EMT Ch 31 Orthopedic Injuries

The correct answer is: proximal femur.

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

The correct answer is: keep her knee flexed and secure it with padded board splints.

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.

The correct answer is: separation of the acromioclavicular joint.

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: Select one: A. posterior dislocation of the shoulder. B. separation of the acromioclavicular joint. C. multiple fractures of the proximal humerus. D. dislocation of the glenohumeral joint.

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

The correct answer is: control the bleeding and cover the wound with a sterile dressing.

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

The correct answer is: place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps.

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: Select one: A. bind both of her legs together with triangular bandages and carefully secure her onto the ambulance stretcher. B. place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps. C. manually stabilize her left leg, apply a traction splint, and then secure her to a long backboard or scoop. D. carefully slide a long backboard underneath her, keep her in a supine position, and apply a splint to her leg.

The correct answer is: pathologic

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

The correct answer is: break in the continuity of the bone.

A fracture is MOST accurately defined as a(n): Select one: A. disruption in the midshaft of a bone. B. abnormality in the structure of a bone. C. total loss of function in a bone. D. break in the continuity of the bone.

The correct answer is: distal humerus.

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

The correct answer is: epiphyseal

A(n) __________ fracture occurs in the growth section of a child's bone and may lead to bone growth abnormalities. Select one: A. diaphyseal B. epiphyseal C. greenstick D. metaphyseal

The correct answer is: the overlying skin is no longer intact.

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

The correct answer is: blood cells.

Bone marrow produces: Select one: A. blood cells. B. electrolytes. C. cartilage. D. lymphocytes.

The correct answer is: keeping the leg at the level of the heart.

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

The correct answer is: positive indicators of a fracture.

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

The correct answer is: swelling.

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

The correct answer is: 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: Select one: A. splint the elbow in the position of deformity and transport immediately. B. make two or three attempts to restore distal circulation by manipulating the elbow. C. carefully straighten the injured arm and secure it with padded board splints. D. apply gentle manual traction in line with the limb and reassess for a pulse.

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

The correct answer is: apply high-flow oxygen, consider spinal precautions, and transport without delay.

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

The correct answer is: the patient is clinically unstable.

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

The correct answer is: articular cartilage.

In moving joints, the ends of the bones are covered with: Select one: A. muscular fascia. B. synovial tendons. C. articular cartilage. D. gliding cartilage.

The correct answer is: If resistance is encountered or the patient experiences severe pain

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

The correct answer is: tendons.

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

The correct answer is: neurovascular compromise.

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

The correct answer is: delaying transport of a critically injured patient.

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

The correct answer is: bones and voluntary muscles of the body.

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

The correct answer is: femur.

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

The correct answer is: carefully assess the patient for breathing problems.

When caring for a patient with a possible fracture of the scapula, the EMT should: Select one: 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.

The correct answer is: in a functional position.

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

The correct answer is: Displaced fracture

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

The correct answer is: Pelvic fracture with hypotension

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

The correct answer is: Compartment syndrome typically develops within 6 to 12 hours after an injury.

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. Most cases of compartment syndrome occur following a severe fracture of the pelvis. D. In most cases, compartment syndrome develops within a few minutes after an injury.

The correct answer is: It forms the major muscle mass of the body and usually crosses at least one joint.

Which of the following statements regarding striated muscle is correct? Select one: 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.

The correct answer is: area of soft-tissue damage surrounding the injury.

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

The correct answer is: stop and splint the leg in the deformed position.

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: Select one: A. assess distal pulses and continue pulling traction. B. flex the knee and place a pillow under the thigh. C. gently massage the thigh muscles to relax them. D. stop and splint the leg in the deformed position.

The correct answer is: assess distal pulse, motor, and sensory functions.

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: Select one: A. place a pillow under his arm and apply a swathe. B. flex his arm at the elbow and then apply a sling. C. gently attempt to move his arm toward his body. D. assess distal pulse, motor, and sensory functions.