Orthopedic Injuries

Question 1

The blood supply in each UE originates from the :

Answer 1

subclavian artery

Question 2

The blood supply in each LE originates from the :

Answer 2

iliac artery

Question 3

abduction

Answer 3

movement AWAY from midline

Question 4

adduction

Answer 4

movement TOWARD the midline

Question 5

Pathologic fracture

Answer 5

Fx caused when a medical condition weakens bone

Question 6

Injuries that commonly occur w/ scapular fx

Answer 6

rib fx
pulmonary contusion
pneumothorax

Question 7

Injuries that commonly occur w/ scaphoid fx

Answer 7

wrist, elbow, or shoulder fx

Question 8

Injuries that commonly occur w/ pelvic fx

Answer 8

lumbosacral spine and long bone fx

intra-abdominal and GU injury

Question 9

Injuries that commonly occur w/ hip dislocations

Answer 9

acetabulum or femoral head fx

Question 10

Injuries that commonly occur w/ femoral fx

Answer 10

dislocation of ipsilateral hip

Question 11

Injuries that commonly occur w/ patella fx

Answer 11

fx-dislocation of ipsilateral hip

Question 12

Injuries that commonly occur w/ knee dislocation

Answer 12

tibial fx (distal pulse may be absent)

Question 13

Injuries that commonly occur w/ calcaneal fx

Answer 13

ankle, leg, hip, pelvis, spine, and other calcaneus fx

Question 14

comminuted fx

Answer 14

bone broken into two fragments

Question 15

epiphyseal fx

Answer 15

occurs in growth section of child’s bone

Question 16

greenstick fx

Answer 16

incomplete fx passing partway through the shaft but may cause substantial angulation

Question 17

incomplete fx

Answer 17

does not run completely through the bone

Question 18

oblique fx

Answer 18

broken at an angle across the bone; usually sharp, angled blow

Question 19

spiral fx

Answer 19

caused by twisting or spinning force, causing a long, spiral-shaped brak

Question 20

transverse fx

Answer 20

straight across the bone; direct blow injury

Question 21

s/s of fx

Answer 21

deformity
shortening
swelling
bruising
point tenderness
pain
guarding
crepitus
false motion
locked joint
exposed bone ends

Question 22

What is a sprain?

Answer 22

Stretch or torn ligaments

Question 23

s/s of sprains

Answer 23

Point tenderness
Swelling
Ecchymosis
Pain
Joint instability

Question 24

What is a strain?

Answer 24

Injury to muscle and/or tendon resulting from a violent muscle contraction or excessive sweating.

Question 25

s/s of strain

Answer 25

``` Swelling Severe muscle weakness Point tenderness Pain Exacerbation of pain w/ passive movement of injured extermity ```

Question 26

s/s Achilles tendon rupture

Answer 26

Pain from heel to calf and sudden inability to plantar flex the foot.

Question 27

Moderate musculoskeletal injuries

Answer 27

Open fx of digits Nondisplaced long bone and pelvic fx Major sprains of major joint

Question 28

Serious musculoskeletal injuries

Answer 28

``` Displaced long bone fx Multiple hand and foot fx Open long bone fx Displaced pelvic dx Dislocation of major joints Multiple digit amputations Lacerations of major nerves or blood vessels ```

Question 29

Severe life-threatening musculoskeletal injuries

Answer 29

Multiple closed fx Limb amputations b/l femur fx

Question 30

Critical musculoskeletal injuries

Answer 30

Multiple open fx of limbs | Suspected pelvic fx w/ hemodynamic instability

Question 31

6 Ps of musculoskeletal assessment

Answer 31

``` Pain Paralysis Paresthesia Pulselessness Pallor Pressure ```

Question 32

Hazards associated w/ improper stabilization of splints

Answer 32

Compression of nerves, tissues, and blood vessels Delay in transport of a pt w/ light-threatening injury Reduction of distal circulation Aggravation of the injury Injury to tissue, nerves, blood vessels, or muscles due to excessive movement of bone or joint

Question 33

Do not use PASG if any of the following exist :

Answer 33

``` Pregnancy Pulmonary edema Acute heart failure Penetrating chest injuries Groin injuries Major head injuries ```

Question 34

Management of compartment syndrome

Answer 34

Elevated extremity Ice packs Opening or loosening constrictive clothing and splint material Administer oxygen IV access. Crystalloid solution as needed Immediate transport

Question 35

Management of crush syndrome

Answer 35

Assess ABCs Supplemental oxygen as needed Consider bolus of crystalloid solution to increase intravascular volume

Question 36

s/s of DVT

Answer 36

Swelling in extremity Discomfort that worsens with use Warmth and erythema of extremity

Question 37

s/s PE

Answer 37

``` sudden onset of dyspnea pleuritic CP tachypnea tachycardia right sided heart failure shock cardiac arrest ```

Question 38

s/s of fat embolism

Answer 38

``` Appear 12-72 hours after injury tachycardia dyspnea tachypnea pulmonary congestion fever petechiae AMS organ dysfunction ```

Question 39

How to manage an elbow injury if limb is pulseless?

Answer 39

Apply gentle manual traction. If pulse does not return after one attempt, splint the limb in the most comfortable position. If pulse is restored, splint in whatever position allows the strongest pulse.

Question 40

lateral compression pelvic ring disruption

Answer 40

Internally rotated around the sacrum Volume of pelvis decreases Other regions of body injured

Question 41

open book pelvic fracture

Answer 41

anterior-posterior compression pelvic ring disruption from head-on injuries significant blood loss

Question 42

vertical shear

Answer 42

Major force applied to the pelvis from above or below. Anterior components : fx of rami or disruption of symphysis pubis posterior component : fx of ilium or sacrum or disruption of sacroiliac joint shortening of affected side massive hemorrhage into pelvis

Question 43

straddle fx

Answer 43

Fall when a person lands in the region of the perineum and sustains b/l fx of interior and superior rami

Question 44

open pelvic fx

Answer 44

life-threatening laceration of skin in pelvic region, vagina, or rectum high-velocity injury w/ subsequent massive hemorrhage

Question 45

Management of pelvic fx

Answer 45

``` Monitor ABCs Immobilize spine IV access ( two if possible) Seek medical direction Stabilization of pelvis Immobilize to long board Transport to trauma center ```

Question 46

signs of posterior dislocated hip

Answer 46

foot drop hip joint flexed internal rotation

Question 47

signs of anterior dislocation hip

Answer 47

Extended straight out | Externally rotated

Question 48

splinting dislocated hips

Answer 48

position of deformity supine on scoop stretcher support affected limb w/ pillows or rolled blankets secure limb to backboard

Question 49

Management of femur fx

Answer 49

``` Assess CMS Splint LE Oxygen as needed Establish IV access 20-mL/kg bolus of isotonic crystalloid solution to maintain radial pulses ```