Chapter 31 Orthopaedic Injuries

Bone marrow produces: A. Electrolytes B. lymphocytes C. cartilage D. blood cells

D. Blood cells

The musculoskeletal system refers to the: A. Connective tissue that supports the skeleton B. nervous system's control over the muscles C. involuntary muscles of the nervous system D. bones and voluntary muscles of the body

D. Bones and voluntary muscles of the body

Which of the following musculoskeletal injuries would MOST likely result in deformity? A. Severe strain B. Hairline fracture C. Moderate sprain D. Displaced fracture

D. Displaced fracture

A supracondylar or intercondylar fracture is also known as a fracture of the: A. Olecranon process B. proximal radius C. radial head D. distal humerus

D. Distal humerus

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 transport time to the hospital is greater than 20 to 30 minutes D. If resistance is encountered or the patient experiences severe pain

D. If resistance is encountered or the patient experiences severe pain

Care for a patient with a fractured tibia and suspected compartment syndrome includes: A. applying traction to maintain distal pulses B. immobilizing the leg with an air splint C. applying chemical hot packs to the leg D. keeping the leg at the level of the heart

D. Keeping the leg at the level of the heart

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. thoracic spine C. coccygeal spine D. lumbar spine

D. Lumbar spine

A fracture caused by minimal force that is associated with diseases such as cancer and osteoporosis is called a _______ fracture. A. transverse B. comminuted C. greenstick D. pathologic

D. Pathologic

Which of the following joints allows no motion? A. Stereo clavicle joint B. Shoulder joint C. Sacroiliac joint D. Skull sutures

D. Skull sutures

The MOST commonly fractured bone(s) in the body is/are the: A. Radius and ulna B. scapula C. midshaft femur D. clavicle

D. clavicle

A fracture is MOST accurately defined as a(n): A. Break in the continuity of the bone B. disruption in the mid shaft of a bone C. abnormality in the structure of a bone D. total loss of function in a bone

A. Break in the continuity of the bone

The MOST common and significant complication associated with fractures or dislocations of the knee is: A. Neurovascular compromise B. ligament and cartilage damage C. total depletion of synovial fluid D. internal bleeding and shock

A. Neurovascular compromise

Crepitus and false motion are: A. Positive indicators of a fracture B. indicators of a severe sprain C. only seen with open fractures D. most common with dislocations

A. Positive indicators of a fracture

A "hip" fracture is actually a fracture of the: A. Proximal femur B. pubic symphysis C. femoral shaft D. pelvic girdle

A. Proximal femur

During your secondary assessment of a 30-year-old male who fell 25 feet, 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. Stabilize the pelvis with a pelvic binder and protect the spine B. defer spinal immobilization and transport to a trauma center C. perform a focused physical exam with emphasis on the pelvis D. log roll the patient onto a long backboard and transport at once

A. Stabilize the pelvis with a pelvic binder and protect the spine

Deformity caused by a fracture would MOST likely be masked by: A. Swelling B. crepitus C. guarding D. ecchymosis

A. Swelling

If a dislocated shoulder has spontaneously reduced before your arrival, the only way to confirm the injury is by noting: A. The patient history B. distal circulation C. the presence of deformity D. bruising to the shoulder

A. the patient history

When splinting an injury of the wrist, the hand should be placed: A. In a straight position B. in a functional position C. into a fist D. in an extended position

B. In a functional position

Which of the following musculoskeletal injuries would pose the greatest threat to a patient's life? A. An amputated extremity B. Pelvic fracture with hypotension C. Nondisplaced long bone fractures D. Bilateral femur fractures

B. 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 is 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

You and your partner are preparing to apply a traction splint to a patient's deformed thigh. As you apply manual traction, the patient resists your efforts and states that the pain is getting worse. You should: A. Flex the knee and place a pillow under the thigh B. stop and splint the leg in the deformed position C. gently massage the thigh muscles to relax them D. assess distal pulses and continue pulling traction

B. Stop and splint the leg in the deformed position

In general, musculoskeletal injuries should be splinted before moving the patient unless: A. Transport time is less than 15 minutes B. the patient is clinically unstable C. the patient is in severe pain D. deformity and swelling are present

B. the patient is clinically unstable

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. Focus. your assessment on his scapulae and clavicles and apply high-flow oxygen B. apply high-flow oxygen, perform a detailed secondary assessment, and transport C. apply high-flow oxygen, consider spinal precautions, and transport without delay D. hyperventilate him with a BVM and monitor his oxygen saturation

C. Apply high-flow oxygen, consider spinal precautions, and transport without delay

Which of the following statements regarding compartment syndrome is correct? A. In most cases, compartment syndrome develops within a few minutes after an injury B. Compartment syndrome occurs because of increased pressure within the bone cavity C. Compartment syndrome typically develops within 6 to 12 hours after an injury D. Most cases of compartment syndrome occur following a severe fracture of the pelvis

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

Traction splints are used primarily to immobilize and secure fractures of the: A. Hip B. humerus C. femur D. pelvis

C. Femur

Which of the following statements regarding striated muscle is correct? A. Striated muscle is involuntary because you have no conscious control over it B. Most of the body's striated muscle is found within the walls of the blood vessels C. It forms the major muscle mass of the body and usually crosses at least one joint D. Striated muscle tissue is attached directly to the bones by tough bands of cartilage

C. It forms the major muscle mass of the body and usually crosses at least one joint

A 17-year-old female dislocated her patella while playing soccer. Her knee is flexed and she complains of severe pain. You should: A. Gently straighten her knee and apply a padded board splint B. flex her knee slightly more and assess for distal circulation C. keep her knee flexed and secure it with padded board splints D. make one attempt to return the patella to its normal position

C. Keep her knee flexed and secure it with padded board splints

Atrophy is a condition that occurs when: A. the tendons that attach muscle to bone become stretched or injured B. carbon dioxide, lactic acid, and other wastes accumulate in the muscle C. muscle decreases in size and function D. increased use of skeletal muscle causes an increase in its strength

C. Muscle decreases in size and function

A 20-year-old male collided with another player during a hockey game and complains of severe pain to the left shoulder. Assessment reveals that the clavicle is bulging anteriorly at the shoulder. The EMT should suspect: A. Posterior dislocation of the shoulder B. dislocation of the glens humoral joint C. separation of the acromioclavicular joint D. multiple fractures of the proximal humerus

C. Separation of the acromioclavicular joint

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. assess for a carotid pulse and assist he ventilations B. administer oxygen and perform a rapid assessment C. stabilize her head and perform a primary assessment D. apply manual stabilization to both of her femurs

C. Stabilize her head and perform a primary assessment

Skeletal muscle is attached to the bone by tough, rope like, fibrous structures called: A. Ligaments B. cartilage C. tendons D. fascia

C. Tensons

An open fracture is MOST accurately defined as a fracture in which: A. A large laceration overlies the frracture 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 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. assess distal pulses as well as sensory and motor functions B. control the bleeding and cover the wound with a sterile dressing C. manually stabilize the leg above and below the site of injury D. gently manipulate the injured leg until the numbness dissipates

B. Control the bleeding and cover the wound with a sterile dressing

Common signs and symptoms of a sprain include all of the following, EXCEPT: A. Swelling B. deformity C. ecchymosis D. point tenderness

B. Deformity

The MOST significant hazard associated with splinting is: A. Compression of nerves, tissues, and vasculature B. delaying transport of a critically injured patient C. aggravation of the injury or worsened pain D. reduction in circulation distal to the injury site

B. Delaying transport of a critically injured patient

During your assessment of a 29-year-old female with significant deformity to her left elbow, you are unable to palate a radial pulse. Your transport time to the hospital is approximately 40 minutes. You should: A. 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 C. splint the elbow in the position of deformity and transport immediately D. 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

With regard to musculoskeletal injuries, the zone of injury is defined as the: A. Part of the body that sustained secondary injury B. area of soft-tissue damage surrounding the injury C. exact part of the bone or joint that was disrupted D. area of obvious deformity over the site of impact

B. Area of soft-tissue damage surrounding the injury

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 arm in a fixed position away from his body. There is an obvious anterior bulge to the area of injury. You should: A. Flex his arm at the elbow and then apply a sling B. assess distal pulse, motor, and sensory functions C. gently attempt to move his arm toward his body D. place a pillow under his arm and apply a swathe

B. Assess distal pulse, motor, and sensory functions

When caring for a patient with a possible fracture of the scapula, the EMT should: A. Apply rigid board splints across the chest and back B. carefully assess the patient for breathing problems C. recognize that scapular fractures are life threatening D. assume that minimal force was applied to the back

B. Carefully assess the patient for breathing problems

Femoral shaft fractures can result in up to _______ mL of internal blood loss. A. 4,000 B. 2,000 C. 1,500 D. 1,000

D. 1,000