EMT Chapter 32: Orthopedic Injuries

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

A. the overlying skin is no longer intact.

What is the primary goal of in-line traction? - Minimize pain - Avoid further neurovascular compromise - Reduce swelling - Prevent permanent disability

Avoid further neurovascular compromise

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 resistance is encountered or the patient experiences severe pain C. If a traction splint will be used to immobilize the injured extremity D. If transport time to the hospital is greater than 20 to 30 minutes

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

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

B. break in the continuity of the bone

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. perform a focused physical exam with emphasis on the pelvis. B. defer spinal immobilization and transport to a trauma center. 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.

D. stabilize the pelvis with a pelvic binder and protect the spine.

A disruption of a joint in which the bone ends are no longer in contact is known as what? - Dislocation - Fracture - Sprain - Strain

Dislocation

Which sign/symptom would give you a high index of suspicion that a patient may have compartment syndrome? - Referred pain - Limb deformity - Disproportionate pain - Hypersensation

Disproportionate pain

Which of the following musculoskeletal injuries has the GREATEST risk for shock due to blood loss? - Pelvic fracture - Posterior hip dislocation - Unilateral femur fracture - Proximal humerus fracture

Pelvic fracture

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

Pelvic fracture with hypotension

What is the most reliable indicator of an underlying fracture? - Deformity - Guarding - Point tenderness - Crepitus

Point tenderness

When assessing distal circulation in a patient's lower extremities, which pulse should you palpate? - Femoral - Dorsalis pedis - Popliteal - Iliac

Popliteal

Which of the following would you use to stabilize an AC separation? - Zippered air splint - Rigid splint - Sling and swathe - Traction splint

Sling and swathe

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? - Splint from the shoulder joint to the wrist joint to stabilize the entire arm. - Apply a Sager traction splint to stabilize the joint. - Apply a sling and swathe to reduce pain. - Apply ice to reduce swelling.

Splint from the shoulder joint to the wrist joint to stabilize the entire arm.

Which of the following is a drawback of an air splint? - Temperature changes affect air pressure in the splint. - It does not provide uniform contact, so bone movement is possible. - It restricts distal blood flow. - It is complicated to use and requires multiple EMTs.

Temperature changes affect air pressure in the splint.

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

area of soft-tissue damage surrounding the injury.

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

carefully assess the patient for breathing problems.

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

delaying transport of a critically injured patient.

When treating an open extremity fracture, you should: - apply a splint and then dress the wound. - dress the wound before applying a splint. - irrigate the wound before applying a dressing. - allow the material that secures the splint to serve as the dressing.

dress the wound before applying a splint.

Which MOI causes a fracture or dislocation at a distant point? - Direct blow - Indirect force - Twisting force - High-impact injury

indirect force

A patient tripped, fell, and landed on her elbow. She is in severe pain and has obvious deformity to her elbow. You should: assess distal pulses. manually stabilize her injury. assess her elbow for crepitus. apply rigid board splints to her arm.

manually stabilize her injury

The purpose of splinting a fracture is to: - reduce the fracture if possible. - prevent motion of bony fragments. - reduce swelling in adjacent soft tissues. - force the bony fragments back into anatomic alignment.

prevent motion of bony fragments.

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

proximal femur.

A young male has a musculoskeletal injury and is unresponsive. You will NOT be able to assess: - false motion. - distal pulses. - capillary refill. - sensory and motor functions.

sensory and motor functions.

In the musculoskeletal injury grading system, under which category would you place a laceration of a major nerve or blood vessel? - Moderate - Serious - Severe - Critical

serious

To effectively immobilize a fractured clavicle, you should apply a(n): - sling and swathe. air splint over the entire arm. - rigid splint to the upper arm, then a sling. - traction splint to the arm of the injured side.

sling and swathe.

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: - wrapping her entire knee area with a pillow. - splinting the leg in the position in which it was found. - straightening her leg and applying two rigid board splints. - straightening her leg and applying and inflating an air splint.

splinting the leg in the position in which it was found.

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. assess for a carotid pulse and assist her ventilations. C. stabilize her head and perform a primary assessment. D. administer oxygen and perform a rapid assessment.

stabilize her head and perform a primary assessment.

You respond to a soccer game for a 16-year-old male with severe ankle pain. When you deliver him to the hospital, the physician tells you that he suspects a sprain. This means that: - there is a disruption of the joint and the bone ends are no longer in contact. - the patient has an incomplete fracture that passes only partway through the bone. - stretching or tearing of the ligaments with partial or temporary dislocation of the bone ends has occurred. - the muscles of the ankle have been severely stretched, resulting in displacement of the bones from the joint.

stretching or tearing of the ligaments with partial or temporary dislocation of the bone ends has occurred.

Skeletal muscle is also referred to as: - smooth muscle. - striated muscle. - autonomic muscle. - involuntary muscle.

striated muscle.