Orthopaedic Injuries
A subluxation occurs when:
a joint is incompletely dislocated.
The zone of injury includes the:
adjacent nerves., adjacent blood vessels., surrounding soft tissue.
Always check neurovascular function:
after applying a splint., before applying a splint., after any manipulation of the limb.
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.
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.
The MOST commonly fractured bone(s) in the body is the:
clavicle.
A(n) _______ is a fracture in which the bone is broken into two or more fragments.
comminuted
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.
A supracondylar or intercondylar fracture is also known as a fracture of the:
distal humerus.
A Colles fracture involves a fracture of the:
distal radius.
Fractures are almost always associated with _______ of the surrounding soft tissue.
ecchymosis
Signs and symptoms of a dislocated joint include all of the following EXCEPT:
ecchymosis.
A(n) _______ fracture occurs in a growth section of a child's bone, which may prematurely stop growth if not properly treated.
epiphyseal
A(n) __________ fracture occurs in the growth section of a child's bone and may lead to bone growth abnormalities.
epiphyseal
Assessing a person's neurovascular status following a musculoskeletal injury includes all of the following, EXCEPT:
evaluating proximal pulses.
Traction splints are used primarily to immobilize and secure fractures of the:
femur.
A(n) _______ fracture is an incomplete fracture that passes only partway through the shaft of a bone but many still cause severe angulation.
greenstick
Blood in the urine is known as:
hematuria.
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(n) _______ may cause a fracture or discoloration at a distant point.
indirect force
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.
Signs and symptoms of sprains include all of the following EXCEPT:
marked deformity.
Atrophy is a condition that occurs when:
muscle decreases in size and function because of disease or trauma.
The act of pulling on a body structure in the direction of its normal alignment is called:
traction.
A fracture is MOST accurately defined as a(n):
break in the continuity of the bone.
When caring for a patient with a possible fracture of the scapula, the EMT should:
carefully assess the patient for breathing problems.
When assessing a patient with a possible fracture of the leg, the EMT should:
compare it to the uninjured leg.
When splinting an injury of the wrist, the hand should be placed:
in a functional position.
Applying ice to and elevating an injured extremity are performed in order to:
reduce pain and swelling.
What type of muscle contracts and relaxes to control the movement of the contents within its structures?
smooth
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:
splint the elbow in the position found and transport.
A _______ is an injury to the ligaments, the articular capsule, the synovial membrane, and the tendons crossing the joint.
sprain
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
If a dislocated shoulder has spontaneously reduced before your arrival, the only way to confirm the injury is by noting:
the patient history.
Femoral shaft fractures can result in up to _____ mL of internal blood loss.
1,000
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 shoulder dislocations is MOST correct?
Most shoulder dislocations occur anteriorly.
Which of the following is a basic type of splint?
Traction, Formable, Rigid
The bones in the skeleton produce _______ in the bone marrow.
blood cells
Bone marrow produces:
blood cells.
Which of the following structures is regulated by smooth muscle?
blood vessels
Smooth muscle is found in the:
blood vessels.
The musculoskeletal system refers to the:
bones and voluntary muscles of the body.
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 pectoral girdle consists of the:
scapulae and clavicles.
Which of the following scenarios is an example of a direct injury?
A passenger fractures her patella after it strikes the dashboard.
Which of the following injuries would be appropriate to treat with a traction splint?
An isolated femur fracture
_______ produce severe damage to the skeleton, surrounding soft tissues, and vital internal organs.
High-energy 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 about compartment syndrome is FALSE?
It most commonly occurs with a fractured femur.
_______ are held together in a tough fibrous structure known as a capsule.
Joints
Which of the following is not considered one of the "6 Ps" of the musculoskeletal assessment?
Peristalsis
_______ is the most reliable indicator of an underlying fracture.
Point tenderness
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.
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.
Your 24-year-old patient fell off a balance beam and landed on his arm. He is complaining of pain in the upper arm, and there is obvious swelling. You know that swelling is a sign of:
bleeding.
The MOST significant hazard associated with splinting is:
delaying transport of a critically injured patient.
A(n) _______ fractures the bone at the point of impact.
direct blow
A _______ is a disruption of a joint in which the bone ends are no longer in contact.
dislocation
The disruption of a joint in which the bone ends are no longer in contact is called a:
dislocation.
Which of the following musculoskeletal injuries would MOST likely result in deformity?
displaced fracture
A(n) _______ fracture produces actual deformity, or distortion, of the limb by shortening, rotating, or angulating it.
displaced fracture.
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.
The MOST common and significant complication associated with fractures or dislocations of the knee is:
neurovascular compromise.
A(n) _______ is also known as a hairline fracture.
nondisplaced fracture.
Of the following musculoskeletal injuries, which is considered to be the LEAST severe?
nondisplaced pelvic fracture
Regardless of the extent and severity of the damage to the skin, you should treat any injury that breaks the skin as a possible:
open fracture.
A fracture caused by minimal force that is associated with diseases such as cancer and osteoporosis is called a __________ fracture.
pathologic
You are called to the local assisted living facility where a 94-year-old man has fallen. He is alert and oriented and denies passing out. His respirations are 18 breaths/min and regular. Pulse is 106 beats/min, regular, and strong. Distal pulses are present. He states that he was walking and heard a pop and fell to the floor. You suspect a(n):
pathologic
Which of the following musculoskeletal injuries would pose the greatest threat to a patient's life?
pelvic fracture with hypotension
Which of the following fractures has the greatest potential for internal blood loss and shock?
pelvis
When caring for patients who have fallen, you must identify the _______ and the mechanism of injury so that you will not overlook associated injuries.
point of contact
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.
You respond to a 19-year-old woman who was involved in a motor vehicle collision. She is alert and oriented. Her airway is open, and respirations are 18 breaths/min and unlabored. Pulse is 94 beats/min and is strong and regular. Distal pulses are present. Her upper arm has obvious deformity. You splint the upper arm. You know that splinting will do all of the following EXCEPT:
prevent the need for surgery.
A "hip" fracture is actually a fracture of the:
proximal femur.
The PASG is absolutely contraindicated in patients who have:
pulmonary edema.
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
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.
A _______ is a stretching or tearing of the muscle.
strain
Skeletal muscle is also referred to as __________ muscle.
striated
Deformity caused by a fracture would MOST likely be masked by:
swelling.
Joints are bathed and lubricated by _______ fluid.
synovial
Skeletal muscle is attached to the bone by tough, ropelike fibrous structures called:
tendons.
You respond to a 19-year-old woman who was kicked in the leg by a horse. She is alert and oriented. Respirations are 20 breaths/min, regular and unlabored. Pulse is 110 beats/min and regular. Distal pulses are present. She has point tenderness at the site of the injury. You should compare the limb to:
the opposite uninjured limb.
An open fracture is MOST accurately defined as a fracture in which:
the overlying skin is no longer intact.
In general, musculoskeletal injuries should be splinted before moving the patient unless:
the patient is clinically unstable.
In-line _______ is the act of exerting a pulling force on a body structure in the direction of its normal alignment.
traction