Deck 9: Orthopedic Trauma

Question 1

When assessing a long bone injury, you should assume that you are dealing with a joint injury when the site of injury is within ________ inch(es) of the joint.

A) 3
B) 2
C) 1
D) 6

Answer 1

3

Question 2

A dislocated knee is MOST likely to damage which of the following vascular structures?

A) Femoral vein
B) Popliteal artery
C) Femoral artery
D) Great saphenous vein

Answer 2

Popliteal artery

Question 3

Not considering other injuries, which of the following musculoskeletal findings warrants immediate transport of your patient?

A) Unstable pelvis
B) Clavicle fracture
C) Posterior shoulder dislocation
D) Open fracture of the tibia and fibula

Answer 3

Unstable pelvis

Question 4

Which of the following is a consideration in preventing orthopedic injury?

A) Proper footwear
B) Well-designed railings
C) Appropriate stepladder use
D) All of the above

Question 5

Upon assessing a patient with a hip injury, you find that his right lower extremity is moved away from the midline of the body. You should describe the right lower extremity as being:

A) abducted.
B) externally rotated.
C) angulated.
D) adducted.

Question 6

Your patient is an 80-year-old woman who fractured a vertebra while coughing. This type of fracture is best described as a(n) ________ fracture.

A) pathological
B) greenstick
C) epiphyseal
D) comminuted

Question 7

The use of a binder is indicated in the treatment of which of the following musculoskeletal injuries?

A) Bilateral tibia/fibula fractures
B) Knee dislocation
C) Lumbar vertebral compression fracture
D) Pelvic fracture

Question 8

Tendons connect ________ to ________.

A) muscles; bones
B) bones; bones
C) cartilage; bones
D) muscles; fascia

Question 9

Your patient is a football player who had his right foot planted and was tackled from the left rear, causing his body to rotate around the axis of his right lower extremity. This mechanism is most consistent with which of the following types of fractures?

A) Oblique
B) Spiral
C) Impacted
D) Comminuted

Question 10

Your patient is a 27-year-old male ice skater whose left skate was planted when he was struck and knocked down by another skater. He is agitated and complaining of severe pain in his leg. Your examination reveals an open fracture 6 inches proximal to the ankle joint. Which of the following describes the most appropriate management of this patient?

A) Focused exam, oxygen, spinal immobilization, splint from the foot to above the knee, begin transport, start a large-bore IV, and request orders for analgesia
B) Focused exam, cover the open wound, apply a lower extremity traction splint, begin transport, start an IV, and request orders for analgesia
C) Focused exam, cover the open wound, splint from the foot to above the knee, begin transport, start an IV, and request orders for analgesia
D) Rapid trauma exam, high-concentration oxygen, cervical spine immobilization, cover the open wound, use the long backboard for initial splinting, initiate transport, start a large-bore IV, perform a detailed examination, use padded board splints to immobilize from the ankle to above the knee, and reassess the patient every 5 minutes

Question 11

Which of the following supplies articular cartilage with oxygen and nutrients?

A) Bursae
B) Capillary beds
C) Synovial fluid
D) The Haversian system

Question 12

Your patient is a seven-year-old boy with a fracture of the proximal tibia. Which of the following is the MOST likely and serious complication of this injury?

A) Juvenile onset arthritis
B) Formation of a bone callus
C) Disruption of the epiphyseal plate
D) Fat embolism

Question 13

A partial displacement of a bone end from its position in the joint is called a:

A) sprain.
B) dislocation.
C) subluxation.
D) contracture.

Question 14

Which of the following types of fractures occurs in pediatric age groups but not in adults?

A) Oblique
B) Transverse
C) Greenstick
D) Impacted

Question 15

A fracture in which significant energy exchange shatters or splinters bone, creating many fragments, is called a(n) ________ fracture.

A) impacted
B) comminuted
C) oblique
D) spiral

Question 16

Your patient is a 20-year-old woman complaining of ankle pain after stepping off a curb. She states that she is concerned because she had a grade III sprain a year and a half ago that required extensive treatment and rehabilitation. Which of the following most accurately describes the patient's previous injury?

A) The ankle ligaments were stretched but not torn.
B) The ankle ligaments had a minor tear.
C) The ankle ligaments were torn but not all the way.
D) The ankle ligaments were completely torn.

Question 17

Your patient is a 50-year-old motorcyclist who received a lateral impact from an automobile as he went through an intersection. He has an open right tibia/fibula fracture. He also has a fracture of his left forearm and some abrasions. He was wearing a helmet and suffered no loss of consciousness. He currently has a strong radial pulse of 100, his skin is warm and moist, and he has adequate respirations at 20 per minute. Assuming no significant findings during a rapid trauma exam and intact distal neurovascular status, which of the following is the best way to manage this patient's lower extremity trauma?

A) Use anatomical splinting provided by placing the patient on a long backboard.
B) Secure padded long board splints laterally and medially.
C) Apply PASG.
D) Apply a traction splint.

Question 18

Which of the following best describes the function of cancellous bone of the medullary canal?

A) It produces erythrocytes.
B) It acts as a growth plate in long bones.
C) Its dense, compact structure is well adapted to weight bearing.
D) It contains yellow bone marrow.

Question 19

Which of the following is the highest priority when managing a patient with bilateral closed femur fractures?

A) Assessing distal neurovascular function
B) Anticipating hypovolemia
C) Providing analgesia
D) Anticipating pulmonary embolism as a complication

Question 20

Which of the following is NOT part of the axial skeleton?

A) Sacrum
B) Pubis
C) Sternum
D) Mandible

Question 21

Your patient has an abrasion on the bony prominence on the inside of her right ankle. This abrasion should be described as being over which of the following structures?

A) Thenar eminence
B) Medial malleolus
C) Lateral malleolus
D) Styloid process

Question 22

Your patient complains of elbow pain and states his doctor told him he had "the bursitis" in his elbow. The patient's condition is characterized by inflammation of the:

A) articular cartilage.
B) synovial sacs.
C) tendons.
D) bone.

Question 23

The pain associated with skeletal fractures is transmitted by nerves in the:

A) epiphysis.
B) yellow bone marrow.
C) osteoclasts.
D) periosteum.

Question 24

Your patient is a 21-year-old football player who was struck in the lateral aspect of the left knee by another player's shoulder. The patient is in extreme pain, and the knee is significantly deformed and swollen. The pedal pulse is weak, but present, and capillary refill is less than 2 seconds. The patient is screaming at you to "fix" his knee. You are 10 minutes from the emergency department. You should:

A) splint the knee as found, start an IV, consider narcotic analgesia.
B) apply gentle axial traction and realign the limb, splint in alignment.
C) flex the knee to a 45-degree angle, splint in position of function.
D) start an IV, administer narcotic analgesia, apply firm axial traction until the pulse returns to normal or resistance is met, then splint.

Question 25

A sprain is an injury best defined as which of the following?

A) Bone ends not anatomically aligned
B) Muscle fibers stretched and torn
C) Partial or complete tearing of the ligaments of the joint capsule
D) A violent muscle spasm that tears away a small piece of bone

Question 26

One of the earliest indications that compartment syndrome is developing in an injured extremity is:

A) burning pain.
B) pallor of the overlying skin.
C) loss of distal pulses.
D) sensation of pressure in the limb.