Chapter 28 Chapter Test: Musculoskeletal Trauma

Distinguishing between a knee dislocation and a patella dislocation can sometimes be difficult. Which of the following statements is NOT​ true? A. The lack of a distal pulse could be a signal of a real emergency. B. In a knee​ dislocation, the tibia is forced anteriorly or posteriorly in relation to the distal femur. C. In a patellar​ dislocation, the knee will be stuck in flexion but the knee cap will not be displaced. D. You should always check for a distal pulse.

Which of the following BEST describes the compartment​ syndrome? A. A​ life-threatening condition caused by trapping the blood flow by a fracture when the bone ends cut the blood vessels B. A​ non-life-threatening condition caused by orthopedic injuries in which blood flow is stopped when the bone ends compress the blood vessels C. A serious condition caused by the amount of equipment that must be carried in the ambulance compartments D. A serious condition caused by the bleeding and swelling from a fracture or crush injury that becomes so strong that the body can no longer perfuse the tissues against that pressure

Which of the following is appropriate in the examination of a​ painful, swollen extremity of a conscious​ patient? A. Seeing if you can elicit crepitus on palpation B. Comparing the injured side to the uninjured side C. Asking the patient to see if he can bear weight on the extremity D. Gently attempting to flex the​ mid-portion of the bone to check for angulation

Which of the following is NOT a contraindication for the use of a traction​ splint? A. Severe swelling and redness at a midshaft femur B. ​Pelvis, hip, or knee injury C. Injury to the lower third of the leg that would interfere with the ankle hitch D. Avulsion or partial amputation where traction could separate the extremity

Blood at the meatus of the penis​ (opening of the​ urethra) is a sign​ of: A. priapism. B. pelvic​ trauma/fracture C. pelvic dislocation syndrome. D. spinal fracture or injury.

Your patient is a​ 12-year-old female who fell onto her outstretched hands while rollerblading. She has a deformity of her​ forearm, about 2 inches proximal to her wrist. This injury is a result of which of the following​ mechanisms? A. Direct force B. Sudden acceleration C. Indirect force D. Twisting motion

Which of the following statements concerning a pelvic wrap is​ FALSE? A. It can be used if the pelvis shows instability. B. You can consider its use based on mechanism of injury​ (MOI). C. It should not be used unless the patient shows signs of shock. D. It can be used if the pelvis shows deformity.

Which of the following is NOT a mechanism of musculoskeletal​ injury? A. Extensive force B. Indirect force C. Twisting or rotational forces D. Direct force

Your patient is a​ 28-year-old male who was ejected from his motorcycle after striking a parked vehicle. He has multiple deformities to his upper and lower extremities on both sides. Which of the following would be the BEST way to immobilize this​ patient's extremities prior to​ transport? A. Immobilize the patient to a long backboard without splinting the extremities individually. B. Use padded board splints for the upper extremities and PASG for the lower extremities. C. Use traction splints for the lower extremities and allow the upper extremities to be immobilized by the long backboard. D. Use moldable splints for the upper and lower​ extremities, padding any voids to fully stabilize the fractures.

You are treating a​ 16-year-old skateboarder who has fallen at the skate park. She has an angulated left forearm that she has in a guarded position. When do you splint this​ injury? A. En route to the hospital B. During the secondary exam C. Immediately D. During the primary exam

Your patient is a​ 37-year-old man who tripped while walking down a hill and now has a​ painful, deformed right leg. Your assessment reveals that the foot is cold and mottled in appearance. You cannot detect a pulse in the foot or ankle. Which of the following is the BEST course of​ action? A. Splint the leg in the position in which it was found and transport without delay. B. Transport rapidly to the nearest trauma center. C. Explain to the patient​ that, because you cannot detect circulation in his​ foot, his leg will most likely have to be amputated above the site of the injury. D. Gently attempt to straighten the leg to regain a pulse before splinting.

The part of the skeleton that is made up from the skull and spinal column is called​ the: A. axial skeleton. B. appendicular skeleton. C. boney skeleton. D. torso.

A traction splint may be used on which of the following musculoskeletal​ injuries? A. Suspected multiple fractures of the​ femur, tibia, and fibula B. Possible fracture of the cervical spine C. Possible fracture of the humerus D. Possible fracture of the femur

The pneumatic​ anti-shock garment​ (PASG) may be used as a splinting device for patients with which of the following suspected​ injuries? A. Fractured pelvis B. Shoulder dislocation C. Compression fracture of the lumbar or sacral spine D. Hip dislocation

Which of the following is NOT a general rule of​ splinting? A. Expose the injury. B. Align​ long-bone injuries to anatomical position. C. In order to avoid loss of use of a​ limb, it is important to splint before​ moving, even if the patient is unstable. D. Assess distal CSM.

Which one of the following statements is FALSE? A. Ligaments are connective tissues that connect bone to bone. B. Cartilage is connective tissue that covers the outside of the bone end and acts as a surface for articulation. C. Muscles are the tissues or fibers that cause movement of body parts or organs. D. Tendons are bands of connective tissue that bind the ligaments to muscles.

Which one of the following definitions is NOT​ true? A. Another name for manual traction is tension. B. A sprain is the stretching and tearing of ligaments. C. Tendons connect muscles to ligaments. D. Joints are places where bones articulate.

Your patient has a crush injury to the arm. The body can no longer perfuse the tissues against the pressure. This condition is known​ as: A. compartment syndrome. B. crushing syndrome. C. fracture syndrome. D. perfusing syndrome.

Which of the following statements is FALSE? A. A comminuted break is when a bone is broken in only one place. B. An angulated break is when the broken bone is bent at an angle. C. A fracture is any break in a bone. D. A greenstick break is an incomplete break in a bone.

Your patient is a​ 20-year-old college student who has fallen from a​ third-level balcony onto a wooden deck below. The patient responds to verbal​ stimuli, is pale in color with moist​ skin, and has a very obvious deformity with protruding bone ends of his right forearm. Which of the following is the BEST sequence of intervention for this​ patient? A. Open the​ airway; assess​ breathing; check the carotid​ pulse; splint the forearm​ injury; immobilize the patient to a long​ backboard; apply​ high-concentration oxygen; and transport. B. Provide manual​ in-line stabilization of the cervical spine along with assessment of​ breathing, pulse, and the presence of significant​ hemorrhage; apply​ high-concentration oxygen; perform a rapid trauma​ exam; immobilize to a long​ backboard; transport; and splint the extremity en route if time and resources allow. C. Provide immediate manual​ in-line stabilization of the cervical​ spine; apply​ high-concentration oxygen by nonrebreather​ mask; perform a focused history and​ assessment; apply the cervical​ collar; apply a padded board​ splint, sling, and swathe to the forearm​ injury; and transport. D. Provide manual​ in-line stabilization of the cervical spine along with assessment of​ breathing, pulse, and the presence of significant​ hemorrhage; apply​ high-concentration oxygen; perform a rapid trauma​ exam; immobilize to a long​ backboard; and check with medical control about the need to splint the forearm injury prior to transport.

Which of the following complications may arise from properly splinting an injured​ extremity? A. Ignoring​ life-threatening problems while focusing on an extremity injury B. Compromising circulation to the extremity C. Converting a closed fracture to an open one D. All of the above

Which of the following structures connect bone​ ends, making joints more​ stable? A. Periosteum B. Tendons C. Ligaments D. Cartilage

A pillow is frequently used to splint an ankle or foot injury. It is​ effective, rapid, and can be used for most patients. Its main weakness​ is: A. it is hard to access distal pulses after application. B. it requires three people to apply. C. you might not have a pillow on your ambulance. D. you are not immobilizing the knee and the joint adjacent to the ankle.

The sound or feeling of the ends of broken bones rubbing together is​ called: A. krepitus. B. breakilation. C. crepitus. D. crapilation.

Which of the following allows for smooth movement of bone surfaces against one another at​ joints? A. Cartilage B. Peritoneum C. Ligaments D. Smooth muscle

Which of the following is NOT a principle of splinting that must be considered by the​ EMT? A. Splint an isolated extremity injury before moving the patient to the stretcher. B. Immobilize the site of an extremity injury from the joint above it to the joint below it. C. Gently replace protruding bone ends back beneath the skin to prevent further contamination. D. Check the distal neurovascular function before and after splinting.

Your patient is a​ 70-year-old male whose tractor rolled over onto him. Your assessment makes you suspicious that the patient has a fractured pelvis. Which of the following complications should you​ anticipate? A. Damage to the nerves of the lower extremities B. Shock C. Damage to internal organs D. All of the above

Which of the following is NOT a benefit of splinting an injury to bones and connective​ tissues? A. It reduces pain. B. It restricts blood flow to the site of the injury to prevent swelling. C. It prevents neurological damage due to movement of bone ends or fragments. D. It may prevent a closed injury from becoming an open injury.

Which of the following is an injury to the musculature of an​ extremity? A. Sprain B. Fracture C. Strain D. Luxation

Your patient is a​ 60-year-old woman who stepped off a curb and injured her ankle. Your exam shows that her left ankle is swollen and painful. Which of the following should you​ do? A. Transport the patient immediately to a trauma​ center, applying​ high-concentration oxygen en route. B. Explain to the patient that her ankle is sprained and transport her with her ankle elevated on a pillow and a cold pack applied to the injury. C. Explain to the patient that her ankle is fractured and you must splint her ankle to prevent further injury and reduce pain. D. Explain to the patient that you cannot tell if her ankle is sprained or fractured until she is​ X-rayed at the emergency​ department, then splint the ankle.

A new EMT who is treating a suspected femur injury asks his​ partner, "How much traction should I​ pull?" The​ partner's BEST reply is which of the​ following? A. No traction splint applied in the field pulls true​ traction; they must pull 20 pounds of countertraction. B. The amount of traction applied should be 15 pounds. C. Pull enough traction to give the patient some relief from the pain. D. The amount of traction applied should be roughly​ 10% of the​ patient's body weight and not exceed 15 pounds.

Your patient is an​ 11-year-old male who has a​ swollen, painful, and angulated right lower arm after falling from his bicycle onto his hands. Which of the following should be considered in the immobilization of his injured​ extremity? A. Immobilize from the shoulder to the wrist. B. Do not attempt to realign the extremity before splinting. C. Use an upper extremity traction splint. D. Check​ pulse, movement, and sensation distal to the injury before and after splinting.

A method of assessing compromise to an extremity when a musculoskeletal injury is suspected is to learn and follow the six Ps. Which of the items below is NOT one of the six​ Ps? A. Placement B. Paresthesia C. Pallor D. Pain

What is the BEST answer for where you could find the​ phalanges? A. Upper and lower extremities B. Upper extremities C. Axial skeleton D. Lower extremities

A painter falls from his ladder and tells you he has dislocated his shoulder again. When you attempt to splint the​ shoulder, it​ "pops back into​ place." What should your next step​ be? A. Check distal​ CSM, apply a traction​ splint, and transport the patient. B. Check distal​ CSM, apply a sling and​ swathe, and transport the patient. C. Contact medical control for input into the best treatment for this patient. D. Continue splinting and report the popping sound to the triage nurse when you arrive at the hospital.

Which of the following describes an open extremity​ injury? A. A gunshot wound has penetrated the skin and then fractured the bone. B. Bone ends have lacerated the soft tissues and skin from the inside. C. The joint capsule has been torn open during a dislocation. D. Both A and B

Which of the following is a complication of bone​ fractures? A. Hemorrhage B. Nerve damage C. Swelling D. All of the above

Your patient is a​ 3-year-old girl who is unable to move her elbow after her mother picked her up by the forearm. Proper splinting of this injury would be to immobilize from the​ ________ to the​ ________. A. ​wrist; shoulder B. ​fingertips; shoulder C. ​wrist; elbow D. ​Upper arm; forearm

When the EMT is assessing compromise to an​ extremity, perhaps due to an orthopedic​ injury, the EMT should initially check what​ "six Ps"? A. ​Pain, pallor,​ paresthesia, pulses,​ placement, and pressure B. ​Pain, pallor,​ position, pulses,​ placement, and pad C. ​Pain, pallor,​ paresthesia, pulses,​ paralysis, and pressure D. ​Pain, pallor,​ position, pulses,​ placement, and pressure

Which of the following statements regarding musculoskeletal injuries is​ correct? A. All musculoskeletal injuries are life threatening due to the bone​ bleeding, leading to hypoperfusion. B. Splints do not adequately fit the​ patient's extremities and must be modified with padding to ensure immobilization. Your answer is not correct. C. Most musculoskeletal injuries are simply splinted and not a life threat to the patient. D. Many musculoskeletal injuries have a grotesque​ appearance, and the EMT cannot be distracted from​ life-threatening conditions by a deformed limb.

A suspected musculoskeletal injury of the shoulder is BEST managed by which of the following​ techniques? A. Placing the arm in a sling and using a triangular bandage to secure it to the body B. Placing two long padded board splints on either side of the​ extremity, extending from the shoulder to the wrist C. Using an upper extremity traction splint D. Using a​ long-arm air splint

Which one of the following statements is NOT true concerning a knee​ injury? A. Fractures can occur to the proximal femur. B. Fractures can occur to the proximal tibia and fibula. C. There could be pain and tenderness. D. Fractures can occur to the patella.

Which of the following bones is found in the​ chest? A. Metacarpals B. Sternum C. Ilium D. Tarsals

The strong white fibrous material called the​ periosteum: A. covers the bones. B. surrounds the heart. C. protects the perineum. D. surrounds the abdominal cavity.

Although it can be difficult to definitively determine hip dislocation in the​ field, certain signs and symptoms are usually there. Which of the following statements is false​? A. An anterior hip dislocation would probably present with the entire lower limb rotated inward and the hip would usually be flexed. B. The posterior hip dislocation is the most common. C. Often there is lack of sensation in the limb. D. A posterior hip dislocation presents with a bent knee and the foot may hang loose.

Which of the following BEST describes compartment​ syndrome? A. Blood vessels and nerves are constricted within a space. B. Blood loss causes hypoperfusion in a patient. C. A bone is seriously fractured. D. The tissues surrounding a bone injury swell up.

Your patient is a​ 28-year-old male who was ejected from his motorcycle after striking a parked vehicle. He has multiple deformities to his upper and lower extremities on both sides. Your assessment is that this patient is unstable. Which of the following would be the BEST way to immobilize this​ patient's extremities prior to​ transport? A. Use traction splints for the lower extremities and allow the upper extremities to be immobilized by the long backboard. B. Use moldable splints for the upper and lower​ extremities, padding any voids to fully stabilize the fractures. C. Immobilize the patient to a long backboard without splinting the extremities individually. D. Use padded board splints for the upper extremities and a pneumatic​ anti-shock garment for the lower extremities.

Which of the following statements about an open extremity injury is​ FALSE? A. Bone ends that have lacerated and broken through the soft tissues and skin from the inside have caused an open extremity injury. B. Breaking the skin is what qualifies an extremity injury as open. C. An open extremity injury involves either severe internal injuries or the breaking or tearing of the skin. D. A gunshot wound that has penetrated the skin and then fractured the bone is an open extremity injury.

Which of the following is NOT a general rule of​ splinting? A. Splint before​ moving, even if the patient is unstable. B. Assess distal CSM. C. Expose the injury. D. Align​ long-bone injuries to anatomical position.

Which of the following is NOT a benefit of splinting an injury to bones and connective​ tissues? A. It prevents an open fracture from becoming a closed fracture. B. It prevents neurological damage due to movement of bone ends or fragments. C. It may prevent additional injury to soft tissues. D. It reduces pain.