EMT Chapter 31

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

A passenger fractures her patella after it strikes the dashboard.

A construction worker's arm was severed just above the elbow when a steel girder fell on it. The stump is covered with a blood-soaked towel. The patient's skin is cool, clammy, and pale. The EMT should:

Apply a tourniquet just below the shoulder

With regard to musculoskeletal injuries, the zone of injury is defined as the:

Area of soft tissue damage surrounding the injury

The MOST significant hazard associated with splinting is: A) Aggravation of the injury or worsened pain. B) Delaying transport of a critically injured patient. C) Reduction in circulation distal to the injury site. D) Compression of nerves, tissues, and vasculature.

B) Delaying transport of a critically injured patient.

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) Stabilize her head and perform a primary assessment. C) Administer oxygen and perform a rapid assessment. D) Assess for a carotid pulse and assist her ventilations.

B) Stabilize her head and perform a primary assessment.

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.

Which of the following structures is regulated by smooth muscles? Heart Skeleton Blood vessels Diaphragm

Blood vessels

When caring for a patient with a possible fracture of the scapula, the EMT should:

Carefully assess the patient for breathing problems

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:

Control the bleeding and over the wound with a sterile dressing

Which of the following musculoskeletal injuries would MOST likely result in deformity? Hairline fracture Moderate sprain Displaced fracture Severe strain

Displaced fracture

A supracondylar or intercondylar fracture is also known as a fracture of the:

Distal humerus

A 17-year-old female dislocated her patella while playing soccer. Her knee is flexed and she complains of severe pain. You should: Make one attempt to return the patella to its normal position Gently straighten her knee and apply a padded board splint Keep her knee flexed and secure it with padded board splints Flex her knee slightly and assess for distal circulation

Keep her knee flexed and secure it with padded board splints

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

Most shoulder dislocations occur anteriorly.

Of the following musculoskeletal injuries, which is considered to be the LEAST severe? Nondisplaced pelvic fracture Open fractures of a long bone An amputation of an extremity Multiple closed long bone fractures

Nondisplaced pelvic fracture

Which of the following fractures has the greatest potential for internal blood loss and sock? Hip Femur Pelvis Humerus

Pelvis

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

Prevent further injury

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

Reduce pain and swelling

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.

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:

Stabilize the pelvis with a pelvic binder and protect the spine

Skeletal muscle is also referred to as______ muscle

Striated

Skeletal muscle is attached to the bone by tough, rope-like, fibrous structures called:

Tendons

The musculoskeletal system refers to the:

The bones and voluntary muscles of the body.

An open fracture is MOST accurately defined as a fracture in which:

The overlying skin is no longer intact

In general, musculoskeletal injuries should be splinted before moving the patient unless: a) the patient is clinically unstable. b) deformity and swelling are present. c) the patient is in severe pain. d) transport time is less than 15 minutes.

The patient is critically unstable

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

a) if resistance is encountered or the patient experiences severe pain

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. You should: apply a traction splint to realign the deformity. flex the knee slightly and apply a formable splint. apply padded board splints to both sides of the leg. bind the legs together and elevate them 6 to 8 inches.

apply padded board splints to both sides of the leg.

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

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

Which of the following statements regarding compartment syndrome is correct? a) Compartment syndrome occurs because of increased pressure within the bone cavity. b) Compartment syndrome typically develops within 6 to 12 hours after an injury. 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.

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

Which of the following musculoskeletal injuries would pose the greatest threat to a patient's life? a) an amputated extremity b) pelvic fracture with hypotension c) bilateral femur fractures d) nondisplaced long bone 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) carefully straighten the injured arm and secure it with padded board splints. c) apply gentle manual traction in line with the limb and reassess for a pulse. d) make two or three attempts to restore distal circulation by manipulating the elbow.

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

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

compare it to the uninjured leg.

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

immobilize the injury with a sling and swathe.

During your 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: splinting her femur fracture with padded board splints. immobilizing her to a backboard and rapidly transporting. applying a traction splint to immobilize her femur. carefully splinting each of her deformed extremities.

immobilizing her to a backboard and rapidly transporting.

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

leave the toes exposed

The MOST reliable indicator of an underlying fracture is: Guarding severe swelling obvious bruising point tenderness

point tenderness

Creptus and false motion are: only seen with open fractures indicators of a severe sprain positive indicators of a fracture most common with dislocations

positive indicators of a fracture

A 30-year-old man complains of severe pain to his right tibia following an injury that occurred the day before. The patient's leg is pale and he is unable to move his foot. The EMT should suspect that: the nerves behind the knee are compromised. a severe infection has developed in the muscle. pressure in the fascial compartment is elevated. the nerves supplying the foot have been severed.

pressure in the fascial compartment is elevated

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

proximal femur

The pectoral girdle consists of the:

scapulae and clavicles.

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 is barely palpable. His vital signs are stable and he denies any other injuries. Your transport time to the closest appropriate hospital is approximately 12 minutes. You should: splint the elbow in the position found and transport. gently manipulate the elbow to improve circulation. gently straighten the elbow and apply an air splint. apply a heat pack to the elbow to reduce swelling.

splint the elbow in the position found and transport.