Ch 31 Orthopaedic Injuries

A 76 year old male experience 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 motor functions are intact. The MOST appropriate method of splinting this injury involves:

Applying padded board splints to both sides of the leg

You have applied a zippered air splint to the 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

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

Bone Marrow produces:

Blood cells

Smooth Muscle is found in the:

Blood vessels

The MOST commonly fractured bones in the body are the

Clavicle

Blood in the urine is known as

Hematuria

Skeletal muscle is also referred to as:

Striated Muscle

In line ______ is the act of exerting a pulling force on a body structure in the direction of its normal alignment

Traction

Which of the following statements regarding the treatment of an amputation is false

You should sever any partial amputation, because this will aid the re-attachment process

A subluxation occurs when:

A joint is incompletely dislocated

Which of the following scenarios is an example of a direct injury

A passenger fractures her patella after it strikes the dashboard

What joint is frequently separated during football and hockey when a player falls and lands on the point of the shoulder

Acromioclavicular joint

In moving joints, the ends of the bones are covered with:

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.

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 weak, and his respirations are 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

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

What is one of the most commonly fractured bones in the body

Clavicle

An ____ is a fracture in which the bone is broken into two or more fragments

Comminuted

Which of the following statements regarding compartment syndrome is correct?

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

The disruption of a joint in which the bone ends are no longer in contact is called a:

Dislocation

A ______ Fracture produces actual deformity, or distortion, of the limb by shortening, rotating, or angulating it.

Displaced fracture

A Colles Fracture involves a fracture of the:

Distal Radius

A supracondylar or intercondylar fracture is also known as a fracture of the:

Distal humerus

When treating an open extremity fracture, you should:

Dress the wound before applying the splint

A ___ fracture occurs in a growth section of a child's none, which may prematurely stop growth if not properly treated

Epiphyseal

What produces severe damage to the skeleton, surrounding soft tissues, and vital internal organs?

High Energy Injury

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 function, you should:

Immobilize the injury with a sling and swathe

During your rapid secondary assessment of a 19 year old female with multiple traumas, you not 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 the patient includes.:

Immobilizing her to a backboard and rapidly trasnporting

While transporting a patient, you continue to recheck the splint you applied. You know that improperly applying a splint can cause all of the following EXCEPT:

Increase of distal circulation if the splint is too tight

A ___ may cause a fracture or discoloration at a distant joint

Indirect force

Which of the following statements regarding striated muscles is correct

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

_____ Are held together in a tough fibrous structure known as a capsule

Joints

When splinting a possible fracture of the foot, it is MOST important for the EMT to:

Leave the toes exposed

The knee is especially susceptible to ___ injuries, which occur when abnormal bending or twisting forces are applied to the joint

Ligament

Because of local tenderness and swelling, it is easy to confuse a nondisplaced or minimally displaced fracture at the knee with a:

Ligament injury

Bones are connected to other bones by bands of tough fibrous tissues called:

Ligaments

The MOST common and significant complication associated with fractures or dislocations of the knee is:

Neurovascular compromise

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 should suspect an

Pathologic

Which of the following musculoskeletal injuries has the GREATEST risk for shock due to blood loss

Pelvic fracture

Which of the following fractures has the greatest potential for internal blood loss and shock

Pelvis

You respond the a 19 year old woman who was involved in a motor vehicle collision. She is alert and orient. Her airway is open, and respirations are 18 breathes/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

The PASG is absolutely contraindicated in patients who have:

Pulmonary edema

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

A ____ is a stretching or tearing of the muscle.

Strain

Signs and symptoms of knee ligament injury include:

Swelling, point tenderness, joint effusion

In general musculoskeletal injuries should be splinted before moving the patient unless:

The Patient is clinically unstable

You respond to a 19 year old woman who was kicked in the leg by a horse. She is alert and orient. Respirations are 20 breaths/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 which

The overlying skin is no longer intact

The act of pulling on a body structure in the direction of its normal alignment is called

Traction

When splinting an injury of the wrist, the hand should be placed

in a functional position

Which of the following injuries would be appropriate to treat with a traction splint

An isolated femur fracture

Common signs and symptoms of a sprain include all of the following EXCEPT:

Deformity

Which of the following is not considered one of the "6 P's" of the musculoskeletal assessment

Peristalsis

A 77-yer 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 hop with pillows, and secure her to the scoop stretcher with straps

When caring for patients who have fallen, you must identify the ____ and 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

Although substantial ligament damage always occurs with a knee dislocation, the more urgent the injury is to the _____ artery, which is often lacerated or compressed by the displaced tibia

Popliteal

The primary purpose for splinting a musculoskeletal injury is to

Prevent further injury

The purpose of splinting a fracture is to

Prevent motion of bony fragments

Applying ice to and elevating an injured extremity are performed in order to

Reduce pain and swelling.

Which of the following is a basic type of splint

Rigid, formable, traction

What type of muscle contracts and relaxes to control the movement of the contents within its structures

SMooth

A Young male has a musculoskeletal injury and is unresponsive. You will NOT be able to assess:

Sensory and motor function

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 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 ________ 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

During your rapid secondary assessment of a 30 year old male who fell 25 ft, you notice crepitus when palpating his pelvis. Your partner advises you that the patient's blood pressure is 80/50 beats/min and weak. After completing your assessment, you should:

Stabilize the pelvis with a pelvic binder and protect the spine