Questions and Answers
What is the total number of bones in the human skeletal system?
What is the first step in the general assessment of a traumatic injury?
What is a sign of compartment syndrome?
What is included in the ABCDEFGHI trauma assessment?
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What is a characteristic of muscles in the musculoskeletal system?
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What should you beware of in the general assessment of a traumatic injury?
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What is a type of injury that may be associated with compartment syndrome?
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What is an important aspect of the focused assessment in the presence of trauma?
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What is the typical color progression of ecchymosis?
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What is the difference between a strain and a sprain?
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What is the purpose of intermittent elevation of the limb in treating strains and sprains?
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What is the typical treatment for a quadriceps tear?
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What is the purpose of the Thompson Test?
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What is a common complication of crush injuries?
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What is the recommended approach to impaling objects in the treatment of impaling injuries?
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What is a potential complication of crush injuries that can lead to renal failure?
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What should be done to a toe dislocation?
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What is a complication of hip dislocation if not relocated within 4-6 hours?
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What is true about radial head subluxation (nursemaid's elbow)?
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What is a type of hip dislocation?
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What is unique about patellar dislocation?
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What is the first step in managing a dislocation?
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What is a common complication associated with knee dislocations?
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What intervention is recommended immediately after a knee dislocation?
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Which statement is true regarding ankle dislocations?
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What is one of the primary interventions for both knee and ankle dislocations?
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What should be monitored closely in patients with knee dislocations?
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Which of the following is an intervention specifically mentioned for ankle dislocations?
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What is a primary complication associated with pelvic fractures?
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Which intervention is appropriate for managing clavicular fractures?
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In the treatment of forearm and wrist fractures, which is a common intervention?
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What condition is characterized by respiratory distress and altered mental status following orthopedic injuries?
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A common complication following a femur fracture is:
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Which of the following is NOT typically treated with splinting?
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For which type of fracture is urgent external fixation most necessary?
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What is one of the key assessments to perform when dealing with dislocations?
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Which of the following injuries typically occurs in children and adolescents?
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What is a significant risk associated with ankle and foot fractures?
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Study Notes
Orthopedic Trauma Emergencies
- Knowledge of skeletal system anatomy and physiology is crucial for assessment and treatment.
- The musculoskeletal system comprises 206 bones, joints, tendons, ligaments, muscles, vessels, and nerves.
General Assessment in Trauma
- Always secure Airway, Breathing, and Circulation (ABC's) before further assessment.
- Conduct a trauma assessment using ABCDEFGHI, focusing on:
- Mechanism of injury
- Onset and duration of symptoms
- Type of injury (blunt or penetrating)
- Preexisting conditions and associated symptoms.
- Perform a focused neurovascular evaluation when trauma is present:
- Assess pain, pulses, paralysis, paresthesia, pallor, and temperature.
Compartment Syndrome
- Identified by disproportionate pain, decreased mobility, paresthesia, cool temperature, and pallor compared to surrounding skin.
- Overlying skin may appear tense; signs and symptoms can evolve in color over days.
Strains and Sprains
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Strain: Overstretching or weakening of muscle at the tendon attachment.
- Patients often report snapping sound, local pain, and slight muscle spasms.
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Sprain: Joint exceeds normal limits, damaging ligaments.
- Presents with pain, swelling, and history of a popping sound.
Treatment Interventions
- Compression bandaging, intermittent limb elevation, cold packs (limited to 15 minutes), and light to no weight bearing as tolerated.
- For tendon injuries:
- Incomplete tears may require rest and alternating ice/heat.
- Complete tears, such as Achilles ruptures, often necessitate surgical intervention.
Impaling Injuries
- Stabilize the impaled object; do not remove it unless surgical intervention is required.
Fracture Management
- Clavicular Fractures: Common in children; complications include pneumothorax, hemothorax, and brachial plexus injuries.
- Scapular Fractures: Uncommon, often due to direct trauma; require neurovascular assessment and potential immobilization.
- Upper Arm Fractures: Common in children and older adults; may risk radial nerve damage.
Pelvic and Hip Injuries
- Pelvic Fractures: Can lead to severe complications including nerve injury, blood loss, and organ damage.
- Hip Fractures: Common in the elderly; complications include hypovolemia and avascular necrosis. Early traction is essential.
Tibial/Fibular and Ankle Injuries
- These injuries can lead to significant blood loss, risk of infections, and compartment syndrome.
- Common treatment involves splinting and cautious reduction only if necessary.
Fat Embolism Syndrome
- Can occur following multiple orthopedic injuries; manifests as respiratory distress and altered mental status.
- Treatment focuses on supportive care and early fixation of fractures.
Dislocations
- Occurs when a joint exceeds its normal motion range; may be partial (subluxation) or complete.
- High risk for ischemia and necrosis; assess neurovascular status urgently.
Specific Joint Dislocations
- Shoulder Dislocations: Commonly require reduction; immobilization necessary post-reduction.
- Knee Dislocations: High risk of popliteal artery injury; require splinting and likely admission for monitoring.
- Ankle Dislocations: Often associated with fractures; require splinting and ice application.
Conclusion
- Detailed knowledge of orthopedic trauma, assessment techniques, and intervention protocols are essential for optimal patient outcomes in emergency scenarios.
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Description
Assess and treat skeletal system injuries with knowledge of anatomy and physiology. Learn ABCDEFGHI trauma assessment and more.
