Chapter 29

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.

Which of the following statements regarding compartment syndrome is correct?

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

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.

Atrophy is a condition that occurs when:

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?

Pelvis.

The MOST reliable indicator of an underlying fracture is:

Point tenderness.

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:

Splint the elbow in the position found and transport.

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.

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

Traction.

a simple joint where the bony projections of the scapula and the clavicle meet at the top of the shoulder

acromioclavicular (AC) joint

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

area of soft-tissue damage surrounding the injury.

a pearly layer of specialized cartilage covering the articular surfaces (contact surfaces on the ends) of bones in synovial joints

articular cartilage

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

articular cartilage.

the heel bone

calcaneus

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

carefully assess the patient for breathing problems

a fracture in which the skin is not broken

closed fracture

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

compare it to the uninjured leg.

swelling in a confined space that produces dangerous pressure; may cut off blood flow or damage sensitive tissue, frequently seen in fractures below the elbow or knee in children

compartment syndrome

..

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:

dislocation

disruption of a joint in which ligaments are damaged and the bone ends are completely displaced

dislocation

..

dislocation.

a fracture in which bone fragments are separated from one another and not in anatomic alignment

displaced fracture

discoloration of the skin associated with a close wound; bruising

ecchymosis

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

epiphyseal

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

evaluating proximal pulses

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

femur.

the outer and smaller bone of the two bones of the lower leg

fibula

a break in the continuity of a bone

fracture

the part of the scapula that joins with the humeral head to form the glenohumeral joint

glenoid fossa

blood in the urine

hematuria

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 simple crack in the bone that has not caused the bone to move from it's normal anatomic position; also called a hairline fracture

nondisplaced fracture

Of the following musculoskeletal injuries, which is considered to be the LEAST severe?

nondisplaced pelvic fracture

any break in a bone in which the overlying skin has been damaged

open fracture

used to splint the bony pelvis to reduce hemorrhage from bone ends, venous disruption and pain

pelvic binders

tenderness that is sharply localized at the site of the injury found by gently palpating along the bone with the tip of one finger

point tenderness

a hand position in which the wrist is slightly dorsiflexed and all finger joints are moderately flexed

position of function

return a dislocation joint or fractured bone to its normal position; set

reduce

the space between the abdominal cavity and the posterior abdominal wall, containing the kidneys, certain large vessels and parts of the gastrointestinal tract

retroperitoneal space

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

skeletal

a bandage or material that helps to support the weight of an injured upper extremity

sling

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

smooth

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.

stretching or tearing of a muscle; also called a muscle pull

strain

Skeletal muscle is also referred to as __________ muscle.

striated

a partial or incomplete dislocation

subluxation

a bandage that passes around the chest to secure an injured arm to the chest

swathe

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

swelling

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

tendons.

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.

the shin bone, the larger of the two bones of the lower leg

tibia

the bleeding control method used when a wound continues to bleed despite the use of direct pressure and elevation; useful if a patient is bleeding severely from a partial or complete amputation

tourniquet

the area of potentially damaged soft tissue, adjacent nerves and blood vessels surrounding an injury to a bone or joint

zone of injury

The MOST significant hazard associated with splinting is:

Delaying transport of a critically injured patient.

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.

a grating or grinding sensation caused by fractured bone ends or joints rubbing together; also air bubbles under the skin that produce a crackling sound or crinkly feeling

crepitus

the place where two bones come into contact

joint

The pectoral girdle consists of the:

scapulae and clavicles

the major nerve to the lower extremities; controls much of muscle function in the leg and sensation in most of the leg and foot

sciatic nerve

Which of the following joints allows no motion

skull sutures

a flexible or rigid appliance used to protect and maintain the position of an injured extremity

splint

a joint injury involving damage to supporting ligaments and sometimes partial or temporary dislocation of bone ends

sprain

longitudinal force applied to a structure

traction

..

traction.