EMT Chapter 31 Orthopaedic Injuries

Femoral shaft fractures can result in up to _____ mL of internal blood loss.

1,000

There is often a significant amount of blood loss, as much as 500 to _____ mL, after a fracture of the shaft of the femur.

1,000

For which of the following should you use a traction splint?

An isolated femur fracture

Which of the following statements regarding compartment syndrome is correct?

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

_____ produce severe damage to the skeleton, surrounding soft tissues, and vital internal organs.

High-energy injuries

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

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 NOT true?

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 musculoskeletal injuries would pose the greatest threat to a patient's life?

Pelvic fracture with hypotension

Which of the following is NOT considered one of the 6 Ps of the musculoskeletal assessment?

Peristalsis

Which of the following is NOT a basic type of splint?

Sling

Dislocation of the ___ is usually associated with fracture of one or both malleoli

ankle

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.

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

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.

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

The bones in the skeleton produce ____ in the bone marrow.

blood cells

Smooth muscle is found in the

blood vessels

The musculoskeletal system refers to the:

bones and voluntary muscles of the body.

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.

The MOST commonly fractured bone(s) in the body is/are the:

clavicle

The _____ is one of the most commonly fractured bones in the body.

clavicle

A _____ fracture is a fracture in which the bone is broken into more than two 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.

A grating or grinding sensation known as _____ can be felt, and sometimes even heard, when fractured bone ends rub together.

crepitus

Signs and symptoms associated with hip dislocation include all of the following EXCEPT:

decreased resistance to any movement of the joint

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

deformity

The MOST significant hazard associated with splinting is:

delaying transport of a critically injured patient.

A _____ fractures the bone at the point of impact

direct blow

______ is a disruption of a joint in which the bone ends are no longer in contact

dislocation

A ____ produces actual deformity, or distortion, of the limb by shortening, rotating, or angulating it

displaced fracture

Which of the following musculoskeletal injuries would MOST likely result in deformity?

displaced fracture

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

Always check neurovascular function at the following times EXCEPT:

during history taking

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 the growth section of a child's bone and may lead to bone growth abnormalities.

epiphyseal

Traction splints are used primarily to immobilize and secure fractures of the:

femur

A _____ fracture is an incomplete fracture that passes only partway through the shaft of a bone but may still cause severe angulation

greenstick

Blood in the urine is known as:

hematuria

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

in a functional position.

Improperly applying a splint can cause all of the following, EXCEPT:

increase of distal circulation if the splint is too tight

An _____ may cause a fracture or dislocation at a distant point

indirect blow

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.

Care for a patient with a fractured tibia and suspected compartment syndrome includes:

keeping the leg at the level of the heart

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

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

ligament injury

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.

A _____ is also known as a hairline fracture

nondisplaced fracture

Regardless of the extent and severity of the damage to the skin, you should treat any injury that breaks the skin as 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 states that he was walking, heard a pop, and fell to the floor. You suspect a ____ fracture

pathologic

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.

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

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

popliteal

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

Splinting will do all of the following EXCEPT:

prevent the need for surgery

A "hip" fracture is actually a fracture of the:

proximal femur

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

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 an injury to the ligaments, the articular capsule, the synovial membrane, and the tendons crossing the joint

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.

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.

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:

stop and splint the leg in the deformed position.

A ____ is a stretching or tearing of the muscle

strain

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

Signs and symptoms of knee ligament injury include all of the following EXCEPT:

the affected leg externally rotated

You respond to a 19 year old woman who was kicked in the leg by a horse. 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.

If a dislocated shoulder has spontaneously reduced before your arrival, the only way to confirm the injury is by noting:

the patient history.

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

the patient is clinically unstable.

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

traction

Fracture of the tibia and fibula are sometimes associated with ____ as a result of the distorted positions of the limb following injury.

vascular injury