Chapter 31 Orthopedic
All of the following are hollow abdominal organs, EXCEPT the:
A. spleen.
Which of the following would you use to stabilize an AC separation?
An AC separation occurs in the shoulder and so using a sling and swathe is an effective way to splint the injury.
Which MOI causes a fracture or dislocation at a distant point?
An indirect force is more likely to cause a fracture or dislocation at a distant point.
Abdominal pain, vomiting, and fever are most likely due to _______.
B. infection
A subluxation occurs when
a joint is incompletely dislocated
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. You should:
apply 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.
What is the primary goal of in-line traction?
avoid further neurovascular compromise
A fracture is MOST accurately defined as a(n):
break in the continuity of the bone.
The MOST commonly fractured bone(s) in the body is the:
clavicle
When assessing a patient with a possible fracture of the leg, the EMT should:
compare it to the uninjured leg.
Common signs and symptoms of a sprain include all of the following, EXCEPT:
deformity.
Traction splints are used primarily to immobilize and secure fractures of the:
femur.
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
During your 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.
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
Atrophy is a condition that occurs when:
muscle decreases in size and function.
The MOST common and significant complication associated with fractures or dislocations of the knee is:
neurovascular compromise.
Which of the following musculoskeletal injuries would pose the greatest threat to a patient's life?
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 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 primary purpose for splinting a musculoskeletal injury is to
prevent further injury.
A "hip" fracture is actually a fracture of the:
proximal femur.
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
What type of muscle contracts and relaxes to control the movement of the contents within its structures?
smooth
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
In general, musculoskeletal injuries should be splinted before moving the patient unless:
the patient is clinically unstable.
Which of the following is a drawback of an air splint?
A drawback of an air splint is that temperature or altitude changes affect the air pressure in the splint.
Which of the following scenarios is an example of a direct injury?
A passenger fractures her patella after it strikes the dashboard.
A 54-year-old male experienced an avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants and remove the foreskin prior to your arrival. Your assessment reveals that he is in severe pain and that the avulsion is bleeding moderately. The MOST appropriate treatment for this patient includes:
A. applying direct pressure with a dry, sterile dressing.
Because the depth of an open abdominal wound is often difficult to determine:
B. prompt transport to the hospital is essential.
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 musculoskeletal injuries would MOST likely result in deformity?
Displaced fracture
Which sign/symptom would give you a high index of suspicion that a patient may have compartment syndrome?
Disproportionate pain on passive stretch of muscles within the compartment is a sign of compartment syndrome.
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 regarding shoulder dislocations is MOST correct?
Most shoulder dislocations occur anteriorly.
Which of the following statements regarding shoulder dislocations is correct?
Most shoulder dislocations occur anteriorly.
Which of the following fractures has the greatest potential for internal blood loss and shock?
Pelvis
The muscular system includes three types of muscles:
Skeletal, smooth, and cardiac
You are attending to a patient with a nondisplaced elbow fracture. She has a strong pulse and good capillary refill. How should you address this type of injury?
When splinting a fracture in and around a joint, be sure to stabilize the bones above and below the injured joint.
When assessing distal circulation in a patient's lower extremities, which pulse should you palpate?
You would palpate the popliteal artery in lower extremity wounds.
Smooth muscle
also called involuntary muscle
Skeletal muscle:
also called striated muscle or voluntary muscle
A construction worker's arm was severed just above the elbow when a steel girder fell on it. The stump is covered with a blood-soaked towel. The patient's skin is cool, clammy, and pale. The EMT should:
apply a tourniquet just below the shoulder.
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.
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.
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.
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.
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.
Bone marrow produces:
blood cells.
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.
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.
When caring for a patient with a possible fracture of the scapula, the EMT should:
carefully assess the patient for breathing problems.
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.
The MOST significant hazard associated with splinting is:
delaying transport of a critically injured patient.
A disruption of a joint in which the bone ends are no longer in contact is known as what?
dislocation
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
A(n) __________ fracture occurs in the growth section of a child's bone and may lead to bone growth abnormalities.
epiphyseal
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
A 17-year-old football player collided with another player and has pain to his left clavicle. 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.
When splinting an injury of the wrist, the hand should be placed:
in a functional position.
A 17-year-old female dislocated her patella while playing soccer. Her knee is flexed and she complains of severe pain. You should:
keep her knee flexed and secure it with padded board splints.
When splinting a possible fracture of the foot, it is MOST important for the EMT to:
leave the toes exposed.
Of the following musculoskeletal injuries, which is considered to be the LEAST severe?
nondisplaced pelvic fracture
A fracture caused by minimal force that is associated with diseases such as cancer and osteoporosis is called a __________ fracture.
pathologic
The MOST reliable indicator of an underlying fracture is
point tenderness.
The MOST reliable indicator of an underlying fracture is:
point tenderness.
What is the most reliable indicator of an underlying fracture?
point tenderness.
Crepitus and false motion are
positive indicators of a fracture.
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.
A 30-year-old man complains of severe pain to his right tibia following an injury that occurred the day before. The patient's leg is pale and he is unable to move his foot. The EMT should suspect that:
pressure in the fascial compartment is elevated.
The primary purpose for splinting a musculoskeletal injury is to:
prevent further injury.
The PASG is absolutely contraindicated in patients who have:
pulmonary edema
Applying ice to and elevating an injured extremity are performed in order to:
reduce pain and swelling.
The pectoral girdle consists of the:
scapulae and clavicles
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:
separation of the acromioclavicular joint.
In the musculoskeletal injury grading system, under which category would you place a laceration of a major nerve or blood vessel?
serious
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 is barely palpable. His vital signs are stable and he denies any other injuries. Your transport time to the closest appropriate hospital is approximately 12 minutes. You should:
splint the elbow in the position found and transport.
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
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 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.
Which of the following are goals of in-line traction?
stabilize the fragments to prevent movement avoid neurovascular compromise align the limb for splinting
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
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:
stabilize the pelvis with a pelvic binder and protect the spine.
Skeletal muscle is also referred to as __________ muscle.
striated
Deformity caused by a fracture would MOST likely be masked by:
swelling
Skeletal muscle is attached to the bone by tough, ropelike fibrous structures called:
tendons
Skeletal muscle is attached to the bone by tough, ropelike, fibrous structures called:
tendons
Skeletal muscle is directly attached to the bone by tough, rope-like structures known as ________ which are extensions of the______
tendons; fascia
An open fracture is MOST accurately defined as a fracture in 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.