Chapter 28 Musculoskeletal Trauma

Question 1

Key Terms

fracture in which the broken bone segments are at an angle to each other

Answer 1

Angulated Fracture

Question 2

Key Terms

hard but flexible living structures that provide support for the body and protection to vital organs

Answer 2

Bones

Question 3

Key Terms

tough tissue that covers the joint ends of bones and helps to form certain body parts such as the ear

Answer 3

Cartilage

Question 4

Key Terms

an injury to an extremity with no associated opening in the skin

Answer 4

Closed Extremity Injury

Question 5

Key Terms

a fracture in which the bone is broken in several places

Answer 5

Comminuted Fracture

Question 6

Key Terms

injury caused when tissues such as blood vessels and nerves are constricted within a space as from swelling or form a tight dressing or cast

Answer 6

Compartment Syndrome

Question 7

Key Terms

a grating sensation or sound made when fractured bone ends rub together

Answer 7

Crepitus

Question 8

Key Terms

the disruption or “coming apart” of a joint

Answer 8

Dislocation

Question 9

Key Terms

the portions of the skeleton that include the clavicles, scapulae, arms, wrists, and hands (upper extremities) and the pelvis, thighs, legs, ankles, and feet (lower extremities)

Answer 9

Extremities

Question 10

Key Terms

any break in a bone

Answer 10

Fracture

Question 11

Key Terms

an incomplete fracture

Answer 11

Greenstick Fracture

Question 12

Key Terms

places where bones articulate or meet

Answer 12

Joints

Question 13

Key Terms

tissues that connect bone to bone

Answer 13

Ligaments

Question 14

Key Terms

the process of applying tension to straighten and realign a fractured limb before splinting. Also called “tension”

Answer 14

Manual Traction

Question 15

Key Terms

tissues or fibers that cause movement of body parts and organs

Answer 15

Muscles

Question 16

Key Terms

an extremity injury in which the skin has been broken or torn through from the inside by an injured bone or from the outside by something that has caused a penetrating wound with associated injury to the bone

Answer 16

Open Extremity Injury

Question 17

Key Terms

the stretching and tearing of ligaments

Answer 17

Sprain

Question 18

Key Terms

muscle injury resulting from overstretching or overexertion of the muscle

Answer 18

Strain

Question 19

Key Terms

tissues that connect muscle to bone

Answer 19

Tendons

Question 20

Key Terms

a splint that applies constant pull along the length of a lower extremity to help stabilize the fractured bone and to reduce muscle spasm in the limb. ________ ______s are used primarily on femoral shaft fractures

Answer 20

Traction Splint

Question 21

Short Answer

Describe the basic anatomy of bone and its purposes.

Answer 21

Bones are hard, flexible, complex structures composed of calcium and protein fibers. Bones are covered by a strong white fibrous material called periosteum, through which the blood vessels and nerves pass as they enter and leave the bone. They are the body’s framework, providing support and protection for the internal organs. They store salts and metabolic materials and are a site of red blood cell production. With the muscles, ligaments, and tendons, they play a major part in the body’s ability to move.

Question 22

Short Answer

Identify the signs and symptoms of musculoskeletal injury.

Answer 22

The signs and symptoms of musculoskeletal injury are pain and tenderness; deformity or angulation; grating, or crepitus; swelling; bruising; exposed bone ends; joints locked into position; and nerve and blood vessel compromise.

Question 23

Short Answer

Describe basic emergency care for painful, swollen, or deformed extremities, including general guidelines for splinting long bones and joints.

Answer 23

Take and maintain all Standard Precautions. Perform the primary assessment. After life-threatening conditions have been addressed, all patients with a painful, swollen, or deformed extremity must be splinted. For a low-priority (stable) patient, splint before transport. For a high-priority (unstable) patient, immobilize the whole body on a long spine board; then load and go. If appropriate, cover open wounds with sterile dressings, elevate the extremity, and apply a cold pack to the area to help reduce swelling. Injured long bones should be splinted in the position found unless the distal extremity is cyanotic or lacks pulses.

Question 24

Short Answer

Explain why angulated deformed injuries to the long bones should be realigned to the anatomic position.

Answer 24

Angulated and deformed injuries to long bones should be realigned to anatomical position to restore effective circulation to the affected extremity and to fit it into a splint.

Question 25

Short Answer

List the basic principles of splinting.

Answer 25

The basic principles of splinting are as follows: expose the area and control bleeding before splinting. Assess pulses, motor, and sensation before and after splinting. Align long-bone injuries with gentle traction if there is severe deformation. Splint to immobilize the injury site and adjacent joints. Splint patients before moving them. Pad splints for patient comfort. Choose a splinting method based on the severity of the patient’s condition and priority decision. If the patient is unstable, don’t waste time splinting.

Question 26

Short Answer

Describe the hazards of splinting.

Answer 26

Some of the hazards of splinting include neglecting life-threatening conditions; applying the splint so tightly that soft tissues are compressed and injury is caused to nerves, blood vessels, and muscles; and applying the splint so loosely or inappropriately that further soft-tissue injury occurs.

Question 27

Short Answer

Describe the basic types of splints carried on ambulances.

Answer 27

The basic splints carried on ambulances include rigid splints, formable splints, and traction splints.

Question 28

Critical Thinking Exercises

List three assessment findings that you would use to help determine if your musculoskeletal injury patient is in shock.

Answer 28

Assessment findings that indicate a patient with a musculoskeletal injury is in shock include vital sign changes; altered mental status; pale, cool, or clammy skin; and nausea and vomiting.

Question 29

Critical Thinking Exercises

Patients who suffer fractures can be in extreme pain. Pain can cause anxiety and elevated pulse rates. How could you differentiate between a patient with a rapid pulse and anxiety from pain versus a patient with rapid pulse and anxiety from shock?

Answer 29

Identifying a patient with a rapid pulse and anxiety from pain versus a patient with a rapid pulse and anxiety from shock really comes down to your ability to conduct thorough assessment and differentiate between patients who are stable and patients who are unstable. The patient in shock may have the additional signs and symptoms of low blood pressure; altered mental status; and pale, cool, and clammy skin. Other signs of shock include thirst, dilated pupils, and cyanosis around the lips and nail beds.