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Questions and Answers
Common signs and symptoms of an acute pulmonary embolism include all of the following, EXCEPT:
Common signs and symptoms of an acute pulmonary embolism include all of the following, EXCEPT:
When you arrive at a motorcycle crash scene, what should you do for a rider with bilaterally deformed femurs?
When you arrive at a motorcycle crash scene, what should you do for a rider with bilaterally deformed femurs?
For a 40-year-old woman with unstable pelvis following a crash, after starting IV, what is your next step?
For a 40-year-old woman with unstable pelvis following a crash, after starting IV, what is your next step?
What is the most appropriate way to treat a patient with a Colles fracture?
What is the most appropriate way to treat a patient with a Colles fracture?
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In addition to stabilizing the suspected fracture site of a lower leg injury, what should you also do?
In addition to stabilizing the suspected fracture site of a lower leg injury, what should you also do?
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For a young man with a traumatic left elbow injury, what should you do given that transport will be delayed?
For a young man with a traumatic left elbow injury, what should you do given that transport will be delayed?
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If a patient with a suspected lower leg fracture experiences excruciating pain, what should you do?
If a patient with a suspected lower leg fracture experiences excruciating pain, what should you do?
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Before removing a tree that has pinned a patient at the thighs, what treatment should you provide?
Before removing a tree that has pinned a patient at the thighs, what treatment should you provide?
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What is the most appropriate treatment intervention for a 68-year-old woman with acute dyspnea and chest pain after hip replacement?
What is the most appropriate treatment intervention for a 68-year-old woman with acute dyspnea and chest pain after hip replacement?
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The MOST appropriate treatment for a 71-year-old man with pain in his hip and neck after a fall includes:
The MOST appropriate treatment for a 71-year-old man with pain in his hip and neck after a fall includes:
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In addition to caring for a 17-year-old man with heel and knee pain after jumping from a balcony, what is MOST important?
In addition to caring for a 17-year-old man with heel and knee pain after jumping from a balcony, what is MOST important?
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Isolated musculoskeletal injuries often result in what?
Isolated musculoskeletal injuries often result in what?
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Hematopoiesis is defined as the process of?
Hematopoiesis is defined as the process of?
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Which of the following structures is NOT part of the axial skeleton?
Which of the following structures is NOT part of the axial skeleton?
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The appendicular skeleton is composed of the?
The appendicular skeleton is composed of the?
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Which of the following bones is MOST vulnerable to injury?
Which of the following bones is MOST vulnerable to injury?
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The upper extremity joins the shoulder girdle at the?
The upper extremity joins the shoulder girdle at the?
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The carpals, especially the scaphoid, are MOST vulnerable to fracture when a person?
The carpals, especially the scaphoid, are MOST vulnerable to fracture when a person?
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The ischium, ilium, and pubis are fused together to form the?
The ischium, ilium, and pubis are fused together to form the?
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Hip fractures are actually fractures of the?
Hip fractures are actually fractures of the?
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The fibula?
The fibula?
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When a person jumps from a height and lands on his or her feet, direct trauma occurs to the?
When a person jumps from a height and lands on his or her feet, direct trauma occurs to the?
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___________ is a dense, fibrous membrane that is important for bone repair and maintenance.
___________ is a dense, fibrous membrane that is important for bone repair and maintenance.
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After 35 years of age, age-related decrease in bone density is accelerated in females because?
After 35 years of age, age-related decrease in bone density is accelerated in females because?
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Osteoporosis is MOST accurately defined as a(n)?
Osteoporosis is MOST accurately defined as a(n)?
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The joints that connect the ribs to the sternum are examples of?
The joints that connect the ribs to the sternum are examples of?
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Diarthroses?
Diarthroses?
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A ____________ is a padlike sac or cavity located within the connective tissue, usually in proximity to a joint.
A ____________ is a padlike sac or cavity located within the connective tissue, usually in proximity to a joint.
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What structure helps maintain the stability of a joint and determines the degree of joint motion?
What structure helps maintain the stability of a joint and determines the degree of joint motion?
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By maintaining a state of partial contraction, __________ muscle allows the body to maintain its posture.
By maintaining a state of partial contraction, __________ muscle allows the body to maintain its posture.
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Skeletal muscles that are not used or exercised tend to?
Skeletal muscles that are not used or exercised tend to?
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The energy for muscular contraction is derived from the metabolism of _______ and results in the production of _______.
The energy for muscular contraction is derived from the metabolism of _______ and results in the production of _______.
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Skeletal muscle is innervated by?
Skeletal muscle is innervated by?
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The upper extremity's blood supply originates from the?
The upper extremity's blood supply originates from the?
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The anterior and posterior tibial arteries are direct subdivisions of the?
The anterior and posterior tibial arteries are direct subdivisions of the?
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A pathologic fracture occurs when?
A pathologic fracture occurs when?
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Which of the following is the BEST example of an indirect injury?
Which of the following is the BEST example of an indirect injury?
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Which of the following musculoskeletal injuries would MOST likely occur together?
Which of the following musculoskeletal injuries would MOST likely occur together?
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What type of fracture occurs at an angle across the bone and is typically caused by direct or twisting force?
What type of fracture occurs at an angle across the bone and is typically caused by direct or twisting force?
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A stress fracture would MOST likely occur when?
A stress fracture would MOST likely occur when?
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The MOST significant immediate risk associated with an open fracture is?
The MOST significant immediate risk associated with an open fracture is?
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In a closed femur fracture, blood loss may exceed _______ before enough pressure develops to tamponade the bleeding.
In a closed femur fracture, blood loss may exceed _______ before enough pressure develops to tamponade the bleeding.
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The MOST reliable sign of a fracture is?
The MOST reliable sign of a fracture is?
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Which of the following statements regarding a nondisplaced fracture is correct?
Which of the following statements regarding a nondisplaced fracture is correct?
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A patient standing with his or her head cocked toward a knocked-down left shoulder MOST likely has a fracture of the?
A patient standing with his or her head cocked toward a knocked-down left shoulder MOST likely has a fracture of the?
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Eliciting for crepitus during your exam of a deformed extremity?
Eliciting for crepitus during your exam of a deformed extremity?
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The BEST way to detect deformity or any other abnormality in an injured extremity is to?
The BEST way to detect deformity or any other abnormality in an injured extremity is to?
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A subluxation occurs when?
A subluxation occurs when?
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A dislocation is considered an urgent injury because of its potential to cause?
A dislocation is considered an urgent injury because of its potential to cause?
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The sudden twisting of a joint beyond its normal range of motion, causing a temporary subluxation, is called a?
The sudden twisting of a joint beyond its normal range of motion, causing a temporary subluxation, is called a?
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Immediate pain from the heel to the calf and a sudden inability for plantar flexion of the foot is MOST indicative of?
Immediate pain from the heel to the calf and a sudden inability for plantar flexion of the foot is MOST indicative of?
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Signs of bursitis include all of the following, EXCEPT?
Signs of bursitis include all of the following, EXCEPT?
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In contrast to osteoarthritis, rheumatoid arthritis?
In contrast to osteoarthritis, rheumatoid arthritis?
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When assessing a multisystems trauma patient, it is MOST important to?
When assessing a multisystems trauma patient, it is MOST important to?
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Closed bilaterally fractured femurs can result in internal blood loss of up to?
Closed bilaterally fractured femurs can result in internal blood loss of up to?
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After ensuring your own safety, your next priority when caring for a patient with an extremity injury is to?
After ensuring your own safety, your next priority when caring for a patient with an extremity injury is to?
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Which of the following is NOT one of the 6 Ps of musculoskeletal injury assessment?
Which of the following is NOT one of the 6 Ps of musculoskeletal injury assessment?
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When assessing distal pulses in a patient with a lower extremity injury, it is MOST important to?
When assessing distal pulses in a patient with a lower extremity injury, it is MOST important to?
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Which of the following medical conditions would MOST likely cause changes in sensation in a patient with an extremity injury?
Which of the following medical conditions would MOST likely cause changes in sensation in a patient with an extremity injury?
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The goal of prehospital pain control in a patient with a musculoskeletal injury should be to?
The goal of prehospital pain control in a patient with a musculoskeletal injury should be to?
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Swelling and inflammation associated with musculoskeletal injuries are reduced?
Swelling and inflammation associated with musculoskeletal injuries are reduced?
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Correctly splinting an injured extremity?
Correctly splinting an injured extremity?
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The FIRST step in splinting a musculoskeletal injury involves?
The FIRST step in splinting a musculoskeletal injury involves?
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The MOST practical method of splinting multiple fractures in a critically injured patient is to?
The MOST practical method of splinting multiple fractures in a critically injured patient is to?
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You should NOT apply a pneumatic splint on a patient if he or she?
You should NOT apply a pneumatic splint on a patient if he or she?
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The likelihood of experiencing systemic complications from a musculoskeletal injury is related to all of the following factors, EXCEPT the?
The likelihood of experiencing systemic complications from a musculoskeletal injury is related to all of the following factors, EXCEPT the?
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Which of the following is NOT an intervention the paramedic can perform to help reduce the risk of long-term disability following a musculoskeletal injury?
Which of the following is NOT an intervention the paramedic can perform to help reduce the risk of long-term disability following a musculoskeletal injury?
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Compartment syndrome occurs when?
Compartment syndrome occurs when?
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The return of myoglobin to the systemic circulation following a crush injury would result in all of the following conditions, EXCEPT?
The return of myoglobin to the systemic circulation following a crush injury would result in all of the following conditions, EXCEPT?
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The risk of a pulmonary embolism following musculoskeletal trauma is highest in patients with?
The risk of a pulmonary embolism following musculoskeletal trauma is highest in patients with?
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Study Notes
Isolated Musculoskeletal Injuries
- Generally associated with potential for short- or long-term disability.
Functions of the Musculoskeletal System
- Hematopoiesis is the process of generating blood cells.
Axial vs. Appendicular Skeleton
- The femoral shaft is NOT part of the axial skeleton.
- The appendicular skeleton includes the pectoral girdle, pelvic girdle, and bones of the extremities.
Vulnerable Bones
- The clavicle is the most vulnerable to injury compared to other bones like the sternum and scapula.
Shoulder Girdle
- The upper extremity connects to the shoulder girdle at the glenohumeral joint.
Carpal Fractures
- Scaphoid fractures are most likely to occur when falling on an outstretched hand.
Pelvic Structure
- The innominate bone is formed by the fusion of the ischium, ilium, and pubis.
Hip Fractures
- Generally occur at the femoral neck.
Fibula
- Not a part of the knee joint structure.
Injury from Impact
- Landing on feet after a jump primarily causes direct trauma to the calcaneus.
Bone Repair Structure
- The periosteum is a dense, fibrous membrane important for bone repair.
Bone Density and Age
- Decreased estrogen levels in females after menopause accelerate age-related bone density loss.
Osteoporosis
- Defined as a significant decrease in bone density.
Joint Connections
- Joints connecting ribs to sternum are cartilaginous joints.
Diarthroses Joints
- Are the most mobile joints in the body, allowing extensive movement.
Bursa
- A bursa is a padlike sac near a joint that helps reduce friction.
Joint Stability
- Ligaments are crucial for maintaining joint stability and motion.
Muscle Function and Posture
- Skeletal muscle helps maintain posture through partial contraction.
Muscle Atrophy
- Occurs in skeletal muscles that are not used or exercised.
Energy for Muscle Contraction
- Derived primarily from glucose, resulting in lactic acid production.
Skeletal Muscle Innervation
- Innervated by somatic motor neurons, not involuntary nerves.
Blood Supply to Upper Extremities
- Originate from the subclavian artery.
Tibial Arteries
- Anterior and posterior tibial arteries are branches of the popliteal artery.
Pathologic Fracture
- Occurs due to abnormal bone weakness from underlying medical conditions.
Indirect Injury Example
- Shoulder dislocation can occur after falling on an outstretched hand.
Fracture Associations
- Knee dislocation is commonly associated with tibial fractures.
Fracture Types
- Oblique fractures occur at an angle, often caused by direct or twisting forces.
Stress Fractures
- Result from muscular development exceeding that of bones, causing stress.
Risks from Open Fractures
- Immediate risk primarily involves hemorrhage.
Blood Loss in Femur Fracture
- Closed femur fractures can result in more than 1,000 mL of blood loss.
Confirmation of Fractures
- Deformity is the most reliable sign of a fracture.
Nondisplaced Fracture Characteristics
- Typically caused by low-energy trauma, not associated with deformity.
Clavicle Fracture Indicators
- A patient with a head tilted toward a shoulder likely has a fractured clavicle.
Crepitus Examination Risks
- Eliciting crepitus could exacerbate injuries.
Examining Deformed Extremities
- Best observed by comparing to the uninjured extremity.
Subluxation Definition
- Partial dislocation of a joint.
Dislocation Urgency
- Considered urgent due to risks of neurovascular compromise.
Sprain Definition
- Sudden twisting beyond normal motion range causing temporary subluxation.
Achilles Tendon Rupture Symptoms
- Characterized by immediate pain from heel to calf and inability to plantar flex.
Bursitis Symptoms
- Common signs include warmth, swelling, and erythema but not deformity.
Differences in Arthritis
- Rheumatoid arthritis is a systemic inflammatory disease affecting multiple body systems.
Multisystem Trauma Assessment
- Focus should remain on avoiding distractions from visually impressive injuries.
Internal Blood Loss from Bilateral Femur Fractures
- Can exceed 3,000 mL.
Injury Care Prioritization
- After ensuring safety, preventing further injury is the next priority.
6 Ps of Musculoskeletal Assessment
- Passive extension is NOT one of the 6 Ps.
Comparing Distal Pulses
- Important to assess the strength of pulses in injured lower extremities.
Sensation Changes in Extremity Injury
- Diabetes could cause changes in sensation following extremity trauma.
Pain Control Goals
- Aim to diminish pain to a tolerable level during prehospital care.
Cold Application
- Reduces swelling and inflammation following acute injuries.
Splinting Purpose
- Effective splinting helps control internal bleeding by facilitating clot formation.
Initial Splinting Step
- Requires exposing and assessing the injury site first.
Splinting Multiple Fractures
- The long backboard is the most practical method for immobilizing multiple fractures.
Pneumatic Splint Contraindications
- Should not be used in cases of open fractures with exposed bone.
Systemic Complications Risk Factors
- Influenced by health, injury location, and impact force, not splinting method.
Long-term Disability Prevention
- Prehospital fracture reduction is NOT an intervention effective in preventing long-term disability.
Compartment Syndrome Definition
- Results from pressure in a fascial compartment affecting circulation and potentially causing muscle death.
Myoglobin Concerns Post-Crush Injury
- Increased myoglobin can lead to renal dysfunction but not metabolic alkalosis.
Pulmonary Embolism Risk
- Highest in patients with pelvic and lower extremity injuries leading to prolonged immobilization.
Acute Pulmonary Embolism Symptoms
- Signs include pleuritic chest pain, right-sided heart failure, tachycardia, and tachypnea, but not pulmonary edema.
Motorcycle Crash Protocol
- Stabilize the head and assess the airway in supine patients with evident deformities.
Unstable Pelvis Management
- Administer intravenous fluids to improve vital signs and mental status after injuries.### Colles Fracture Management
- A Colles fracture is identified in a patient with stable vital signs and mild pain (2/10).
- The best treatment approach involves administering analgesia followed by proper splinting of the injury.
Lower Leg Injury Assessment
- An isolated injury to the left lower leg shows deformity and ecchymosis, with intact distal circulation and stable condition.
- Essential treatment includes immobilizing both the knee and ankle to stabilize the fracture.
Elbow Injury Protocol
- A patient with direct trauma to the left elbow presents with deformity and ecchymosis, but maintains good circulation.
- The most suitable action is to splint the elbow in its current position and reassess distal circulation.
Managing Severe Pain and Complications
- A young woman with a suspected lower leg fracture experiences excruciating pain despite narcotic treatment, with taut skin and weak pedal pulse upon reassessment.
- Immediate actions should include loosening the splint, elevating the leg, applying ice, and notifying the hospital for further assistance.
Treatment for Pinning Trauma Victim
- A patient trapped under a tree displays severe pain, stable vital signs but with a fast pulse and increased respiration rate.
- Prior to tree removal, administer IV therapy with crystalloid fluid bolus and consider nebulized albuterol for airway support.
Dyspnea and Chest Pain After Hip Replacement
- An elderly woman presents with acute dyspnea and sharp chest pain post-hip replacement, displaying stable vital signs.
- The priority is oxygenation and ventilation support along with rapid transport to a medical facility.
Hip and Neck Injury in Elderly Patient
- A 71-year-old man has experienced a fall, showing signs of a potential hip fracture and head hematoma but with stable vital signs.
- Appropriate treatment includes spinal motion restriction, stabilization of the hip with pillows, oxygen support, and IV administration of normal saline.
Lower-Extremity Injury After Jump
- A 17-year-old male reports pain in his heels and knees after jumping from a height, with swelling and ecchymosis observed in his feet.
- Beyond addressing lower-extremity injuries, applying spinal motion restriction precautions is crucial to prevent further complications.
Studying That Suits You
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Description
Test your knowledge on orthopedic trauma with these flashcards from Chapter 38. This quiz will cover key concepts related to isolated musculoskeletal injuries and their implications. Ideal for students studying orthopedics or related medical fields.