ATCN 2024 Chapter 8 Musculoskeletal
Trauma
A patient with long bone fractures above and below the diaphragm is at increased risk - ANSWER for
associated internal torso injuries.
Severe crush injuries cause the release of __________________________ from the muscle, which can
precipitate in the renal tubules and result in renal failure.
____________________________, an uncommon but highly lethal complication of long-bone fractures,
can lead to pulmonary failure and impaired cerebral function - ANSWER Severe crush injuries cause the
release of myoglobin from the muscle, which can precipitate in the renal tubules and result in renal
failure.
Fat embolism, an uncommon but highly lethal complication of long-bone fractures, can lead to
pulmonary failure and impaired cerebral function
Appropriate __________________________ fractures can significantly decrease bleeding by reducing
motion and enhancing the tamponade effect of the muscle and fascia. - ANSWER Appropriate splinting
of fractures can significantly decrease bleeding by reducing motion and enhancing the tamponade effect
of the muscle and fascia.
Assess injured extremities for
_____________________________________________________________________________________
____________ - ANSWER Assess injured extremities for external bleeding, loss of previously palpable
pulse, and changes in pulse quality, Doppler tone, and ankle/brachial index.
The ankle/brachial Index is determined by taking - ANSWER the systolic blood pressure value at the
ankle of the injured leg and dividing it by the systolic blood pressure of the uninsured arm.
If time to operative intervention is longer than 1 hour, a single attempt to - ANSWER deflate the
tourniquet may be considered in an otherwise stable patient
Application of ______________________________________ into bleeding open wounds while the
patient is in the ED is not advised, unless a superficial vessel is clearly identified. - ANSWER Application
, of vascular clamps into bleeding open wounds while the patient is in the ED is not advised, unless a
superficial vessel is clearly identified.
Joint dislocations should be - ANSWER Joint dislocations should be reduced, if possible; if the joint
cannot be reduced, emergency orthopedic intervention may be required.
Patients with bilateral femur fractures are at higher risk for - ANSWER significant blood loss, severe
associated injuries, pulmonary complications, multiple organ failure, and death.
Crush syndrome, or traumatic rhabdomyolysis, refers to the clinical effects of - ANSWER injured muscle
that, if left untreated, can lead to acute renal failure and shock.
The muscle insult is a combination of - ANSWER direct muscle injury, muscle ischemia, and cell death
with release of myoglobin.
Amber-colored urine in the presence of __________________________________________________ or
more is indicative of rhabdomyolysis when urine myoglobin levels are not available. Rhabdomyolysis can
lead to metabolic acidosis, hyperkalemia, hypocalcemia, and DIC - ANSWER Amber-colored urine in the
presence of serum creatine kinase of 10,000 U/L or more is indicative of rhabdomyolysis when urine
myoglobin levels are not available. Rhabdomyolysis can lead to metabolic acidosis, hyperkalemia,
hypocalcemia, and DIC
Myoglobin -induced renal failure can be prevented with? - ANSWER Myoglobin -induced renal failure
can be prevented with intravascular fluid expansion, alkalinization of the urine by intravenous
administration of bicarbonate, and osmotic diuresis.
Proper application of a splint helps ___________________________, _________________________,
and prevents further neurovascular compromise and soft-tissue injury. If an open fracture is present,
pull the exposed bone back into the wound, because open fractures require surgical debridement. -
ANSWER Proper application of a splint helps control blood loss, reduces pain, and prevents further
neurovascular compromise and soft-tissue injury. If an open fracture is present, pull the exposed bone
back into the wound, because open fractures require surgical debridement.
Key aspects of the patient history are - ANSWER mechanism of injury, environment, preinjury status and
predisposing factors, and prehospital observations and care.
Trauma
A patient with long bone fractures above and below the diaphragm is at increased risk - ANSWER for
associated internal torso injuries.
Severe crush injuries cause the release of __________________________ from the muscle, which can
precipitate in the renal tubules and result in renal failure.
____________________________, an uncommon but highly lethal complication of long-bone fractures,
can lead to pulmonary failure and impaired cerebral function - ANSWER Severe crush injuries cause the
release of myoglobin from the muscle, which can precipitate in the renal tubules and result in renal
failure.
Fat embolism, an uncommon but highly lethal complication of long-bone fractures, can lead to
pulmonary failure and impaired cerebral function
Appropriate __________________________ fractures can significantly decrease bleeding by reducing
motion and enhancing the tamponade effect of the muscle and fascia. - ANSWER Appropriate splinting
of fractures can significantly decrease bleeding by reducing motion and enhancing the tamponade effect
of the muscle and fascia.
Assess injured extremities for
_____________________________________________________________________________________
____________ - ANSWER Assess injured extremities for external bleeding, loss of previously palpable
pulse, and changes in pulse quality, Doppler tone, and ankle/brachial index.
The ankle/brachial Index is determined by taking - ANSWER the systolic blood pressure value at the
ankle of the injured leg and dividing it by the systolic blood pressure of the uninsured arm.
If time to operative intervention is longer than 1 hour, a single attempt to - ANSWER deflate the
tourniquet may be considered in an otherwise stable patient
Application of ______________________________________ into bleeding open wounds while the
patient is in the ED is not advised, unless a superficial vessel is clearly identified. - ANSWER Application
, of vascular clamps into bleeding open wounds while the patient is in the ED is not advised, unless a
superficial vessel is clearly identified.
Joint dislocations should be - ANSWER Joint dislocations should be reduced, if possible; if the joint
cannot be reduced, emergency orthopedic intervention may be required.
Patients with bilateral femur fractures are at higher risk for - ANSWER significant blood loss, severe
associated injuries, pulmonary complications, multiple organ failure, and death.
Crush syndrome, or traumatic rhabdomyolysis, refers to the clinical effects of - ANSWER injured muscle
that, if left untreated, can lead to acute renal failure and shock.
The muscle insult is a combination of - ANSWER direct muscle injury, muscle ischemia, and cell death
with release of myoglobin.
Amber-colored urine in the presence of __________________________________________________ or
more is indicative of rhabdomyolysis when urine myoglobin levels are not available. Rhabdomyolysis can
lead to metabolic acidosis, hyperkalemia, hypocalcemia, and DIC - ANSWER Amber-colored urine in the
presence of serum creatine kinase of 10,000 U/L or more is indicative of rhabdomyolysis when urine
myoglobin levels are not available. Rhabdomyolysis can lead to metabolic acidosis, hyperkalemia,
hypocalcemia, and DIC
Myoglobin -induced renal failure can be prevented with? - ANSWER Myoglobin -induced renal failure
can be prevented with intravascular fluid expansion, alkalinization of the urine by intravenous
administration of bicarbonate, and osmotic diuresis.
Proper application of a splint helps ___________________________, _________________________,
and prevents further neurovascular compromise and soft-tissue injury. If an open fracture is present,
pull the exposed bone back into the wound, because open fractures require surgical debridement. -
ANSWER Proper application of a splint helps control blood loss, reduces pain, and prevents further
neurovascular compromise and soft-tissue injury. If an open fracture is present, pull the exposed bone
back into the wound, because open fractures require surgical debridement.
Key aspects of the patient history are - ANSWER mechanism of injury, environment, preinjury status and
predisposing factors, and prehospital observations and care.
