Chapter 15: Injuries to Muscles and Bones

Muscles that can be contracted and relaxed by a person at will are called: A. voluntary. B. involuntary. C. cardiac. D. antagonistic.

A.

Signs that indicate an injury to a limb may include all of the following EXCEPT: A. ability to bear weight. B. swelling or bruising. C. tenderness or pain with motion. D. deformity.

A.

Splints made from wood, aluminum, or plastic are called: A. rigid splints. B. traction splints. C. soft splints. D. commercial splints.

A.

Use of the capillary refill test: A. will indicate a circulation problem. B. takes 2 to 3 minutes. C. gives an accurate indication under all circumstances. D. can only be used in adults.

A.

Which of the following is not part of the treatment of hand, wrist, and finger injuries? A. Place one or two soft roller dressings on the back of the patient's hand. B. Cover all wounds with a dry, sterile dressing. C. Place the injured hand or wrist into a position of function. D. Apply a splint to hold the wrist, hand, and fingers in the position of function, and secure the splint with a soft roller bandage.

A.

Define: Osteoporosis

Abnormal brittleness of the bones in older people

List three signs or symptoms of extremity injuries.

An open wound, deformity, and swelling bruising.

1. Muscles of the body may be called: A. unvoluntary. B. involuntary. C. cooperative. D. antagonistic.

B.

A man who shows no sign of injury in his arm is unable to make a fist. He has most likely injured what structures in the arm? A. Nerves B. Muscles C. Bones D. Tendons and ligaments

B.

A triangular bandage or similar material tied around the neck to support the weight of an injured upper extremity is called a(n): A. improvised splint. B. sling. C. traction sling. D. rigid splint.

B.

An injury in which a joint is partially dislocated and there is excessive stretching of supporting ligaments is called a(n): A. open fracture. B. sprain. C. dislocation. D. closed fracture.

B.

If a patient with injuries to the chest exhibits a reversed movement of the chest during breathing: A. you should avoid oxygen therapy B. suspect flail chest. C. place a pillow on the patient's chest. D. restrict the movement with a splint.

B.

Muscles that are found inside the digestive tract and other internal organs are called: A. voluntary. B. involuntary. C. cardiac. D. antagonistic.

B.

Musculoskeletal injuries may be caused by all of the following EXCEPT: A. direct force. B. oblique force. C. twisting force. D. indirect force.

B.

To determine if a patient has adequate circulation in an injured arm, you should check the _______ pulse. A. carotid B. radial C. tibial D. femoral

B.

To test for sensation in an injured arm, you should touch the tips of the ________ fingers. A. index and middle B. index and little C. middle and little D. middle and ring

B.

Which of the following is false regarding the treatment of penetrating chest wounds? A. Quickly seal an open chest wound with a material that will prevent more air from entering the chest cavity. B. If a knife or other object is impaled in the chest, remove it immediately. C. Any chest injury that results in air leakage and bleeding requires prompt attention. D. A conscious patient with chest trauma may demand to be placed in a sitting position to ease breathing.

B.

Which of the following statements best describes an open fracture? A. The ends of the bones at the break are aligned but are more than an inch apart. B. The risk of infection is high because dirt and bacteria often enter the wound. C. Bleeding is minimal because the bone end causes a puncture wound. D. To break the bone, a bullet or some sharp object must have broken the skin.

B.

You should always inflate a soft splint with: A. water. B. your mouth (breath). C. an air pump. D. an air cylinder.

B.

You are in a remote rural area where a fire is burning near some farm equipment. You need to move a patient with a fractured thighbone, but EMTs will not arrive for another 10 minutes. The best way to prevent additional injury would be to: A. wait for the EMTs to arrive. B. try to put the fire out. C. leave the patient and find help. D. secure the injured leg to the uninjured leg and then move the patient.

D.

Define: Dislocation

Disruption of a joint so that the bone ends are no longer in alignment

You are dispatched to the scene of a "long fall." When you arrive, you find a 26-year-old man lying on the snow next to a ladder leaning against the house and Christmas lights hanging from the front of the house. His right leg is deformed. What should you do?

First examine the limb for an open wound, deformity, swelling, or bruising. Throughout the whole procedure check for the pulse, capillary refill, sensation, and movement. Support the injured leg, then slide the splint under the limb, and place the splint around the limb. First rescuer removes hands and the second rescuer inflates the splint.

Define: Closed fracture

Fracture in which the overlying skin has not been damaged

List the seven areas of the skeletal system.

Head, skull, face, spinal column, shoulder girdle, upper extremities, rib cage (thorax), pelvis, and lower extremities

Describe the treatment for a head injury.

Immobilize the head into a neutral position, stabilize the neck and prevent the head from moving. Do not move the head if it causes resistance. Maintain an open airway using the jaw-thrust maneuver. Be prepared to suction if the patient vomits and do not move the head and neck. Support the patient's breathing, if needed, by using mouth-to-mask or mouth- to-barrier ventilation. Administer oxygen if you are trained to. Monitor circulation and perform CPR if the patient's heart stops. Check to see if blood is seeping from a wound, nose or ears. Control bleeding from the head by using dry, sterile dressings. Use direct pressure without disturbing the underlying tissue. Treat other serious injuries and provide prompt transportation to an appropriate medical facility.

_______ is the abnormal brittleness of the bones in older people caused by loss of calcium.

Osteoporosis

Skill Drill15-1: Checking Circulation, Sensation, and Movement in an Injured Extremity: Fill in the Blank and label the step number. Release pressure. ____ color should return.

Pink/4

Define: Trauma

Wound or injury, either physical or psychological

A spinal cord injury may paralyze respiratory muscles and cause the patient to breathe using only the diaphragm, which is known as ________ breathing.

abnormal

Example: Twisting force

an ankle being turned in an unnatural way

What two questions should you ask a patient who has a limb injury?

ask the patient where it hurts most and where there is tingling or numbness

One sign of a head injury, known as ________ sign, is a bruise behind one or both ears.

battle

Name two ways to check for adequate circulation in an injured limb.

capillary refill or pulse

Skill Drill15-1: Checking Circulation, Sensation, and Movement in an Injured Extremity: Fill in the Blank and label the step number. {1-8} Test ______ _______ on finger/toe of injured limb.

capillary refill/3

Name four things you should always check on an injured limb both before and after splinting.

check the pulse, capillary refill, sensation, and movement of the injured limb

Describe the three types of mechanisms of injury.

direct force, indirect force, and twisting force

A(n) ________ is a disruption that tears the supporting ligaments of the joint.

dislocation

Fracture of three or more ribs in at least two places causes a condition known as _________ chest.

flail

Name the three major types of injuries to the musculoskeletal system.

fractures, dislocations, sprains, and strains

Example: Direct force

having your knee get struck directly

Example: Indirect force

having your know get struck and the force travels through the leg

Name three key signs and symptoms of a spinal injury.

laceration, bruise, and tenderness near the head and neck

How injuries occur is known as the _________ of injury.

mechanism

The primary danger in severe facial injuries is _________ of the airway.

obstructed

Name four signs of injury you should look for during a visual examination of the limb.

open wound, deformity, swelling, and bruising

Skill Drill15-1: Checking Circulation, Sensation, and Movement in an Injured Extremity: Fill in the Blank and label the step number. {1-8} If lower extremity injury, check __________ pulse.

posterior/2

Skill Drill15-1: Checking Circulation, Sensation, and Movement in an Injured Extremity: Fill in the Blank and label the step number. {1-8} Check for circulation. If upper extremity injury, check ____ pulse.

radial/1

Splinting of the cervical spine is accomplished with a(n) ____________ ____________ and a long or short spine board or backboard.

rigid collar

Skill Drill15-1: Checking Circulation, Sensation, and Movement in an Injured Extremity: Fill in the Blank and label the step number. Check for _____ at fingertips.

sensation/5

Skill Drill15-1: Checking Circulation, Sensation, and Movement in an Injured Extremity: Fill in the Blank and label the step number. Check for _____ at toes.

sensation/6

What are the five steps for splinting a forearm injury with a SAM splint?

stabilize the injured limb, unroll the SAM splint, place the splint under the injured limb, and fasten the limb with gauze

Name the four primary functions of the skeletal system.

supports the body, protects the vital structures, assists the body movement, and manufactures red blood cells

The three basic types of splints are rigid, soft, and __________.

traction

Describe four signs or symptoms of a head injury.

Confusion, unusual behavior, unconsciousness, and nausea or vomiting.

Signs and symptoms of a spinal cord injury include all of the following EXCEPT: A. tenderness over any point on the spine or neck. B. increased bowel or bladder control. C. laceration, bruise, or otht;r sign of injury to the head, neck, or spine. D. tingling or burning sensation in any part of the body below the neck.

D.

Define: Cerebrospinal fluid

Clear, watery, straw-colored fluid that fills the space between the brain and spinal cord

Which of the following is not associated with head injuries? A. Bleeding and/or swelling within the skull B. Seepage of CSF C. Injury to the spine D. Development of diabetes

D.

A clear plastic, inflatable splint is a type of: A. rigid splint. B. traction splint. C. soft splint. D. generic splint.

C.

An injury in which the bone is broken but the skin remains intact is called a(n): A. bruise. B. contusion. C. closed fracture. D. open fracture.

C.

An injury that causes tears of the ligaments and separation of the bone ends is a(n): A. open fracture. B. sprain. C. dislocation. D. closed fracture.

C.

Common causes of spinal cord injuries include all of the following EXCEPT: A. falls less than three times the patient's height. B. athletic collisions. C. hangings. D. diving injuries.

C.

During examination of an injured limb, the EMR's best indicator of an underlying fracture, dislocation, or sprain is: A. an open wound. B. bruising. C. tenderness. D. swelling.

C.

Emergency care of a patient who has a broken thighbone should include placing the patient in a comfortable position and: A. elevating the injured leg. B. bending the injured leg at the knee. C. treating the patient for shock. D. applying ice or cold compresses to the leg.

C.

General principles of splinting limb injuries include which of the following? A. Do not splint joints unless injury is visible. B. Leave clothing in place. C. Pad all rigid splints. D. Do not immobilize any joints.

C.

Most splinting operations require two people; the first applies the splint, and the second: A. inflates the splint. B. distracts the patient. C. stabilizes and supports the injured limb. D. makes sure the splint is applied properly.

C.

One way a dislocation differs from a sprain is that in a dislocation: A. fewer nerves are damaged. B. there is less pain. C. the supporting ligaments are torn from the joint. D. the bones always realign into their natural position in the joint.

C.

The mechanism of injury refers to: A. how to move an injured patient. B. whether a patient can move an injured limb. C. the means by which an injury has occurred. D. the type of transport needed for injuries.

C.

To test for sensation in an injured leg, you should touch the tip of the big toe and the: A. heel. B. arch of the foot. C. top of the foot. D. side of the little toe.

C.

What is the first step for an EMR to take if there are signs or symptoms of head injury? A. Check and maintain the airway B. Call for additional help. C. Immobilize the head and stabilize the neck. D. Check circulation and for bleeding.

C.

When facial injuries are present: A. place the patient in the recovery position. B. bandage the entire head and face. C. stabilize the head in a neutral position. D. encourage the patient to eat.

C.

When responding to motor vehicle crashes with broken glass or other sharp objects: A. you should be more concerned about the patient than your safety. B. latex gloves will provide optimal protection. C. it is wise to wear heavy rescue gloves that provide protection from sharp objects. D. all of the above.

C.

Which of the following does NOT describe musculoskeletal injuries? A. Fractures, dislocations, and sprains B. Closed and open fractures C. Warm and pink D. Painful, swollen, deformed extremity

C.

For a patient with a spinal cord injury, you should not move the patient unless it is necessary to perform __________ or remove him or her from a dangerous situation.

CPR

Emergency care of a patient who has no pulse or capillary refill in an injured limb should be to: A. encourage the patient to move the limb. B. briskly rub the limb to stimulate circulation. C. warm the limb to stimulate circulation. D. arrange for immediate transport to a hospital.

D.

Your unit is dispatched to an altercation at a local bar. When you arrive, you see one man sitting outside the bar with a towel on his head. You notice the towel is covered with blood; the patient tells you he was struck in the head with a beer bottle. The bartender tells you that two men were fighting in the bar and that one of the men left the scene before your arrival. What should you do?

Immobilize the head, stabilize the neck and prevent the head from moving. Do not move the head if it causes resistance. Use the jaw-thrust maneuver, if needed. Support the patient's breathing, if needed, by using mouth-to-mask or mouth- to-barrier ventilation. Administer oxygen if you are trained to. Monitor circulation and perform CPR if the patient's heart stops. Check to see if there is blood coming from wounds, nose, or ears. Control bleeding from the head by using dry, sterile dressings. Use direct pressure without disturbing the underlying tissue. Treat other serious injuries and provide prompt transportation to an appropriate medical facility.

Define: Paralysis

Inability of a conscious person to move voluntarily

Define: Sprain

Joint injury in which the joint is partially or temporarily dislocated and supporting ligaments are either stretched or torn

Describe how you would splint an injury to the elbow.

Splint the elbow as it is. A pillow splint is the most effective. Wrap the injury with pillows and padding. The padded wire ladder or SAM splint could also be used. Rest the elbow onto their lap when transporting.

Define: Seizures

Sudden episodes of uncontrolled electrical activity in the brain

Define: Mechanism of injury

The means by which a traumatic injury occurs

Define: Joint

The place where two bones come in contact with each other