EMT Chapter 31 - Orthopaedic Injuries, EMT - Chapter 31: Orthopaedic Injuries

What is the primary goal of in-line traction? -Minimize pain -Avoid further neurovascular compromise -Reduce swelling -Prevent permanent disability

- Avoid further neurovascular compromise

Which sign/symptom would give you a high index of suspicion that a patient may have compartment syndrome? -Referred pain -Limb deformity -Disproportionate pain -Hypersensation

- Disproportionate pain Disproportionate pain on passive stretch of muscles within the compartment is a sign of compartment syndrome.

Which MOI causes a fracture or dislocation at a distant point? - Direct blow - Indirect force - Twisting force - High-impact injury

- Indirect force An indirect force is more likely to cause a fracture or dislocation at a distant point.

What is the most reliable indicator of an underlying fracture? - Deformity - Guarding - Point tenderness - Crepitus

- Point tenderness The most reliable indicator of an underlying fracture is point tenderness.

Which of the following is a drawback of an air splint? - Temperature changes affect air pressure in the splint. - It does not provide uniform contact, so bone movement is possible. - It restricts distal blood flow. - It is complicated to use and requires multiple EMTs.

- Temperature changes affect air pressure in the splint. A drawback of an air splint is that temperature or altitude changes affect the air pressure in the splint.

In which situations should you splint the limb in the position of deformity? - When the deformity is the result of a dislocation and is severe - When you encounter resistance or extreme pain when applying traction - When distal pulses are absent - When the fracture is an open fracture

- When the deformity is the result of a dislocation and is severe - When you encounter resistance or extreme pain when applying traction

A disruption of a joint in which the bone ends are no longer in contact is known as what? -Dislocation -Fracture -Sprain -Strain

-Dislocation A dislocation is a disruption of a joint in which the bone ends are no longer in contact.

When assessing distal circulation in a patient's lower extremities, which pulse should you palpate? -Femoral -Dorsalis pedis -Popliteal -Iliac

-Popliteal You would palpate the popliteal artery in lower extremity wounds.

In the musculoskeletal injury grading system, under which category would you place a laceration of a major nerve or blood vessel? -Moderate -Serious -Severe -Critical

-Serious

Which of the following would you use to stabilize an AC separation? -Zippered air splint -Rigid splint -Sling and swathe -Traction splint

-Sling and swathe An AC separation occurs in the shoulder and so using a sling and swathe is an effective way to splint the injury.

You are attending to a patient with a nondisplaced elbow fracture. She has a strong pulse and good capillary refill. How should you address this type of injury? -Splint from the shoulder joint to the wrist joint to stabilize the entire arm. -Apply a Sager traction splint to stabilize the joint. -Apply a sling and swathe to reduce pain. -Apply ice to reduce swelling.

-Splint from the shoulder joint to the wrist joint to stabilize the entire arm. When splinting a fracture in and around a joint, be sure to stabilize the bones above and below the injured joint.

Which of the following are goals of in-line traction? -Stabilize the fragments to prevent movement -Align the limb for splinting -Stop bleeding -Avoid neurovascular compromise

-Stabilize the fragments to prevent movement -Align the limb for splinting -Avoid neurovascular compromise

Rearrange the injuries from least to most severe based on the musculoskeletal injury grading system. 1) Dislocated fingers 2) Bilateral femur fracture 3) Displaced pelvic fracture 4) Pelvic fracture with hemodynamic instability 5) Nondisplaced long bone fracture

1) Dislocated fingers 5) Nondisplaced long bone fracture 3) Displaced pelvic fracture 2) Bilateral femur fracture 4) Pelvic fracture with hemodynamic instability

Which of the following scenarios is an example of a direct injury? A. A passenger fractures her patella after it strikes the dashboard. B. A skier dislocates his knee after a twisting injury to the ankle. C. A person lands on his or her feet and fractures the lumbar spine. D. A child dislocates his elbow after falling on his outstretched arm.

A. A passenger fractures her patella after it strikes the dashboard.

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

A. Compartment syndrome typically develops within 6 to 12 hours after an injury.

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

A. articular cartilage.

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: A. assess distal pulse, motor, and sensory functions. B. gently attempt to move his arm toward his body. C. place a pillow under his arm and apply a swathe. D. flex his arm at the elbow and then apply a sling.

A. assess distal pulse, motor, and sensory functions.

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. bind his legs together on the backboard, keep him warm, and transport without delay. B. apply traction splints to both of his legs, keep him warm, and transport without delay. C. splint each of his deformed femurs with long board splints and transport immediately. D. apply the PASG to stabilize his femurs and transport at once.

A. bind his legs together on the backboard, keep him warm, and transport without delay.

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

A. bones and voluntary muscles of the body.

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

A. bones and voluntary muscles of the body.

A fracture is MOST accurately defined as a(n): Select one: A. break in the continuity of the bone. B. disruption in the midshaft of a bone. C. abnormality in the structure of a bone. D. total loss of function in a bone.

A. break in the continuity of the bone.

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

A. carefully assess the patient for breathing problems.

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

A. carefully assess the patient for breathing problems.

The MOST commonly fractured bone(s) in the body is the: A. clavicle. B. scapula. C. radius and ulna. D. midshaft femur.

A. clavicle.

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

A. nondisplaced pelvic fracture

The primary purpose for splinting a musculoskeletal injury is to: A. prevent further injury. B. maximize distal circulation. C. make the patient comfortable. D. facilitate ambulance transport.

A. prevent further injury.

The pectoral girdle consists of the: A. scapulae and clavicles. B. clavicles and rib cage. C. sternum and scapulae. D. acromion and clavicles.

A. scapulae and clavicles.

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

A. 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. splint the elbow in the position found and transport. B. gently manipulate the elbow to improve circulation. C. gently straighten the elbow and apply an air splint. D. apply a heat pack to the elbow to reduce swelling.

A. splint the elbow in the position found and transport.

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

A. swelling.

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

A. the overlying skin is no longer intact.

The act of pulling on a body structure in the direction of its normal alignment is called: A. traction. B. reduction. C. stabilization. D. immobilization.

A. traction.

Which of the following musculoskeletal injuries would pose the greatest threat to a patient's life? Select one: A. An amputated extremity B. Pelvic fracture with hypotension C. Nondisplaced long bone fractures D. Bilateral femur fractures

B. Pelvic fracture with hypotension

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. splint the elbow in the position of deformity and transport immediately. B. apply gentle manual traction in line with the limb and reassess for a pulse. C. carefully straighten the injured arm and secure it with padded board splints. D. 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.

Bone marrow produces: A. platelets. B. blood cells. C. lymphocytes. D. electrolytes.

B. blood cells.

A fracture is MOST accurately defined as a(n): 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. break in the continuity of the bone.

When assessing a patient with a possible fracture of the leg, the EMT should: A. assess proximal circulation. B. compare it to the uninjured leg. C. carefully move it to elicit crepitus. D. ask the patient to move the injured leg.

B. compare it to the uninjured leg.

Common signs and symptoms of a sprain include all of the following, EXCEPT: A. swelling. B. deformity. C. ecchymosis. D. point tenderness.

B. deformity.

A supracondylar or intercondylar fracture is also known as a fracture of the: A. radial head. B. distal humerus. C. proximal radius. D. olecranon process.

B. distal humerus.

A supracondylar or intercondylar fracture is also known as a fracture of the: Select one: A. proximal radius. B. distal humerus. C. olecranon process. D. radial head.

B. distal humerus.

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

B. distal radius.

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: A. applying and inflating the pneumatic antishock garment (PASG) and transporting. B. immobilizing her to a backboard and rapidly transporting. C. applying a traction splint to immobilize her femur. D. carefully splinting each of her deformed extremities.

B. immobilizing her to a backboard and rapidly transporting.

A fracture caused by minimal force that is associated with diseases such as cancer and osteoporosis is called a __________ fracture. A. greenstick B. pathologic C. transverse D. comminuted

B. pathologic

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

B. positive indicators of a fracture.

A 45-year-old female was the unrestrained passenger of a small car that rear-ended another vehicle at a moderate rate of speed. She is conscious and alert, but complains of pain to both of her knees. There is visible damage to the dashboard on the passenger's side of the vehicle. In addition to fractures or dislocations of the knees, you should be MOST suspicious for: A. anterior hip dislocation. B. posterior hip dislocation. C. a thoracic spine fracture. D. fracture of the tibia or fibula.

B. posterior hip dislocation.

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

B. proximal femur.

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

B. 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.

B. reduce pain and swelling.

Which of the following types of muscle is under direct voluntary control of the brain? A. cardiac B. skeletal C. smooth D. autonomic

B. skeletal

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. strain B. sprain C. fracture D. dislocation

B. sprain

During your secondary assessment of a 30-year-old male who fell 25 feet, you note crepitus when palpating his pelvis. Your partner advises you that the patient's blood pressure is 80/50 mm Hg and his heart rate is 120 beats/min and weak. After completing your assessment, you should: Select one: A. perform a focused physical exam with emphasis on the pelvis. B. stabilize the pelvis with a pelvic binder and protect the spine. C. log roll the patient onto a long backboard and transport at once. D. defer spinal immobilization and transport to a trauma center.

B. stabilize the pelvis with a pelvic binder and protect the spine.

Skeletal muscle is also referred to as __________ muscle. A. smooth B. striated C. connective D. involuntary

B. striated

Skeletal muscle is attached to the bone by tough, ropelike fibrous structures called: A. fascia. B. tendons. C. cartilage. D. ligaments.

B. tendons.

If a dislocated shoulder has spontaneously reduced before your arrival, the only way to confirm the injury is by noting: A. distal circulation. B. the patient history. C. bruising to the shoulder. D. the presence of deformity.

B. the patient history.

In general, musculoskeletal injuries should be splinted before moving the patient unless: A. the patient is in severe pain. B. the patient is clinically unstable. C. deformity and swelling are present. D. transport time is less than 15 minutes.

B. the patient is clinically unstable.

Which of the following statements regarding compartment syndrome is correct? Select one: 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.

C. Compartment syndrome typically develops within 6 to 12 hours after an injury.

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

C. Most shoulder dislocations occur anteriorly.

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

C. a joint is incompletely dislocated.

A 76-year-old male experienced sudden pain to his left thigh when he was standing in line at the grocery store. Your assessment reveals ecchymosis and deformity to the distal aspect of his left femur, just above the knee. Distal circulation and sensory and motor functions are intact. The MOST appropriate method of splinting this injury involves: A. applying a traction splint to realign the deformity. B. applying and fully inflating the pneumatic antishock garment (PASG). C. applying padded board splints to both sides of the leg. D. binding the legs together and elevating them 6″ to 8″.

C. applying padded board splints to both sides of the leg.

With regard to musculoskeletal injuries, the zone of injury is defined as the: A. area of obvious deformity over the site of impact. B. exact part of the bone or joint that was disrupted. C. area of soft-tissue damage surrounding the injury. D. part of the body that sustained secondary injury.

C. area of soft-tissue damage surrounding the injury.

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: A. elevate the injured arm and reassess distal sensory function. B. inflate the splint with more air until the patient is comfortable. C. assess the amount of air in the splint and let air out as necessary. D. remove the air splint and reimmobilize with padded board splints.

C. assess the amount of air in the splint and let air out as necessary.

Which of the following structures is regulated by smooth muscle? A. heart B. skeleton C. blood vessels D. diaphragm

C. blood vessels

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. assess distal pulses as well as sensory and motor functions. B. manually stabilize the leg above and below the site of injury. C. control the bleeding and cover the wound with a sterile dressing. D. gently manipulate the injured leg until the numbness dissipates.

C. control the bleeding and cover the wound with a sterile dressing.

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

C. delaying transport of a critically injured patient.

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

C. epiphyseal

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

C. evaluating proximal pulses.

Traction splints are used primarily to immobilize and secure fractures of the: A. hip. B. pelvis. C. femur. D. humerus.

C. femur.

In which of the following situations should the EMT splint an injured limb in the position of deformity? A. when distal circulation and neurological functions are absent B. if transport time to the hospital is greater than 20 to 30 minutes C. if resistance is encountered or the patient experiences severe pain D. if a traction splint will be used to immobilize the injured extremity

C. if resistance is encountered or the patient experiences severe pain

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. perform a rapid secondary assessment. B. straighten his arm and apply a board splint. C. immobilize the injury with a sling and swathe. D. place a pillow under his arm and apply a sling.

C. immobilize the injury with a sling and swathe.

A 17-year-old female dislocated her patella while playing soccer. Her knee is flexed and she complains of severe pain. You should: Select one: A. make one attempt to return the patella to its normal position. B. flex her knee slightly more and assess for distal circulation. C. keep her knee flexed and secure it with padded board splints. D. gently straighten her knee and apply a padded board splint.

C. keep her knee flexed and secure it with padded board splints.

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

C. muscle decreases in size and function because of disease or trauma.

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

C. pelvis

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

C. positive indicators of a fracture.

During your rapid secondary assessment of a 30-year-old male who fell 25′, you note crepitus when palpating his pelvis. Your partner advises you that the patient's blood pressure is 80/50 mm Hg and his heart rate is 120 beats/min and weak. After completing your assessment, you should: A. defer spinal immobilization and transport to a trauma center. B. perform a focused physical exam with emphasis on the pelvis. C. stabilize the pelvis with a pelvic binder and protect the spine. D. log roll the patient onto a long backboard and transport at once.

C. stabilize the pelvis with a pelvic binder and protect the spine.

Skeletal muscle is attached to the bone by tough, ropelike, fibrous structures called: Select one: A. ligaments. B. cartilage. C. tendons. D. fascia.

C. tendons.

In general, musculoskeletal injuries should be splinted before moving the patient unless: Select one: A. deformity and swelling are present. B. the patient is in severe pain. C. the patient is clinically unstable. D. transport time is less than 15 minutes.

C. the patient is clinically unstable.

Which of the following musculoskeletal injuries would MOST likely result in deformity? Select one: A. Severe strain B. Hairline fracture C. Moderate sprain D. Displaced fracture

D. Displaced fracture

In which of the following situations should the EMT splint an injured limb in the position of deformity? Select one: A. When distal circulation and neurological functions are absent B. If transport time to the hospital is greater than 20 to 30 minutes C. If a traction splint will be used to immobilize the injured extremity D. If resistance is encountered or the patient experiences severe pain

D. If resistance is encountered or the patient experiences severe pain

Which of the following statements regarding striated muscle is correct? A. Striated muscle is involuntary because you have no conscious control over it. B. Most of the body's striated muscle is found within the walls of the blood vessels. C. Striated muscle tissue is attached directly to the bones by tough bands of cartilage. D. It forms the major muscle mass of the body and usually crosses at least one joint.

D. It forms the major muscle mass of the body and usually crosses at least one joint.

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. splint the elbow in the position of deformity and transport immediately. C. make two or three attempts to restore distal circulation by manipulating the elbow. D. apply gentle manual traction in line with the limb and reassess for a pulse.

D. apply gentle manual traction in line with the limb and reassess for a pulse.

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: A. hyperventilate him with a bag-mask device and monitor his oxygen saturation. B. apply high-flow oxygen, perform a detailed secondary assessment, and transport. C. focus your assessment on his scapulae and clavicles and apply high-flow oxygen. D. apply high-flow oxygen, consider spinal precautions, and transport without delay.

D. apply high-flow oxygen, consider spinal precautions, and transport without delay.

With regard to musculoskeletal injuries, the zone of injury is defined as the: Select one: A. part of the body that sustained secondary injury. B. exact part of the bone or joint that was disrupted. C. area of obvious deformity over the site of impact. D. area of soft-tissue damage surrounding the injury.

D. area of soft-tissue damage surrounding the injury.

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: A. assess distal pulses as well as sensory and motor functions. B. manually stabilize the leg above and below the site of injury. C. gently manipulate the injured leg until the numbness dissipates. D. control the bleeding and cover the wound with a sterile dressing.

D. control the bleeding and cover the wound with a sterile dressing.

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

D. 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. fracture. D. dislocation.

D. dislocation.

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

D. displaced fracture

When splinting an injury of the wrist, the hand should be placed: A. into a fist. B. in a straight position. C. in an extended position. D. in a functional position.

D. in a functional position.

Bones are connected to other bones by bands of tough fibrous tissues called: A. bursa. B. tendons. C. cartilage. D. ligaments.

D. ligaments.

Which of the following musculoskeletal injuries would pose the greatest threat to a patient's life? A. an amputated extremity B. bilateral femur fractures C. nondisplaced long bone fractures D. pelvic fracture with hypotension

D. pelvic fracture with hypotension

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

D. point tenderness.

What type of muscle contracts and relaxes to control the movement of the contents within its structures? A. cardiac B. skeletal C. striated D. smooth

D. smooth

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: A. apply manual stabilization to both of her femurs. B. administer oxygen and perform a rapid assessment. C. assess for a carotid pulse and assist her ventilations. D. stabilize her head and perform a primary assessment.

D. stabilize her head and perform a primary assessment.

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. apply manual stabilization to both of her femurs. B. administer oxygen and perform a rapid assessment. C. assess for a carotid pulse and assist her ventilations. D. stabilize her head and perform a primary assessment.

D. stabilize her head and perform a primary assessment.

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

D. the overlying skin is no longer intact.

Fractures of the proximal femur usually involve the hip joint. T/F

F Correct. Fractures of the proximal femur are usually called hip fractures, but they rarely involve the hip joint.

If you are unable to restore the distal pulse on scene, you should splint the limb in a straight position and provide prompt transport to the hospital. T/F

F Correct. If you are unable to restore the distal pulse, splint the limb in the position that is most comfortable for the patient and provide prompt transport to the hospital.

Examination of the injured limb should include the 6 Ps of musculoskeletal assessment:

Pain Paralysis Paresthesia (numbness or tingling) Pulselessness Pallor Pressure

A fracture of the femoral shaft is best stabilized with a traction splint, such as a Sager splint. T/F

T Correct. A fracture of the femoral shaft is best stabilized with a traction splint, such as a Sager splint.

Lateral and medial dislocations to the knee are less common than posterior dislocations and are less likely to injure the popliteal artery. T/F

T Correct. Lateral and medial dislocations to the knee are less common than posterior dislocations and are less likely to injure the popliteal artery.

Fractures of the distal radius, which are especially common in older patients with osteoporosis, are known as ----> Colles fractures.

The term silver fork deformity is used to describe the distinctive appearance of the patient's arm. In children, this fracture may occur through the growth plate and can have long-term consequences.