive a call to a local gymnasium for a basketball player with a dislocated shoulder. Upon arrival, you find the patient, a 17-year-old male, sitting on the ground. He is holding his left arm in a fixed position away from his body. There is an obvious anterior bulge to the area of injury. You should: Select one: A. flex his arm at the elbow and then apply a sling. B. gently attempt to move his arm toward his body. C. assess distal pulse, motor, and sensory functions. D. place a pillow under his arm and apply a swathe.
C
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: Select one: A. gently straighten the elbow and apply an air splint. B. gently manipulate the elbow to improve circulation. C. apply a heat pack to the elbow to reduce swelling. D. splint the elbow in the position found and transport.
D
A Colles fracture involves a fracture of the: Select one: A. proximal radius. B. distal ulna. C. radius and ulna. D. distal radius.
D
Common signs and symptoms of a sprain include all of the following, EXCEPT: Select one: A. point tenderness. B. ecchymosis. C. swelling. D. deformity.
D
The musculoskeletal system refers to the: Select one: A. nervous system's control over the muscles. B. connective tissue that supports the skeleton. C. involuntary muscles of the nervous system. D. bones and voluntary muscles of the body
D
The pectoral girdle consists of the: Select one: A. clavicles and rib cage. B. sternum and scapulae. C. acromion and clavicles. D. scapulae and clavicles
D
When splinting a possible fracture of the foot, it is MOST important for the EMT to: Select one: A. observe for tissue swelling. B. use a pillow as a splint. C. apply a pneumatic splint. D. leave the toes exposed
D
Which of the following statements regarding striated muscle is correct? Select one: A. Striated muscle tissue is attached directly to the bones by tough bands of cartilage. B. Striated muscle is involuntary because you have no conscious control over it. C. Most of the body's striated muscle is found within the walls of the blood vessels. D. It forms the major muscle mass of the body and usually crosses at least one joint.
D
