Chapter 31 - Orthopaedic Injuries

Bone marrow produces: a-blood cells. b-platelets. c-lymphocytes. d-electrolytes.

a-blood cells.

Assessing a person's neurovascular status following a musculoskeletal injury includes all of the following, EXCEPT: a-evaluating proximal pulses. b-assessing sensory function. c-determining capillary refill. d-assessing motor function.

a-evaluating proximal pulses.

Femoral shaft fractures can result in up to _____ mL of internal blood loss. a-2,000 b-1,000 c-4,000 d-1,500

b-1,000

A subluxation occurs when: a-ligaments are partially severed. b-a joint is incompletely dislocated. c-a bone develops a hairline fracture. d-a fracture and a dislocation exist.

b-a joint is incompletely dislocated.

A Colles fracture involves a fracture of the: a-radius and ulna. b-distal ulna. c-distal radius. d-proximal radius.

c-distal radius.

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

c-if resistance is encountered or the patient experiences severe pain

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: a-apply high-flow oxygen, consider spinal precautions, and transport without delay. b-apply high-flow oxygen, perform a detailed secondary assessment, and transport. c-hyperventilate him with a bag-mask device and monitor his oxygen saturation. d-focus your assessment on his scapulae and clavicles and apply high-flow oxygen.

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

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

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

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-control the bleeding and cover the wound with a sterile dressing. b-manually stabilize the leg above and below the site of injury. c-assess distal pulses as well as sensory and motor functions. d-gently manipulate the injured leg until the numbness dissipates.

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

Traction splints are used primarily to immobilize and secure fractures of the: a-femur. b-humerus. c-hip. d-pelvis.

a-femur.

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-sprain b-fracture c-strain d-dislocation

a-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: a-stabilize her head and perform a primary assessment. b-administer oxygen and perform a rapid assessment. c-apply manual stabilization to both of her femurs. d-assess for a carotid pulse and assist her ventilations.

a-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: a-traction. b-immobilization. c-reduction. d-stabilization.

a-traction.

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-Most cases of compartment syndrome occur following a severe fracture of the pelvis. d-In most cases, compartment syndrome develops within a few minutes after an injury.

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

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-make two or three attempts to restore distal circulation by manipulating the elbow. b-apply gentle manual traction in line with the limb and reassess for a pulse. c-splint the elbow in the position of deformity and transport immediately. d-carefully straighten the injured arm and secure it with padded board splints.

b-apply gentle manual traction in line with the limb and reassess for a pulse.

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-gently attempt to move his arm toward his body. b-assess distal pulse, motor, and sensory functions. c-place a pillow under his arm and apply a swathe. d-flex his arm at the elbow and then apply a sling.

b-assess distal pulse, motor, and sensory functions.

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-symphysis pubis. b-lumbar spine. c-coccygeal spine. d-thoracic spine.

b-lumbar spine.

A fracture caused by minimal force that is associated with diseases such as cancer and osteoporosis is called a __________ fracture. a-comminuted b-pathologic c-greenstick d-transverse

b-pathologic

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: a-manually stabilize her left leg, apply a traction splint, and then secure her to a long backboard or scoop. b-place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps. c-bind both of her legs together with triangular bandages and carefully secure her onto the ambulance stretcher. d-carefully slide a long backboard underneath her, keep her in a supine position, and apply a splint to her leg.

b-place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps.

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: a-splint each of his deformed femurs with long board splints and transport immediately. b-apply traction splints to both of his legs, keep him warm, and transport without delay. c-bind his legs together on the backboard, keep him warm, and transport without delay. d-apply the PASG to stabilize his femurs and transport at once.

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

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: a-gently straighten the elbow and apply an air splint. b-apply a heat pack to the elbow to reduce swelling. c-splint the elbow in the position found and transport. d-gently manipulate the elbow to improve circulation.

c-splint the elbow in the position found and transport.

An open fracture is MOST accurately defined as a fracture in which: a-a large laceration overlies the fracture. b-a bullet shatters the underlying bone. c-the overlying skin is no longer intact. d-bone ends protrude through the skin.

c-the overlying skin is no longer intact.

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: a-applying and fully inflating the pneumatic antishock garment (PASG). b-applying a traction splint to realign the deformity. c-binding the legs together and elevating them 6″ to 8″. d-applying padded board splints to both sides of the leg.

d-applying padded board splints to both sides of the leg.

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: a-perform a rapid secondary assessment. b-place a pillow under his arm and apply a sling. c-straighten his arm and apply a board splint. d-immobilize the injury with a sling and swathe.

d-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: a-carefully splinting each of her deformed extremities. b-applying and inflating the pneumatic antishock garment (PASG) and transporting. c-applying a traction splint to immobilize her femur. d-immobilizing her to a backboard and rapidly transporting.

d-immobilizing her to a backboard and rapidly transporting.

Bones are connected to other bones by bands of tough fibrous tissues called: a-cartilage. b-bursa. c-tendons. d-ligaments.

d-ligaments.

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: a-fracture of the tibia or fibula. b-anterior hip dislocation. c-a thoracic spine fracture. d-posterior hip dislocation.

d-posterior hip dislocation.

What type of muscle contracts and relaxes to control the movement of the contents within its structures? a-skeletal b-striated c-cardiac d-smooth

d-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: a-log roll the patient onto a long backboard and transport at once. b-perform a focused physical exam with emphasis on the pelvis. c-defer spinal immobilization and transport to a trauma center. d-stabilize the pelvis with a pelvic binder and protect the spine.

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

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 presence of deformity. c-bruising to the shoulder. d-the patient history.

d-the patient history.