Ch 32 EMT: Musculoskeletal Trauma Quiz
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Questions and Answers

Which of the following should you do with a patient who has a swollen and painful ankle?

  • 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.
  • 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. (correct)
  • Explain to the patient that her ankle is fractured and you must splint her ankle to prevent further injury and reduce pain.
  • Transport the patient immediately to a trauma center, applying high-concentration oxygen en route.

    • Which of the following is not a benefit of splinting an injury to bones and connective tissues?

  • It prevents neurological damage due to movement of bone ends or fragments.
  • It reduces pain.
  • It restricts blood flow to the site of the injury to prevent swelling. (correct)
  • It may prevent a closed injury from becoming an open injury.

    • A suspected musculoskeletal injury of the shoulder is best managed by which technique?

  • Placing two long padded board splints on either side of the extremity, extending from the shoulder to the wrist.
  • Placing the arm in a sling and using a triangular bandage to secure it to the body. (correct)
  • Using an upper extremity traction splint
  • Using a long-arm air splint

    • The PASG may be used as a splinting device for patients with which suspected injuries?

    <p>Fractured pelvis</p> Signup and view all the answers

    Your patient has a forearm deformity after falling onto her outstretched hands. This injury is a result of which mechanism?

    <p>Indirect force</p> Signup and view all the answers

    Which of the following statements is false regarding hip dislocation?

    <p>An anterior hip dislocation would probably present with the entire lower limb rotated inward.</p> Signup and view all the answers

    Which of the following is a complication of bone fractures?

    <p>All of the above</p> Signup and view all the answers

    Which of the following statements is not true concerning a pelvic wrap?

    <p>It should not be used unless the patient shows signs of shock.</p> Signup and view all the answers

    Which of the following statements is not true?

    <p>A comminuted break is when a bone is broken in only one place.</p> Signup and view all the answers

    A traction splint may be used on which of the following musculoskeletal injuries?

    <p>Possible fracture of the femur</p> Signup and view all the answers

    Which of the following best describes compartment syndrome?

    <p>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.</p> Signup and view all the answers

    When should you splint a 16-year-old skateboarder's angulated forearm injury?

    <p>During the secondary exam</p> Signup and view all the answers

    Which of the following is not a principle of splinting that must be considered by the EMT?

    <p>Gently replace protruding bone ends back beneath the skin to prevent further contamination.</p> Signup and view all the answers

    Proper splinting of a 3-year-old girl who cannot move her elbow would be to immobilize from the ________ to the ________.

    <p>forearm; humerus</p> Signup and view all the answers

    What is a primary problem when treating musculoskeletal injuries?

    <p>Many musculoskeletal injuries have a grotesque appearance, and the EMT cannot be distracted from life-threatening conditions by a deformed limb.</p> Signup and view all the answers

    For a patient with a painful, deformed leg and a cold, mottled foot with no detectable pulse, what is the best course of action?

    <p>Gently attempt to straighten the leg to regain a pulse before splinting.</p> Signup and view all the answers

    Which of the following bones is found in the chest?

    <p>Sternum</p> Signup and view all the answers

    The part of the skeleton that includes the skull and spinal column is called:

    <p>axial skeleton</p> Signup and view all the answers

    Which of the following is not a mechanism of musculoskeletal injury?

    <p>Extensive force</p> Signup and view all the answers

    Which of the following describes an open extremity injury?

    <p>Both A and B</p> Signup and view all the answers

    Which of the following would be the best way to immobilize a patient with multiple deformities to upper and lower extremities?

    <p>Immobilize the patient to a long backboard without splinting the extremities individually.</p> Signup and view all the answers

    Where could you find the phalange bones?

    <p>Hands and feet</p> Signup and view all the answers

    Which of the following is not a general rule of splinting?

    <p>In order to avoid loss of use of a limb, it is important to splint before moving, even if the patient is unstable.</p> Signup and view all the answers

    A method of assessing compromise to an extremity when a musculoskeletal injury is suspected is to learn the six Ps. Which of the items below is not one of the six Ps?

    <p>Parenthesis</p> Signup and view all the answers

    Which of the following hazards may arise from properly splinting an injured extremity?

    <p>All of the above</p> Signup and view all the answers

    Which of the following allows for smooth movement of bone surfaces against one another at joints?

    <p>Cartilage</p> Signup and view all the answers

    When assessing compromise to an extremity due to an orthopedic injury, the EMT should initially check what 'six Ps'?

    <p>Pain, pallor, paresthesia, pulses, paralysis, and pressure</p> Signup and view all the answers

    Which one of the following statements is not true?

    <p>Tendons are bands of connective tissue that bind the ligaments to muscles.</p> Signup and view all the answers

    A new EMT treating a suspected femur injury asks, 'How much traction should I pull?' The best reply is which of the following?

    <p>The amount of traction applied should be roughly 10% of the patient's body weight and not exceed 15 pounds.</p> Signup and view all the answers

    Which of the following is appropriate in the examination of a painful, swollen extremity of a conscious patient?

    <p>Comparing the injured side to the uninjured side.</p> Signup and view all the answers

    The sound or feeling of the ends of broken bones rubbing together is called:

    <p>Crepitus</p> Signup and view all the answers

    Which of the following structures connect bone ends and allow for a stable range of motion?

    <p>Ligaments</p> Signup and view all the answers

    The strong white fibrous material called the periosteum:

    <p>Covers the bones.</p> Signup and view all the answers

    Which one of the following definitions is not true?

    <p>Tendons connect muscles to ligaments.</p> Signup and view all the answers

    Which of the following is not a contraindication for the use of a traction splint?

    <p>Severe swelling and redness at a midshaft femur.</p> Signup and view all the answers

    Which one of the following statements is not true concerning a knee injury?

    <p>Fractures can occur to the proximal femur.</p> Signup and view all the answers

    A painter falls from a ladder and dislocates his shoulder. When it pops back into place, what should your next step be?

    <p>Check distal CSM, apply a sling and swathe, and transport the patient.</p> Signup and view all the answers

    A type of musculoskeletal injury involving the bones that can be classified as open or closed is?

    <p>Fracture</p> Signup and view all the answers

    What must happen for a joint to dislocate?

    <p>Soft tissue and ligaments must be stretched</p> Signup and view all the answers

    When performing a primary assessment of a patient with musculoskeletal injuries, you should?

    <p>Avoid your focus being distracted by the most dramatic extremity injuries</p> Signup and view all the answers

    A fracture in which the broken bone segments are at an angle to each other is called?

    <p>Angulated fracture</p> Signup and view all the answers

    A primary reason for splinting a bone or joint injury is?

    <p>Preventing movement to reduce the chance for further injury</p> Signup and view all the answers

    Guidelines for splinting long-bone injuries include?

    <p>Immobilizing the hand or foot in the position of function</p> Signup and view all the answers

    The tough connective tissues that bind bone ends together at joints are termed?

    <p>Ligaments</p> Signup and view all the answers

    Which of the following should be applied to provide stability for an upper arm injury?

    <p>Sling and swathe</p> Signup and view all the answers

    Based on the assessment findings, the patient is most likely suffering from which of the following?

    <p>Dislocation</p> Signup and view all the answers

    What mechanism of injury was applied?

    <p>Twisting force</p> Signup and view all the answers

    Bones are covered by a strong, white, fibrous material called?

    <p>Periosteum</p> Signup and view all the answers

    Appropriate treatment would be to?

    <p>Splint with a padded rigid splint</p> Signup and view all the answers

    Which element of the musculoskeletal system belongs to the lower extremities of the appendicular skeleton?

    <p>Legs</p> Signup and view all the answers

    Application of a cervical collar to a patient should happen?

    <p>During the secondary assessment</p> Signup and view all the answers

    Twisting force involves?

    <p>Stretching or tearing of muscles and ligaments</p> Signup and view all the answers

    Based on the findings, the patient is most likely experiencing which of the following conditions?

    <p>Compartment syndrome</p> Signup and view all the answers

    To realign an extremity, an EMT grasps the distal extremity while a partner does what?

    <p>The partner supports the site while the first EMT creates gentle manual traction in the direction of the long axis of the extremity</p> Signup and view all the answers

    The first step in the progression of compartment syndrome is that?

    <p>A fracture or crush injury causes bleeding or swelling in an extremity</p> Signup and view all the answers

    If you see angulation when assessing a patient, then?

    <p>A bone or bones are out of anatomical position</p> Signup and view all the answers

    A fracture may be classified as?

    <p>Open or closed</p> Signup and view all the answers

    In a dislocation, what structures other than the joint capsule are likely to be injured?

    <p>Ligaments</p> Signup and view all the answers

    When treating a patient with an open musculoskeletal injury to the thigh, how would you best treat the open wound?

    <p>Cover the open wound with a sterile dressing, elevate the extremity, and apply a cold pack to the area to help reduce swelling</p> Signup and view all the answers

    The humerus is an example of?

    <p>Appendicular bone</p> Signup and view all the answers

    To test the air splint, you can?

    <p>See if you can cause a slight dent in the plastic with fingertip pressure</p> Signup and view all the answers

    The first effects of a bone injury are swelling of soft tissue and?

    <p>The formation of a blood clot in the area of the fracture</p> Signup and view all the answers

    To see the effect of direct force, you would look at?

    <p>The area of the point of impact</p> Signup and view all the answers

    To stabilize a hip fracture, how should you bind the legs together?

    <p>Place a folded blanket between the patient's legs and bind the legs together with wide straps, Velcro-equipped straps, or wide cravats</p> Signup and view all the answers

    A fracture that results in multiple bone pieces at the fracture site is termed?

    <p>Comminuted fracture</p> Signup and view all the answers

    When palpating a fracture site on a patient's mid-thigh, you notice a grating sensation. This is known?

    <p>Crepitus</p> Signup and view all the answers

    For a high-priority, unstable patient with musculoskeletal injuries, you should?

    <p>Immobilize the whole body on a long spine board and 'load and go'</p> Signup and view all the answers

    What is the primary concern about a splint that is applied too loosely?

    <p>It could allow the bone fragments to move, which could cause further damage</p> Signup and view all the answers

    A 14-year-old girl has fallen from her bicycle. According to the principles of indirect mechanisms of injury, which of the following bones is least likely to have been injured in this fall?

    <p>Thoracic vertebra</p> Signup and view all the answers

    Which of the following is the best sign of a pelvic injury?

    <p>Pain in the pelvis, significant mechanism of injury, obvious deformity</p> Signup and view all the answers

    A pillow is frequently used to splint an ankle or foot injury. Its main weakness is?

    <p>You are not immobilizing the knee and the joint adjacent to the ankle</p> Signup and view all the answers

    Which of the following is a muscle injury caused by overstretching or overexertion of the muscle?

    <p>Strain</p> Signup and view all the answers

    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. What should be considered in the immobilization of his injured extremity?

    <p>Check pulse, movement, and sensation distal to the injury before and after splinting</p> Signup and view all the answers

    One of the more serious conditions that EMTs encounter would occur as follows: A fracture or crush injury causes bleeding and swelling within the extremity. What is this condition called?

    <p>Compartment syndrome</p> Signup and view all the answers

    Your patient is a 70-year-old male whose tractor rolled over onto him. What signs and symptoms should you anticipate?

    <p>All of the above</p> Signup and view all the answers

    Your patient is a 20-year-old college student who has fallen from a third-level balcony. Which is the best sequence of intervention for this patient?

    <p>Provide manual in-line stabilization of the cervical spine along with assessment of breathing, pulse, and significant hemorrhage; apply high-concentration oxygen; perform a rapid trauma exam; immobilize to a long backboard; and splint the extremity en route if time and resources allow</p> Signup and view all the answers

    Blood at the meatus of the penis (opening of the urethra) is a sign of?

    <p>Pelvic trauma/fracture</p> Signup and view all the answers

    Distinguishing between a knee dislocation and a patella dislocation can sometimes be difficult. Which statement is not true?

    <p>In a patellar dislocation, the knee will be stuck in flexion but the knee cap will not be displaced</p> Signup and view all the answers

    Study Notes

    Musculoskeletal Injuries Overview

    • Musculoskeletal injuries can be classified as open or closed fractures.
    • A fracture indicates a break in the bone, which can cause angulation or displacement of bone segments.

    Dislocations and Joint Injuries

    • Dislocation occurs when soft tissue and ligaments are stretched, causing bones to move out of their normal position.
    • Common joint injuries can be observed by the position of the extremities and accompanying pain.

    Patient Assessment

    • During initial assessments, avoid focusing only on dramatic injuries; assess for life-threatening conditions first.
    • Check pulse, motor function, and sensation distal to the injury before and after splinting.

    Splinting Techniques

    • The primary purpose of splinting is to prevent movement and reduce the chance for further injury.
    • For long-bone injuries, immobilize the limb in the position of function to ensure stability.
    • Use sling and swathe method for upper arm injuries; immobilization should extend from the shoulder to the wrist.

    Specific Injuries and Management

    • A comminuted fracture features multiple fragments at the fracture site; a displaced fracture results in bone segments not aligning properly.
    • Compartment syndrome arises from pressure buildup within muscles, leading to potential tissue loss if untreated.
    • Blood at the meatus of the penis signals possible pelvic trauma or fracture.

    Mechanisms of Injury

    • Twisting forces cause muscle strain and ligament tears, while direct force results in immediate localized damage.
    • Fractures can occur from both trauma and non-traumatic causes, such as stress on the bone from repetitive activity.

    Identification and Response to Serious Conditions

    • Signs of pelvic fractures may include pain, shock, and inability to lift legs.
    • Patients with suspected fractures must be immobilized and transported carefully to prevent further damage.

    Importance of Proper Treatment

    • Angulation at a fracture site indicates a need for careful realignment and splinting.
    • It is crucial to explain uncertainty regarding sprains versus fractures to patients before any definitive treatment.

    General Principles

    • Always assess for distal pulses and sensations post-injury and post-splinting.
    • Elevated legs and the use of cold packs can help manage swelling in open musculoskeletal injuries.

    Special Considerations

    • Use of a PASG may be relevant for certain conditions like fractured pelvis, emphasizing its role in stabilization.
    • Specific techniques vary depending on the injury location, with targeted approaches for shoulder, ankle, knee, etc.

    These notes highlight critical aspects of assessment, identification, and management of musculoskeletal injuries that are essential for effective emergency care.### Hip Dislocation Overview

    • Hip dislocations are serious injuries usually accompanied by severe pain, immobility, and deformity.
    • They can be classified into posterior and anterior dislocations, with posterior being more common.

    Mechanisms of Injury

    • Injuries such as forearm deformities can occur from falls, typically categorized as indirect force (e.g., falling onto outstretched hands).
    • Indirect force leads to injuries through energy transmitted to the limb, often resulting in fractures above or below the point of impact.

    Signs of Hip Dislocation

    • Posterior hip dislocation commonly results in the limb being positioned with the knee bent and foot in a loose position.
    • Anterior dislocation may have outwardly rotated lower limbs, contrary to earlier assumptions.

    Complications of Bone Fractures

    • Bone fractures can lead to complications including hemorrhage, nerve damage, and significant swelling.

    Usage of Pelvic Wraps

    • Pelvic wraps are indicated in cases of instability or deformity of the pelvis and should be assessed based on mechanism of injury.

    Types of Fractures

    • A comminuted fracture involves multiple bone fragments, unlike a simple fracture that occurs in just one place.
    • Fractures can also be classified by characteristics such as angulated (angular displacement) or greenstick (incomplete).

    Splinting Techniques

    • Proper splinting should occur during secondary examinations for injuries like angulated forearms.
    • Principles include checking distal neurovascular function, immobilizing both joints above and below injury sites, and avoiding actions that may worsen conditions.

    Assessment of Extremity Injuries

    • Assessment utilizes the "six Ps": Pain, pallor, paresthesia, pulses, paralysis, and pressure, to detect circulatory and nerve compromise.
    • Careful comparison of injured and uninjured sides helps identify potential injuries.

    Circulatory Concerns in Limb Injuries

    • In cases of severe deformities with cold and mottled feet, exploring the possibility of restoring circulation should be prioritized before splinting.

    Anatomic Terminology

    • The sternum is a vital bone located in the chest.
    • The axial skeleton comprises the skull and spinal column, contrasting with the appendicular skeleton (limb bones).

    Complications from Improper Splinting

    • Proper management is crucial to avoid ignoring life-threatening conditions or compromising circulation while addressing extremity injuries.

    Physiological Structures of Bones and Joints

    • Cartilage facilitates smooth movements between bone surfaces at joints, while ligaments connect bones and stabilize them.
    • The periosteum wraps around bones, providing protection and receiving blood supply.

    Knowledge Gaps and Misconceptions

    • Misconceptions regarding tendon and ligament functions (tendons connect muscles to bones, not ligaments) must be clarified.

    Application of Traction Splints

    • In cases of suspected femur injuries, applying traction involves utilizing about 10% of the patient's body weight, not exceeding 15 pounds.

    Evaluating Joint Injuries

    • Careful palpation and movement evaluation can reveal symptoms of joint injuries, but never assume integrity before a thorough check.

    Emergency Medical Response

    • EMTs must prioritize patient safety, ensuring primary survey focuses on life threats before becoming involved in orthopedic evaluations.
    • Injuries to joints, like the knee, may include fractures to associated bones such as the patella and proximal tibia and fibula but not the femur.

    Post-Injury Protocol

    • Post-dislocation through splinting should always begin with checking distal circulation before securing a sling and swathe for transport.

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    Description

    Test your knowledge on musculoskeletal injuries with this quiz focused on Chapter 32 of the EMT curriculum. Explore key concepts such as fractures, dislocations, and the mechanics of joint injuries. Perfect for EMT students preparing for exams!

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