Chapter 31: Orthopaedic Injuries

While transporting a patient, you continue to recheck the splint you applied. You know that improperly applying a splint can cause all of the following EXCEPT: A. an increase of distal circulation if the splint is too tight. B. a delay in transport of a patient with a life-threatening injury. C. a reduction of distal circulation. D. a compression of nerves, tissues, and blood vessels.

A

You are called to a 16-year-old girl who was injure din a basketball game. She is alert and oriented. Her airway is open, and respirations are within normal limits. Her pulse is strong and regular. Distal pulses are present. She states that she felt her ankle pop and immediately became nauseated. You decide to assess neurovascular status. When would you NOT perform the motor test? A. When you get a pain response. B. When the patient walks away. C. When you feel a distal pulse. D. When the patient feels your touch.

A

You respond to a 19-year-old woman who was involved in a motor vehicle collision. She is alert and oriented. Her airway is open, and respirations are 18 breaths/min and unlabored. Pulse is 94 beats/min and is strong and regular. Distal pulses are present. Her upper arm has obvious deformity. You splint the upper arm. You know that splinting will do all of the following EXCEPT: A. prevent the need for surgery. B. reduce shock. C. minimize compromised circulation. D. reduce pain.

A

You respond to a 19-year-old woman who was kicked in the leg by a horse. She is alert and oriented. Respirations are 20 breaths/min, regular and unlabored. Pulse is 110 beats/min and regular. Distal pulses are present. She has point tenderness at the site of the injury. You should compare the limb to: A. the opposite uninjured limb. B. one of your limbs or one of your partner's limbs. C. an injury chart. D. none of the above.

A

Your 24-year-old patient fell off a balance beam and landed on his arm. He is complaining of pain in the upper arm and there is obvious swelling. You know that swelling is a sign of: A. bleeding B. laceration C. a locked joint D. compartment syndrome

A

A _____ is a disruption of a joint in which the bone ends are no longer in contact. A. torn ligament B. dislocation C. fracture dislocation D. sprain

B

A _____ is a stretching or tearing of the muscle. A. sprain B. strain C. torn ligament D. split

B

A(n) _____ fracture is a fracture in which the bone is broken into more than two fragments. A. greenstick B. comminuted C. pathologic D. epiphyseal

B

A(n) _____ may cause a fracture or dislocation at a distant point. A. direct blow B. indirect force C. twisting force D. high-energy injury

B

Because of local tenderness and swelling, it is easy to confuse a nondisplaced or minimally displaced fracture at the knee with a: A. tendon injury. B. ligament injury. C. dislocation. D. fracture-dislocation.

B

Fibrous tissue that covers all skeletal muscle: A. Striated B. Fascia C. Smooth D. Joint E. Ligaments F. Closed fracture G. Point tenderness H. Displaced fracture I. Articular cartilage J. Open fracture K. Traction

B

For which of the following should you use a traction splint? A. injuries of the pelvis B. an isolated femur fracture C. partial amputation avulsions with bone separation D. lower leg or ankle injury

B

Smooth muscle is found in the: A. back B. blood vessels C. heart D. leg

B

The ______ is one of the most commonly fractured bones in the body. A. scapula B. clavicle C. humerus D. radius

B

The knee is especially susceptible to _______ injuries, which occur when abnormal bending or twisting forces are applied to the joint. A. tendon B. ligament C. dislocation D. fracture-dislocation

B

What joint is frequently separated during football and hockey when a player falls and lands on the point of the shoulder? A. Glenohumeral joint B. Acromioclavicular joint C. Sternoclavicular joint D. Sacroiliac joint

B

Which of the following statements about compartment syndrome is FALSE? A. It occurs 6 to 12 hours after an injury B. it most commonly occurs with a fractured femur. C. It is usually a result of excessive bleeding, a severely crushed extremity, or the rapid return of blood to an ischemic limb. D. It is characterized by paint that is out of proportion to the injury.

B

You are called to the local junior high school where a 12-year-old boy fella and hurt his wrist. There is obvious deformity. He is alert and oriented. Respirations and pulse are within normal limits. Distal pulse is present. It is important to remember to: A. use a zippered air splint B. splint in a position of function C. splint the wrist only D. completely cover the wrist and hand

B

You respond to a motorcycle accident for a 41-year-old man who is unconscious. He has obvious deformity to both lower legs and is bleeding moderately from an open fracture. His airway is open, and he is making gurgling noises. You load the patient, secure the airway, and immobilize the fractures. How often should you reassess his vital signs? A. every 2 minutes B. every 5 minutes C. every 10 minutes D. every 15 minutes

B

_____ are held together in a tough fibrous structure known as a capsule. A. Tendons B. Joints C. Ligaments D. Bones

B

regardless of the extent and severity of the damage to the skin, you should treat any injury that breaks the skin as a possible: A. closed fracture B. open fracture C. nondisplaced fracture D. displaced fracture

B

A _____ is an injury to the ligaments, the articular capsule, the synovial membrane, and the tendons crossing the joint. A. dislocation B. strain C. sprain D. torn ligament

C

A(n) _____ is also known as a hairline fracture. A. closed fracture B. open fracture C. nondisplaced fracture D. displaced fracture

C

Although substantial ligament damage always occurs with a knee dislocation, the more urgent injury is to the______ artery, which is often lacerated or compressed by the displaced tibia. A. tibial B. femoral C. popliteal D. dorsalis pedis

C

Dislocation of the ______ is usually associated with fractures of one or both malleoli. A. knee B. elbow C. ankle D. hip

C

Fractures are almost always associated with _____ of the surrounding soft tissue. A. laceration B. crepitus C. ecchymosis D. swelling

C

In-line _____ is the act of exerting a pulling force on a body structure in the direction of its normal alignment. A. stabilization B. immobilization C. traction D. direction

C

Involuntary muscle: A. Striated B. Fascia C. Smooth D. Joint E. Ligaments F. Closed fracture G. Point tenderness H. Displaced fracture I. Articular cartilage J. Open fracture K. Traction

C

Signs and symptoms of sprains include all of the following EXCEPT: A. point tenderness B. pain preventing the patient from moving or using the limb normally C. marked deformity D. instability of the joint indicated by increased motion

C

There is often a significant amount of blood loss, as much as ______ mL, after a fracture of the shaft of the femur. A. 100 to 250 B. 250 to 500 C. 500 to 1,000 D. 1,000 to 1,500

C

When caring for patients who have fallen, you must identify the _____ and the mechanism of injury so that you will not overlook associated injuries. A. site of injury B. height of fall C. point of contact D. twisting forces

C

You are called to the local assisted living facility where a 94-year-old man has fallen. He is alert and oriented and denies passing out. His respirations are 18 breaths/min and regular. Pulse is 106 BPM, regular and strong. Distal pulses are present. He states that he was walking, heard a pop, and fell to the floor. You suspect a(n) _____ fracture. A. greenstick B. comminuted C. pathologic D. epiphyseal

C

You respond to a motorcycle accident for a 41-year-old man who is unconscious. He has obvious deformity to both lower legs and is bleeding moderately from an open fracture. His airway is open, and he is making gurgling noises. Pulse is rapid and weak. Distal pulses are very weak. You first priority with this patient is to: A. control bleeding B. apply splints C. maintain an airway D. apply a pneumatic antishock garment

C

_____ is the most reliable indicator of an underlying fracture. A. Crepitus B. Deformity C. Point tenderness D. Absence of distal pulse

C

A(n) _____ fracture occurs in a growth section of a child's bone, which may prematurely stop growth if not properly treated. A. greenstick B. comminuted C. pathologic D. epiphyseal

D

A(n) _____ produces actual deformity, or distortion, of the limb by shortening, rotating, or angulating it. A. closed fracture B. open fracture C. nondisplaced fracture D. displaced fracture

D

Always check neurovascular function at the following times EXCEPT: A. after any manipulation of the limb. B. before applying a splint. C. after applying a splint. D. during history taking.

D

Signs and symptoms associated with hip dislocation include all of the following EXCEPT: A. severe pain in the hip B. lateral and posterior aspects of the hip region are tender on palpation. C. being able to palpate the femoral head deep within the muscles of the buttock. D. decreased resistance to any movement of the joint.

D

Signs and symptoms of a dislocated joint include all of the following EXCEPT: A. marked deformity B. tenderness or palpation C. locked joint D. ecchymosis

D

Signs and symptoms of knee ligament injury include all of the following EXCEPT: A. swelling B. point tenderness C. joint effusion D. the affected leg externally rotated

D

The zone of injury includes all of the following EXCEPT: A. adjacent nerves B. adjacent blood vessels C. surrounding soft tissue D. the incident scene

D

When you have applied a traction splint, the last thing that you do is: A. check pulse, motor, and sensation. B. release traction if the pulse disappears. C. apply elasticized straps. D. secure the patient to a backboard.

D

Where two bones contact: A. Striated B. Fascia C. Smooth D. Joint E. Ligaments F. Closed fracture G. Point tenderness H. Displaced fracture I. Articular cartilage J. Open fracture K. Traction

D

Which of the following is NOT a basic type of splint? A. rigid B. formable C. traction D. sling

D

Which of the following is NOT considered one of the 6 Ps of the musculoskeletal assessment? A. Pain B. Pulselessness C. Pressure D. Peristalsis

D

_____ produce severe damage to the skeleton, surrounding soft tissues, and vital internal organs. A. Direct blows B. Indirect forces C. Twisting forces D. High-energy injuries

D

Hold joints together: A. Striated B. Fascia C. Smooth D. Joint E. Ligaments F. Closed fracture G. Point tenderness H. Displaced fracture I. Articular cartilage J. Open fracture K. Traction

E

Any fracture in which the skin has not been broken: A. Striated B. Fascia C. Smooth D. Joint E. Ligaments F. Closed fracture G. Point tenderness H. Displaced fracture I. Articular cartilage J. Open fracture K. Traction

F

True or False: When splinting a fracture, you should be careful to immobilize only the joint above the injury site.

F

True or False: You should use traction to reduce a fracture and force all bone fragments back into alignment.

F

Tenderness sharply located at the site of injury: A. Striated B. Fascia C. Smooth D. Joint E. Ligaments F. Closed fracture G. Point tenderness H. Displaced fracture I. Articular cartilage J. Open fracture K. Traction

G

Any injury that makes the limb appear in an unnatural position: A. Striated B. Fascia C. Smooth D. Joint E. Ligaments F. Closed fracture G. Point tenderness H. Displaced fracture I. Articular cartilage J. Open fracture K. Traction

H

A thin layer of cartilage, covering the articular surface of bone in synovial joints: A. Striated B. Fascia C. Smooth D. Joint E. Ligaments F. Closed fracture G. Point tenderness H. Displaced fracture I. Articular cartilage J. Open fracture K. Traction

I

Any break in the bone in which the overlying skin has been damaged as well: A. Striated B. Fascia C. Smooth D. Joint E. Ligaments F. Closed fracture G. Point tenderness H. Displaced fracture I. Articular cartilage J. Open fracture K. Traction

J

The act of exerting a pulling force on a structure: A. Striated B. Fascia C. Smooth D. Joint E. Ligaments F. Closed fracture G. Point tenderness H. Displaced fracture I. Articular cartilage J. Open fracture K. Traction

K

True or False: All extremity injuries should be splinted before moving a patient unless the patient's life is in immediate danger.

T

True or False: Compartment syndrome can develop in the forearm in children with a fracture of the humerus.

T

True or False: Cover wounds with a dry, sterile dressing before applying a splint.

T

True or False: Fractures of the distal radius re known as Colles fractures

T

True or False: One of the steps of the neurologic examination is to palpate the pulse distal to the site of injury.

T

True or False: Splinting reduces pain and prevents the motion of bone fragments.

T

True or False: When applying traction, the direction of pull is always along the axis of the limb.

T

True or False: White blood cells and platelets are produced in the marrow cavity.

T

Joints are bathed and lubricated by: A. synovial fluid. B. articular fluid. C. viscous fluid. D. sebaceous fluid.

A

Skeletal muscle: A. Striated B. Fascia C. Smooth D. Joint E. Ligaments F. Closed fracture G. Point tenderness H. Displaced fracture I. Articular cartilage J. Open fracture K. Traction

A

The bones in the skeleton produce _____ in the bone marrow. A. blood cells B. minerals C. electrolytes D. hormones

A

Which of the following statements regarding the treatment of an amputation is FALSE? A. You should sever any partial amputation because this will aid in the reattachment process. B. in some areas, wrapping the amputated part in a dry, sterile dressing is appropriate. C. In some areas, wrapping the amputated part in dressings moistened with sterile saline is appropriate. D> after wrapping the amputated part, place it in a plastic bag.

A

A(n) _____ fractures the bone at the point of impact. A. direct blow B. indirect force C. twisting force D. high-energy injury

A

A(n) ______ fracture is an incomplete fracture that passes only partway through the shaft of a bone but may still cause severe angulation. A. greenstick B. comminuted C. pathologic D. epiphyseal

A

Blood in the urine is known as: A. hematuria B. hemotysis C. hematocrit D. hemoglobin

A

Fracture of the tibia and fibula are sometimes associated with ______ as a result of the distorted positions of the limb following injury. A. vascular injury B. muscular injury C. tendon injury D. ligament injury

A