Musculoskeletal trauma (test 4)
Which of the following scenarios is an example of a direct injury? A) A passenger fractures her patella after it struck 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 struck the dashboard
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
Which of the following statements regarding compartment syndrome is MOST correct? A) Pressure within the fascial compartment is increased. B) It most commonly develops within minutes of the injury. C) It most commonly occurs following a pelvic fracture. D) It is caused by elevated pressure within the bone cavity.
a) Pressure within the fascial compartment is increased.
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.
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.
When caring for a patient with a possible fracture of the scapula, the EMT-B 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.
The MOST commonly fractured bone(s) in the body is/are the: A) clavicle. B) scapula. C) radius and ulna. D) midshaft femur.
a) clavicle.
The MOST significant complication associated with fractures or dislocations of the knee is: A) neurovascular compromise. B) internal bleeding and shock. C) ligament and cartilage damage. D) total depletion of synovial fluid.
a) neurovascular compromise.
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.
Deformity caused by a fracture would MOST likely be masked by: A) swelling. B) guarding. C) crepitus. D) ecchymosis.
a) swelling.
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 types of muscle is under direct voluntary control of the brain? A) Cardiac B) Skeletal C) Smooth D) Autonomic
b) Skeletal
The pneumatic antishock garment (PASG) would be MOST appropriate to use when immobilizing: A) hip fractures. B) a fractured pelvis. C) tibia/fibula fractures. D) unilateral femur fractures.
b) a fractured pelvis.
A fracture is MOST accurately defined as a: 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-B 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 Colles' fracture involves a fracture of the: A) distal ulna. B) distal radius. C) proximal radius. D) radius and ulna.
b) distal radius.
When splinting a suspected fracture of the radius and ulna, the EMT-B should immobilize the: A) wrist and hand. B) elbow and wrist. C) wrist and shoulder. D) elbow and shoulder.
b) elbow and wrist.
When splinting a possible fracture of the foot, it is MOST important for the EMT-B to: A) use a pillow as a splint. B) leave the toes exposed. C) apply a pneumatic splint. D) observe for tissue swelling.
b) leave the toes exposed.
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: A) thoracic spine. B) lumbar spine. C) coccygeal spine. D) symphysis pubis.
b) lumbar spine.
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) carcinogenic D) comminuted
b) pathologic
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.
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
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.
Bilateral femur fractures can result in up to _____ mL of internal blood loss. A) 1,000 B) 1,500 C) 2,000 D) 4,000
c) 2,000
In which of the following situations should the EMT-B 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 minute 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
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) It involves the acromion process and humerus.
c) Most shoulder dislocations occur anteriorly.
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
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.
A/an __________ 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) epipyseal
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.
Smooth muscle is found in all of the following organs, EXCEPT for the: A) esophagus. B) blood vessels. C) myocardium. D) large intestine.
c) myocardium.
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.
Bone marrow produces: A) platelets. B) lymphocytes. C) red blood cells. D) white blood cells.
c) red blood cells.
During your rapid trauma 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 the rapid trauma 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 the PASG and transport immediately. D) log roll the patient onto a long backboard and transport at once.
c) stabilize the pelvis with the PASG and transport immediately.
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
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
What type of muscle contracts and relaxes to control the movement of the contents within its respective structure? A) Cardiac B) Skeletal C) Striated D) Smooth
d) Smooth
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.
Prior to splinting an open extremity fracture, the EMT-B should first: A) assess the injury for crepitation. B) manually stabilize the injury site. C) assess distal neurovascular status. D) cover all bleeding or open wounds.
d) cover all bleeding or open wounds.
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.
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 tough fibrous tissues called: A) bursa. B) tendons. C) cartilage. D) ligaments.
d) ligaments.
The MOST reliable indicator of a fracture is: A) guarding. B) severe swelling. C) obvious bruising. D) point tenderness.
d) point tenderness.
A "hip" fracture is actually a fracture of the: A) pelvic girdle. B) femoral shaft. C) pubic symphysis. D) proximal femur.
d) proximal femur.
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.