Chapter 32 Orthopedic Injuries
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
Which of the following types of muscle is under direct voluntary control of the brain?
Skeletal
A simple joint where the bony projections of the scapula and the clavicle meet at the top of the shoulder.
acromioclavicular joint
An injury in which part of the body is completely severed.
amputation
With regard to musculoskeletal injuries, the zone of injury is defined as the:
area of soft-tissue damage surrounding the injury
A pearly white layer of specialized cartilage covering the articular surfaces (contact surfaces on the ends) of bones in synovial joints.
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
Bone marrow produces:
blood cells
A fracture is MOST accurately defined as a(n):
break in the continuity of the bone
The heel bone.
calcaneus
Any break in a bone in which the overlying skin is not broken.
closed fracture
A fracture in which the bone is broken into more than two fragments
comminuted fracture
Swelling in a confined space that produces dangerous pressure; may cut off blood flow or damage sensitive tissue.
compartment syndrome
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 or sound caused by fractured bone ends or joints rubbing together.
crepitus
The MOST significant hazard associated with splinting is:
delaying transport of a critically injured patient
Disruption of a joint in which ligaments are damaged and the bone ends are no longer in contact.
dislocation
A fracture in which bone fragments are separated from one another, producing deformity in the limb.
displaced fracture
When treating an open extremity fracture, you should:
dress the wound before applying a splint
A buildup of blood beneath the skin that produces a characteristic blue or black discoloration as the result of an injury.
ecchymosis
A fracture in the growth section of a child's bone
epiphyseal fracture
Movement that occurs in a bone at a point where there is no joint, indicating a fracture; also called free movement.
false motion
The fiber-like connective tissue that covers arteries, veins, tendons, and ligaments.
fascia
The smaller of the two bones that form the lower leg, located on the lateral side.
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
An incomplete fracture that passes only partway through the shaft of a bone
greenstick fracture
Blood in the urine.
hematuria
When splinting an injury of the wrist, the hand should be placed:
in a functional position
A fracture that does not run completely through the bone
incomplete fracture
The place where two bones come into contact.
joint
Bands of fibrous tissue that connect bones to bones. These tissues support and strengthen a joint.
ligaments
Bones are connected to other bones by bands of tough fibrous tissues called:
ligaments
A patient tripped, fell, and landed on her elbow. She is in severe pain and has obvious deformity to her elbow. You should:
manually stabilize her injury
Atrophy is a condition that occurs when:
muscle decreases in size and function.
A simple crack in the bone that has not caused the bone to move from its normal anatomic position; also called a hairline fracture.
nondisplaced fracture
A fracture in which the bone is broken at an angle across the bone
oblique fracture
Any break in a bone in which the overlying skin is broken.
open fracture
A fracture caused by minimal force that is associated with diseases such as cancer and osteoporosis is called a __________ fracture.
pathologic
A fracture of weakened or diseased bone
pathologic fracture
A device to splint the bony pelvis to reduce hemorrhage from bone ends, venous disruption, and pain.
pelvic binder
Which of the following musculoskeletal injuries has the GREATEST risk for shock due to blood loss
pelvic fracture
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
The purpose of splinting a fracture is to:
prevent motion of bony fragments
A "hip" fracture is actually a fracture of the:
proximal femur
To return a dislocated joint or fractured bone to its normal position; to 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
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
A motorcyclist crashed his bike and has closed deformities to both of his midshaft femurs. He is conscious, but restless; his skin is cool and clammy; and his radial pulses are rapid and weak. The MOST appropriate splinting technique for this patient involves:
securing him to a long backboard
A young male has a musculoskeletal injury and is unresponsive. You will NOT be able to assess:
sensory and motor functions
A bandage or material that helps to support the weight of an injured upper extremity.
sling
To effectively immobilize a fractured clavicle, you should apply a(n):
sling and swathe
A fracture caused by a twisting force, causing an oblique fracture around and through the bone
spiral fracture
A flexible or rigid device used to protect and maintain the position of an injured extremity.
splint
A patient injured her knee while riding a bicycle. She is lying on the ground, has her left leg flexed, is in severe pain, and cannot move her leg. Your assessment reveals obvious deformity to her left knee. Distal pulses are present and strong. The MOST appropriate treatment for her injury involves:
splinting the leg in the position in which it was found.
A joint injury involving damage to supporting ligaments, and sometimes partial or temporary dislocation of bone ends.
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
You respond to a soccer game for a 16-year-old male with severe ankle pain. When you deliver him to the hospital, the physician tells you that he suspects a sprain. This means that:
stretching or tearing of the ligaments with partial or temporary dislocation of the bone ends has occurred.
Skeletal muscle is also referred to as:
striated muscle
A bandage that passes around the chest to secure an injured arm to the chest.
swathe
An open fracture is MOST accurately defined as a fracture in which:
the overlying skin is no longer intact
The shinbone; 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; useful if a patient is bleeding severely from a partial or complete amputation.
tourniquet
Longitudinal force applied to a structure.
traction
A fracture that occurs straight across the bone
transverse fracture
The area of potentially damaged soft tissue, adjacent nerves, and blood vessels surrounding an injury to a bone or a joint.
zone of injury