Chapter 31 - Orthopaedic Emergencies

Blood in the urine is known as: Select one: A. hematuria. B. hemotysis. C. hematocrit. D. hemoglobin.

A. hematuria.

Improperly applying a splint can cause all of the following, EXCEPT: Select one: A. increase of distal circulation if the splint is too tight. B. delay in transport of a patient with a life-threatening injury. C. aggravation of the distal circulation. D. compression of nerves, tissues, and blood vessels.

A. increase of distal circulation if the splint is too tight.

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

D. Displaced fracture

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

D. proximal femur.

An open fracture is MOST accurately defined as a fracture in which: Select one: A. bone ends protrude through the skin. B. a large laceration overlies the fracture. C. a bullet shatters the underlying bone. D. the overlying skin is no longer intact.

D. the overlying skin is no longer intact.

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

D> stabilize her head and preform a primary assessment.

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

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

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

A. bones and voluntary muscles of the body

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

A. carefully assess the patient for breathing problems.

Which of the following statements about compartment syndrome is NOT true? Select one: A. It occurs 6 to 12 hours after an injury. B. It most commonly occurs with a fractured femur. C. It is usually a result of excessive bleeding, a severely crushed extremity, or the rapid return of blood to an ischemic limb. D. It is characterized by pain that is out of proportion to the injury.

B. It most commonly occurs with a fractured femur

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

B. distal humerus.

Because of local tenderness and swelling, it is easy to confuse a nondisplaced or minimally displaced fracture of the knee with a: Select one: A. tendon injury. B. ligament injury. C. dislocation. D. fracture-dislocation.

B. ligament injury.

Skeletal muscle is attached to the bone by tough, ropelike, fibrous structures called: Select one: A. fascia. B. tendons. C. cartilage. D. ligaments.

B. tendons.

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

B. the patient is clinically unstable.

In which of the following situations should the EMT splint an injured limb in the position of deformity? Select one: A. When distal circulation and neurological functions are absent B. If transport time to the hospital is greater than 20 to 30 minutes C. If resistance is encountered or the patient experiences severe pain D. If a traction splint will be used to immobilize the injured extremity

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

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

C. area of soft-tissue damage surrounding the injury.

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

C. positive indicators of a fracture.

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: Select one: A. defer spinal immobilization and transport to a trauma center. B. perform a focused physical exam with emphasis on the pelvis. C. stabilize the pelvis with a pelvic binder and protect the spine. D. log roll the patient onto a long backboard and transport at once.

C. stabilize the pelvis with a pelvic binder and protect the spin.

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

D. Pelvic fracture with hypotension

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: Select one: A. assess distal pulses as well as sensory and motor functions. B. manually stabilize the leg above and below the site of injury. C. gently manipulate the injured leg until the numbness dissipates. D. control the bleeding and cover the wound with a sterile dressing.

D. control the bleeding and cover the wound with a sterile dressing.

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

D. delaying transport of a critically injured patient.

Signs and symptoms of a dislocated joint include all of the following, EXCEPT: Select one: A. marked deformity. B. tenderness on palpation. C. locked joint. D. ecchymosis.

D. ecchymosis.

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

D. keep her knee flexed and secure it with padded board splints.

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: Select one: A. splint the elbow in the position of deformity and transport immediately. B. apply gentle manual traction in line with the limb and reassess for a pulse. C. carefully straighten the injured arm and secure it with padded board splints. 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.