Chapter 29

Femoral shaft fractures can result in up to _____ mL of internal blood loss.

1,000

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 statements regarding compartment syndrome is correct?

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

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 shoulder dislocations is MOST correct?

Most shoulder dislocations occur anteriorly

A subluxation occurs when:

a joint is incompletely dislocated

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 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

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

area of soft-tissue damage surrounding the injury

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

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:

assess distal pulse, motor, and sensory functions

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:

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

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

Bone marrow produces:

blood cells

Which of the following structures is regulated by smooth muscle?

blood vessels

The musculoskeletal system refers to the:

bones and voluntary muscles of the body

A fracture is MOST accurately defined as a(n):

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

clavicle

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

compare it to the uninjured leg

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

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

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

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

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

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

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

leave the toes exposed

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

ligaments

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

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

neurovascular compromise

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

nondisplaced pelvic fracture

A fracture caused by minimal force that is associated with diseases such as cancer and osteoporosis is called a __________ fracture.

pathologic

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

pelvic fracture with hypotension

Which of the following fractures has the greatest potential for internal blood loss and shock?

pelvis

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

Crepitus and false motion are:

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:

posterior hip dislocation

The primary purpose for splinting a musculoskeletal injury is to:

prevent further injury

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

proximal femur

The PASG is absolutely contraindicated in patients who have:

pulmonary edema

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

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

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 ____________ 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 80/50mm 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

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

swelling

Skeletal muscle is attached to the bone by tough, rope-like 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 act of pulling on a body structure in the direction of its normal alignment is called:

traction