Musculoskeletal System & Emergencies

Question 1

What are the functions of the musculoskeletal system?

Answer 1

• Gives body shape
• Protects internal organs
• Provides for movement
• Consists of more than 600 muscles

Question 2

What is the anatomy of the musculoskeletal system?

Answer 2

• Muscles: provide movement & generate heat
• Ligaments: connect bone to bone
• *injury = sprain**
• Tendons: connect bone to muscle
• *injury strain**
• Bones: protect & shape

Question 3

What is the function of the skeletal system?

Answer 3

1. Gives form to the body
2. Protects vital organs
3. Consist of 206 bones
4. Acts as a framework for attatchment of muscles
5. Designed to permit motion of the body

Question 4

Identify these bones of the skull:

Nasal bone, Ethmoid bone, Vomer, Maxillae, Parietal bone, Frontal bone, Sphenoid bone, Temporal bone, Lacrimal bone, Zygomatic bone, Middle/Inferior nasal concha, Mandible, Maxilla, Palatine, Sphenoid bone, Vomer, Occipital bone.

Answer 4

Question 5

Identify these muscles of the neck: Thyroid cartilage, Cricoid cartilage, Cricothyroid membrane, Trachea, Carotid arteries, Sternocleido-mastoid muscle

Answer 5

Question 6

Identify these sections of the spinal colulmn and include how many vertebrae are in each: Cervical, Thoracic, Lumbar, Sacrum, Coccyx.

Answer 6

Question 7

Identify these bones of the thorax: Jugular nothc, Angle of Lois, Sternum, Xiphoid process, Anterior ribs, Costal arch, Posterior Ribs, Scapula. C7, Clavicle.

Answer 7

Question 8

Identify the vessels and Bones of the pelvis: Femoral vein, Descending aorta, Femoral artery, Inferior vena cava, Sacrum, Lliac crest, Pubis, Ischial tuberosity, Llium, Pubic symphysis.

Answer 8

Question 9

Identify these bones of the lower extremity: Pelvis, leg, tibia, foot, thigh, phalanges, patella, femur, tarsals, hip, metatarsals, ankle.

Answer 9

Question 10

Know the Shoulder girdle, arm, elbow, forearm, wrist, and hand of the upper extremity.

Question 11

What are the types of muscle? Which type is voluntary and involuntary?

Answer 11

1. Skeletal muscle: attatches to the bones of the body
   - voluntary
2. Smooth muscle: carry out the automatic muscular functions of the body
   - involuntary

Question 12

What are the types of injuries of the musculoskeletal system?

Answer 12

• Sprain
• Strain
• Dislocation
• Closed fracture
• Open fracture

Question 13

What are sprains and strains?

Answer 13

1. Sprain: joint injury with tearing of ligament
2. Strain: stretching or tearing of muscle

Question 14

What are the signs and symptoms of sprains and strains? What is the treatment?

Answer 14

1. -Pain
   -Edema & Ecchymosis
   (small hemorrhagic spot in the skin or a mucous membran)
   -Joint instability
2. Immobilize, ice & elevate

Question 15

What is a dislocation?

Answer 15

A disruption of a joint in which the bone ends are no longer in contact and the supporting ligaments are torn

Question 16

What are the S/S of dislocation? Treatment?

Answer 16

1. -Marked deformity
   - Edema
   - Pain
   - Tendernesson palpation
   * *-Complete loss of joint function
   - Distal numbness**
2. Immobilize, ice, & elevate

Question 17

What are the types of fractures? How is each different?

Answer 17

1. Closed fracture
   - does not break skin
2. Open fracture
   - external wound
3. Nondisplaced fracture
   - simple crack
4. Displaced fracture
   - deformity

Question 18

What is the S/S and treatment for a closed fracture?

Answer 18

1. S/S:
   * *-pain
   - edema
   - possible deformity
   - contusion
   - loss of motion
   - false motion
   - crepitus
   - guarding**
2. Treatment:
   * *-immobilize
   - ice
   - elevate**

Question 19

What are the S/S and treatment for an open fracture?

Answer 19

1. S/S:
   * *-pain
   - deformity
   - break in skin/exposed bone**
2. _Treatment: _
   * *-dressing
   - immobilize
   - ice
   - elevate**

Question 20

What is the old terminology for fractures?

Answer 20

Simple and compound

Question 21

What are other types of fractures?

Answer 21

• Green stick
• Spiral
• Transverse
• Comminuted
• Pathologic
• Epiphyseal

Question 22

What are some complications of fractures?

Answer 22

1. Blood vessel & nerve damage
2. Fat embolus
3. Disability or deformity

Question 23

What is internal bleeding? How much blood can be bled internally per: femur, pelvis, tibia?

Answer 23

1. Bleeding from bone fractures, they have their own blood supply
2. -Femur: 1 liter
   - Pelvis: 1 liter
   - Tibia: 500 cc

Question 24

What are some other fracture considerations?

Answer 24

• What is beneath fracture site
• Open fracture
• Joint involved

Question 25

What are some other types of fractures?

Answer 25

* **Angulation or angulated extremity** * **Depressed skull fracture** * **Basilar skull fracture** * **Flail chest**

Question 26

What are the _types_ of **hip injuries**?

Answer 26

1. **Hip fracture**: classic presentation _-shortened, externally rotated_ 2. **Hip dislocation**: classic presentation _-usually flexed and internlly rotated_ \*requires significant force\*

Question 27

What is the _treatment_ for a **hip injury?**

Answer 27

* **Draw sheet method** * **Make no attempt to straighten leg** * **Support with rolled blankets** * **Prevent hip movement**

Question 28

How do you _asses_ the **injury of extremities**?

Answer 28

* **PMSC** - Pulse, movement, sensation, capillary refill * **Cold, blue, pulseless extremity has circulation problem**

Question 29

Why do we **splint**?

Answer 29

* **Relieve pain** * **Reduce tissue/vessel damage during movement**

Question 30

What are the _types_ of **splints**?

Answer 30

1. **Self splinting** 2. **Pillows, blankets, & items of clothing** 3. **Sling & swath** 4. **Rigid** * -cardboard, plastic, ladder* 5. **Air or vaccum** 6. **Traction**

Question 31

_When_ would you use a **traction splint**?

Answer 31

For a closed, mid shaft femur fracture without hip, knee or ankle injury

Question 32

What are the general rules for splinting? \*Part 1\*

Answer 32

* **Remove clothing** * **PMSC** * **Dress all wounds** * **Do not move the patient before splinting** * **Immobilize the joints** * **When in doubt, splint**

Question 33

What are the general rules for splinting? \*Part 2\*

Answer 33

* **Pad rigid splints** * **Maintain manual immobilization** * **Realign angulations PRN** * **Reassess PMSC** * **Immobilize all suspected spinal injuries in neutral line position** - pain, resistance, crepitus

Question 34

When _should you_ **realign a joint**? When _should you not_?

Answer 34

1. **Only realign pulseless, longbone fractures** 2. **Never realign a joint** or an **injury with good distal function**

Question 35

What shoul you _document_ and _check_ in regards to **splinting**?

Answer 35

* **Always check distal function _before and after_ splinting** * **Document what you find**

Question 36

What are the _hazards_ of **improper splinting**?

Answer 36

* **Further damage** * **Delay in transport** * **Reduction of distal circulation** * **Aggravation of the injury** * **Injury to the tissue, nerves, blood vessels, or muscle**

Question 37

What is an important note about fractures?

Answer 37

No matter how bad a fracture is, **ABC's are a priority**!

Question 38

_Identify_ these parts of the _foot_: **achilles tendon, talus, navicular, phalanges, calcaneus, metatarsal, medical/lateral/intermediate cuneiform** \*book\*

Answer 38

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Question 39

WHat is: **symphysis, joint capsule, synovial membrane, synovial fluid, balll and socket joint, hinge joint**

Answer 39

1. **Symphysis**: _bone ends are held together by fibrous tissue_ 2. **Joint capsule**: _a fibrous sac that holds together bone ends of a joint_ 3. **Synovial membrane**: _inner lining of the joint capsule. Creates synovial fluid_ 4. **Synovial fluid**: _a thick lubricant that allows the ends of the bines to glide over eachother _ 5. **Ball and socket joint:** _allows rotation and bending_ - shoulder 6. **Hinge joint:** _motion restricted to one plane_ - finger, elbow, knees