Mod 9: Chapter 30 Abdominal and Genitourinary Injuries, Chapter 31 Orthopaedic Injuries, Chapter 32 Environmental Emergencies

A person's ability to shiver is lost when his or her body temperature falls below:

90°F (32°C).

Hypothermia occurs when the core body temperature falls below:

95°F (35°C).

Which of the following statements regarding compartment syndrome is correct?

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

When should you visually inspect the external genitalia on your patient?

Only when there is a complaint of severe pain or other injury

Which of the following are considered solid organs?

Pancreas and spleen

The body's natural protective mechanisms against heat loss are:

asoconstriction and shivering.

High humidity reduces the body's ability to lose heat through:

evaporation.

The body's natural cooling mechanism, in which sweat is converted to a gas, is called:

evaporation.

Geriatric patients, newborns, and infants are especially prone to hyperthermia because they:

exhibit poor thermoregulation.

Traction splints are used primarily to immobilize and secure fractures of the:

femur.

All of the following terms are used to describe a cold body part that is not frozen, EXCEPT:

frostbite

You are dispatched to a residence for a young female who was kicked in the abdomen. While en route to the scene, you should ask the dispatcher if:

law enforcement is at the scene.

When splinting a possible fracture of the foot, it is MOST important for the EMT to:

leave the toes exposed.

While assessing a 21-year-old female who struck a tree head-on with her small passenger car, you note that her air bag deployed. You should:

lift the air bag and look for deformity to the steering wheel.

Bones are connected to other bones by bands of tough fibrous tissues called:

ligaments.

Right upper quadrant (RUQ) consist of?

liver, gallbladder, duodenum of the intestines, and a small portion of the pancreas

Crepitus and false motion are

positive indicators of a fracture.

The EMT must assume that any unwitnessed water-related incident is accompanied by:

possible spinal injury.

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:

posterior hip dislocation.

The primary purpose for splinting a musculoskeletal injury is to:

prevent further injury.

Because the depth of an open abdominal wound is often difficult to determine:

prompt transport to the hospital is essential.

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

the overlying skin is no longer intact.

If a dislocated shoulder has spontaneously reduced before your arrival, the only way to confirm the injury is by noting:

the patient history.

In general, musculoskeletal injuries should be splinted before moving the patient unless:

the patient is clinically unstable.

Most of the serious injuries associated with scuba diving are caused by:

too rapid of an ascent.

The act of pulling on a body structure in the direction of its normal alignment is called:

traction.

Most of the ________ system lies behind the digestive tract.

urinary

Rough handling of a hypothermic patient with a pulse may cause:

ventricular fibrillation.

Heat loss from the body through respiration occurs when:

warm air is exhaled into the atmosphere.

Which of the following scenarios is an example of a direct injury?

A passenger fractures her patella after it strikes the dashboard.

Which of the following is true about injuries to the kidneys?

A sign of kidney damage is hematuria. A penetrating wound that reaches the kidneys almost involves other organs.

open abdominal injuries

An injury in which there is a break in the surface of the skin or mucous membrane, exposing deeper tissue to potential contamination

closed abdominal injuries

An injury in which there is soft-tissue damage inside the body but the skin remains intact.

melena

Black, foul-smelling, tarry stool containing digested blood

hematuria

Blood in the urine.

Low-velocity injuries

Caused by hand-held or hand-powered objects such as knives and other edged weapons

High-velocity injuries:

Caused by larger weapons such as high-powered rifles and the higher-powered handguns

Medium-velocity penetrating wounds:

Caused by smaller caliber handguns and shotguns

In moving joints, the ends of the bones are covered with:

articular cartilage.

Which of the following medications increases a person's risk of a heat-related emergency?

Diuretics

What is the most common mechanism of injury in geriatric patients?

Falls

A 66-year-old male presents with dark red rectal bleeding and abdominal pain. He is conscious and alert; however, his skin is cool and clammy and his pulse is rapid. Further assessment reveals that his blood pressure is 112/60 mm Hg. Which of the following questions would be MOST pertinent to ask him?

Have you experienced recent abdominal trauma?

Which of the following signs would indicate that an injury to the kidney has occurred?

Hematuria

Compression injury is most likely due to which of the following?

Improperly placed lab belt

Which of the following is true regarding injury to the kidneys?

Injury to the kidneys usually indicates injury to other organs.

guarding

Involuntary muscle contractions (spasm) of the abdominal wall to minimize the pain of movement and protect the inflamed abdomen; a sign of peritonitis

Which of the following statements regarding striated muscle is correct?

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

Which of the following statements regarding rebound tenderness is correct?

It is often discovered when the patient is jarred or moved suddenly.

Which of the following statements regarding drowning is correct?

Laryngospasm following submersion in water makes rescue breathing difficult.

Which of the following statements regarding lightning strikes is correct?

Lighting often results in a brief period of asystole that resolves spontaneously.

Bruising over the right upper quadrant could indicate injury to which of the following?

Liver

Which of the following organs would MOST likely bleed profusely when injured?

Liver

You should have an index of suspicion that a patient with pain referred to the right shoulder has an injury to which organ?

Liver

Three levels of velocity that are common in traumatic injuries:

Low-velocity injuries; Medium-velocity penetrating wounds; High-velocity injuries:

You are dispatched to a residence for a young female who is sick. The patient complains of a rash to her lower extremities and truncal area. Your assessment reveals a small, painful blister on her inner thigh. As your partner is taking the patient's vital signs, she states that she and her family returned from a camping trip two days ago. On the basis of this patient's presentation, you should suspect:

Lyme disease.

Which of the following is an indication of a spleen injury?

Referred left shoulder pain

The genitourinary system controls:

Reproductive functions The waste discharge system

What is the major cause of death following injury to a hollow organ in the abdomen?

Sepsis

solid organs

Solid masses of tissue where much of the chemical work of the body takes place (e.g., the liver, spleen, pancreas, and kidneys).

hollow organs

Structures through which materials pass, such as the stomach, small intestines, large intestines, ureters, and urinary bladder.

peritoneal cavity

The abdominal cavity.

Which of the following MOST accurately describes hyperthermia?

The body is exposed to more heat than it can lose.

evisceration

The displacement of organs outside of the body.

Left lower quadrant (LLQ)

The left lower quadrant holds both the large and small intestines, notably the descending colon and the left half of the transverse colon.

peritoneum

The membrane lining the abdominal cavity (parietal peritoneum) and covering the abdominal organs (visceral peritoneum).

Which of the following statements regarding abdominal eviscerations is correct?

The protruding organs should be kept warm and moist.

flank

The region below the rib cage and above the hip.

Left upper quadrant (LUQ)

The stomach occupies most of the LUQ, but it shares this space with the spleen. The pancreas occupies some of this space but is mostly posterior to the region.

What is the purpose of wrapping a sexual assault victim in a burn sheet?

To preserve potential evidence

A patient who has sustained a blunt abdominal injury should be log rolled to a supine position onto a backboard.

True

A very common early sign of a significant abdominal injury is tachycardia.

True

Free air in the peritoneal cavity is abnormal and indicates that a hollow organ or loop of bowel has perforated.

True

You should allow patients with peritonitis to lie still with their legs drawn up.

True

Which of the following organs is at MOST risk for injury as the result of a pelvic fracture?

Urinary bladder

Which of the following statements regarding trauma during pregnancy is correct?

Uterine trauma is likely to cause shock in the pregnant patient.

You are assessing a 33-year-old male who complains of severe abdominal pain, weakness, and nausea. He tells you that he was gathering wood to build a fire when he felt a sudden, sharp pain on the back of his hand. Your assessment reveals that the patient's abdomen is rigid and painful to palpation. You should suspect:

a black widow spider bite.

You should suspect a kidney injury anytime the patient presents with _______.

a hematoma in the flank region

A subluxation occurs when

a joint is incompletely dislocated.

Compression injuries to the abdomen that occur during a motor vehicle crash are typically the result of:

a poorly placed lap belt.

Compared to adults, infants and children are at higher risk for hypothermia for all of the following reasons, EXCEPT:

a relatively small surface area.

Signs of late heatstroke include:

a weak, rapid pulse.

To assess a patient's general temperature, pull back on your glove and place the back of your hand on his or her skin at the:

abdomen.

The MOST prominent symptom of decompression sickness is:

abdominal or joint pain.

An unresponsive trauma patient has a large open abdominal wound with massive external bleeding. You should:

apply direct pressure to the wound.

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:

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:

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

A 54-year-old male experienced an avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants and remove the foreskin prior to your arrival. Your assessment reveals that he is in severe pain and that the avulsion is bleeding moderately. The MOST appropriate treatment for this patient includes:

applying direct pressure with a dry, sterile dressing.

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:

applying padded board splints to both sides of the leg.

Injuries to the external male genitalia _______.

are rarely life-threatening

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

area of soft-tissue damage surrounding the injury.

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

assess distal pulse, motor, and sensory functions.

A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F (−1°C). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unconscious, pale, and apneic. You should:

assess for a carotid pulse for up to 45 seconds.

You and your partner respond to a park where several people were reportedly struck by lightning. When you arrive, you find three patients. The first patient is lying supine on the ground; he is unresponsive and does not appear to be breathing. The second patient is ambulatory, appears confused, and is holding his arm against his chest. The third patient is sitting on the ground holding the sides of his head. After calling for backup, you should:

assess the unresponsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the AED as soon as possible.

A 20-year-old male was accidentally shot in the right upper abdominal quadrant with an arrow during an archery contest. Prior to your arrival, the patient removed the arrow. Your assessment reveals that he is conscious and alert with stable vital signs. The entrance wound is bleeding minimally and appears to be superficial. You should:

assume that the arrow injured an internal organ.

When documenting a call involving a female patient who was sexually assaulted, the EMT should:

avoid speculation and document only factual data.

A dysbarism injury refers to the signs and symptoms related to changes in:

barometric pressure.

Your documentation on a sexual assault victim should _______.

be objective and factual

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:

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

Assessing a person's neurovascular status following a musculoskeletal injury includes all of the following, EXCEPT:

evaluating proximal pulses.

Hypothermia can worsen internal bleeding secondary to:

blood clotting abnormalities.

Patients with generalized hypothermia are at an increased risk of a local cold injury because:

blood is shunted away from the extremities to the body's core.

Which of the following structures is regulated by smooth muscle?

blood vessels

A football player was struck by another player in the right flank area just below the posterior rib cage. He complains of severe pain and point tenderness to the area. Your assessment reveals that there is a small amount of blood in his underwear. You should be MOST suspicious for:

blunt injury to the kidney.

The musculoskeletal system refers to the:

bones and voluntary muscles of the body.

The diving reflex may allow a person to survive extended periods of submersion in cold water secondary to:

bradycardia and a slowing of the metabolic rate.

A fracture is MOST accurately defined as a

break in the continuity of the bone.

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

carefully assess the patient for breathing problems.

The venom of a brown recluse spider is cytotoxic, meaning that it:

causes severe local tissue damage.

The temporary wound channel caused by high-velocity weapons is called _______.

cavitation

Geriatric patients are at a higher risk for heatstroke because:

circulation to the skin is reduced.

The MOST commonly fractured bone(s) in the body is the:

clavicle.

You are transporting a patient with blunt abdominal trauma. The patient is unstable and is experiencing obvious signs and symptoms of shock. Your estimated time of arrival at the hospital is less than 10 minutes. After treating the patient appropriately, you should:

closely monitor him and reassess him frequently.

When assessing a patient with a possible fracture of the leg, the EMT should:

compare it to the uninjured leg.

When a warm hand is immersed in water that is 70°F (21°C), heat is transferred from the hand to the water through a process called:

conduction.

Your presence is requested by law enforcement to assess a 33-year-old female who was sexually assaulted. The patient is conscious and obviously upset. As you are talking to her, you note an impressive amount of blood on her clothes in the groin area. Her blood pressure is 98/58 mm Hg, her pulse is 130 beats/min, and her respirations are 24 breaths/min. You should:

control any external bleeding, administer oxygen, and transport at once.

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:

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

The transfer of heat to circulating air, such as when cool air moves across the body's surface, is called:

convection.

All of the following snakes are pit vipers, EXCEPT for the:

coral snake.

A man has a large laceration across his lower abdominal wall and a loop of bowel is protruding from the wound. He is conscious and alert and there is minimal bleeding from the wound. You should:

cover the exposed bowel with a moist sterile dressing and then secure it in place with a dry bandage.

Drowning is MOST accurately defined as:

death from suffocation after submersion in water.

Common signs and symptoms of a sprain include all of the following, EXCEPT:

deformity.

The MOST significant hazard associated with splinting is:

delaying transport of a critically injured patient

Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured:

diaphragm.

The disruption of a joint in which the bone ends are no longer in contact is called a:

dislocation.

Which of the following musculoskeletal injuries would MOST likely result in deformity?

displaced fracture

You are assessing a patient who reports pain that is tearing and describes it as going from the abdomen posteriorly. What should you suspect?

dissecting abdominal aneurysm

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

distal humerus.

A Colles fracture involves a fracture of the:

distal radius

When the body loses sweat, it also loses:

electrolytes.

A(n) __________ fracture occurs in the growth section of a child's bone and may lead to bone growth abnormalities.

epiphyseal

A 40-year-old male presents with severe abdominal pain following blunt trauma. He is diaphoretic, intensely thirsty, and has a weak and rapid pulse. Appropriate treatment for this patient includes all of the following, EXCEPT:

giving him small sips of plain water.

When a patient stiffens the muscles of the abdomen, it is known as _______.

guarding.

Covering a patient's _________ will significantly minimize radiation heat loss.

head

A sign of kidney damage following blunt trauma is:

hematuria.

Damage to solid organs typically leads to _______.

hemorrhage

Common signs and symptoms of heat exhaustion include all of the following, EXCEPT:

hot, dry skin.

Which of the following conditions would be the LEAST likely to increase a person's risk of hypothermia?

hyperglycemia

In which of the following situations should the EMT splint an injured limb in the position of deformity?

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

immobilize the injury with a sling and swathe.

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:

immobilizing her to a backboard and rapidly transporting.

When splinting an injury of the wrist, the hand should be placed:

in a functional position.

Shivering is a mechanism in which the body generates heat by:

increasing the metabolic rate.

Abdominal pain, vomiting, and fever are most likely due to _______.

infection

You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a nonrebreathing mask and full spinal precautions have been applied. During your reassessment, you note his level of consciousness has decreased and his respirations have become shallow. You should:

insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a BVM.

Abdominal rigidity and periumbilical bruising are signs of _______.

internal bleeding

To obtain the MOST accurate reading of a patient's core body temperature, you should place a special hypothermia thermometer:

into the patient's rectum.

A 48-year-old male was stung on the leg by a jellyfish while swimming in the ocean. He is conscious and alert, but complains of intense pain at the wound site. Specific treatment for this patient includes:

irrigating the wound with vinegar and immersing his leg in hot water.

In contrast to the brown recluse spider, the black widow spider:

is large and has a red-orange hourglass mark on its abdomen.

In order for sweating to be an effective cooling mechanism:

it must be able to evaporate from the body.

Management of evisceration injuries includes _______.

keeping the injury moist and warm

Right lower quadrant (RLQ)

large and small intestines that include the ascending colon and the right half of the transverse colon. descending colon, called the appendix

In pediatric patients, the liver and spleen are _______.

larger in proportion to the abdomen

You receive a call to a residence for a sick patient. Upon your arrival, you find the patient, a 53-year-old diabetic male, lying down on his front porch. His wife tells you that he had been mowing the lawn in the heat for the past 3 hours. The patient is confused and has hot, moist skin. His pulse is weak and thready, and his blood pressure is 90/50 mm Hg. In addition to administering 100% oxygen, you should:

load him into the ambulance and begin rapid cooling interventions.

Which of the following is an early sign of pit viper envenomation?

local swelling and ecchymosis

A person who experiences a calcaneus fracture after jumping and landing on his or her feet would MOST likely experience an accompanying fracture of the

lumbar spine.

Placing a pregnant patient in a supine position during the third trimester of pregnancy:

may decrease the amount of blood that returns to the heart.

A frostbitten foot can be identified by the presence of:

mottling and blisters.

You and your partner are standing by at a large social event at a river resort when a frantic woman tells you that she found a young male floating face-down in the water. Nobody claims to have witnessed the event. After you and your partner enter the water and reach the patient, you should:

move him as a unit to a supine position.

You are dispatched to a local high school track and field event for a 16-year-old male who fainted. The outside temperature is approximately 95°F (35°C) with high humidity. Upon your arrival, the patient is conscious, alert, and complains of nausea and a headache. His skin is cool, clammy, and pale. You should:

move him into the cooled ambulance.

Atrophy is a condition that occurs when:

muscle decreases in size and function because of disease or trauma

The venom of a black widow spider is toxic to the:

nervous system.

The MOST common and significant complication associated with fractures or dislocations of the knee is:

neurovascular compromise.

Signs and symptoms of an air embolism include all of the following, EXCEPT:

pale skin.

Which of the following musculoskeletal injuries would pose the greatest threat to a patient's life?

pelvic fracture with hypotension

When a hollow organ is punctured during a penetrating injury to the abdomen:

peritonitis may not develop for several hours.

Your assessment of a 23-year-old female reveals a core body temperature of 93.4°F (34°C). She is conscious, answers your questions appropriately, is shivering, and complains of nausea. Her skin is cold and pale, her muscles appear rigid, and her respirations are rapid. In addition to monitoring her ABCs, administering oxygen, and turning up the heat in the back of the ambulance, you should:

place heat packs to her groin, axillae, and behind her neck; cover her with warm blankets; and avoid rough handling.

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:

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:

point tenderness.

You are transporting a 28-year-old man with a frostbitten foot. The patient's vital signs are stable and he denies any other injuries or symptoms. The weather is treacherous and your transport time to the hospital is approximately 45 minutes. During transport, you should:

protect the affected part from further injury.

A 20-year-old male was pulled from cold water by his friends. The length of his submersion is not known and was not witnessed. You perform a primary assessment and determine that the patient is apneic and has a slow, weak pulse. You should:

provide rescue breathing, remove wet clothing, immobilize his spine, keep him warm, and transport carefully.

A "hip" fracture is actually a fracture of the:

proximal femur.

The PASG is absolutely contraindicated in patients who have:

pulmonary edema.

High air temperature reduces the body's ability to lose heat by:

radiation.

A patient with a core body temperature of 95°F (35°C) will MOST likely experience:

rapid breathing.

Applying ice to and elevating an injured extremity are performed in order to:

reduce pain and swelling.

The pectoral girdle consists of the:

scapulae and clavicles.

An air embolism associated with diving occurs when:

the diver holds his or her breath during a rapid ascent.

Which of the following types of muscle is under direct voluntary control of the brain?

skeletal

Which of the following joints allows no motion?

skull sutures

What type of muscle contracts and relaxes to control the movement of the contents within its structures?

smooth

All of the following are hollow abdominal organs, EXCEPT the:

spleen.

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

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:

stabilize her head and perform a primary assessment.

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:

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

Skeletal muscle is also referred to as __________ muscle.

striated

You respond to a local lake where a diver complains of difficulty breathing that occurred immediately after rapidly ascending from a depth of approximately 30′. On assessment, you note that he has cyanosis around his lips and has pink froth coming from his nose and mouth. You should:

suction his mouth and nose, apply high-flow oxygen, position him on his left side with his head down, and contact medical control regarding transport to a recompression facility.

Burns associated with lightning strikes are typically:

superficial.

While drinking beer with his friends near a creek, a 31-year-old male was bitten on the leg by an unidentified snake. The patient is conscious and alert and in no apparent distress. Your assessment of his leg reveals two small puncture marks with minimal pain and swelling. In addition to administering oxygen and providing reassurance, further care for this patient should include:

supine positioning, splinting the leg, and transporting.

The two MOST efficient ways for the body to eliminate excess heat are:

sweating and dilation of skin blood vessels.

Deformity caused by a fracture would MOST likely be masked by:

swelling.

Breath-holding syncope is caused by a decreased stimulus to breathe and occurs when:

swimmer hyperventilates before entering water.

Which of the following would be the LEAST likely to occur in a patient with a core body temperature of between 89°F (32°C) and 92°F (33°C)?

tachycardia

Skeletal muscle is attached to the bone by tough, ropelike fibrous structures called:

tendons

Heatstroke occurs when:

the body's heat-eliminating mechanisms are overwhelmed.