Chapter 31

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 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.

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.

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

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

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

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.

The PASG is absolutely contraindicated in patients who have:

pulmonary edema

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 ____________ 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 80/50 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

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, ropelike fibrous structures called:

tendons