WorksheetsTrauma knowledge 3
Total questions: 25
Worksheet time: 13mins
Paralysis of the extremities would MOST likely result from injury to the:
cerebellum.
diencephalon.
cerebral cortex.
hypothalamus.
A flail chest is characterized by:
bulging of fractured ribs during inspiration.
excessive negative intrathoracic pressure.
a free-floating segment of fractured ribs.
drawing in of fractured ribs during expiration.
Pneumothorax is MOST accurately defined as:
air or gas within the pleural cavity.
perforation of a lung by a broken rib.
injury to the visceral or parietal pleura.
partial or complete collapse of a lung.
Traumatic injuries to the aorta are MOST commonly the result of:
rear-end collisions.
shearing forces.
penetrating trauma.
motorcycle crashes.
A 16-year-old boy collapsed after being struck in the center of the chest by a line drive during a high school baseball game. Your assessment reveals that he is pulseless and apneic. As your partner initiates one-rescuer CPR, your MOST important action should be to:
perform intubation to secure the patient's airway.
rapidly assess the chest for signs of a sternal fracture.
attach the ECG leads and be prepared to defibrillate.
start an IV line and administer an antiarrhythmic drug.
Unlike a tension pneumothorax, a massive hemothorax would MOST likely present with:
signs of shock.
tracheal deviation.
collapsed jugular veins.
severe respiratory distress.
You are dispatched to a residence for an injured person. The scene has been secured by law enforcement. The patient, a young female, tells you that her boyfriend kicked her in the chest yesterday during an argument. Your assessment reveals that the patient is in significant pain, is dyspneic, has a strong pulse rate of 98 beats/min, and has an area of ecchymosis over her left lower rib cage. Auscultation to the left side of her chest reveals coarse crackles. Which of the following treatment interventions is likely NOT indicated for this patient?
Cardiac monitoring
Titrated IV analgesics
End-tidal CO2 monitoring
IV fluid boluses
You should be MOST suspicious that your patient has a pericardial tamponade if he or she presents with hypotension, jugular vein distention, and:
loud heart tones.
normal lung sounds.
respiratory distress.
a bounding pulse.
Which of the following thoracic injuries would you LEAST likely discover in the primary survey?
Flail chest
Myocardial contusion
Bronchial disruption
Open pneumothorax
Intraabdominal bleeding may produce few signs and symptoms of trauma because:
the intraabdominal cavity can accommodate large amounts of blood.
blood in the peritoneum can compress the aorta and maintain perfusion.
it takes approximately 4 L of blood loss before signs of shock manifest.
the abdominal musculature can sustain massive blunt force without bruising.
Generalized abdominal pain following rupture of a hollow organ is MOST suggestive of:
severe intraabdominal bleeding.
gas accumulation in the peritoneum.
diffuse peritoneal contamination.
inflammation of deep nerve endings.
When blood is released into the peritoneal cavity:
the abdomen almost immediately becomes grossly distended.
it is most often the result of blunt force trauma to the pancreas.
blood pressure falls with as little as 500 mL of internal blood loss.
nonspecific signs such as tachycardia and hypotension may occur.
EMS providers can have the MOST positive impact on mortality and morbidity from abdominal trauma by:
recognizing the need for rapid transport.
initiating fluid resuscitation in the field.
contacting medical control immediately.
performing a careful abdominal assessment.
Grey Turner sign is defined as ecchymosis to the _________ and is indicative of _________.
umbilicus, peritoneal bleeding
epigastrium, stomach rupture
flank, retroperitoneal bleeding
back, traumatic aortic dissection
Periumbilical ecchymosis is:
commonly observed in the prehospital setting following blunt force trauma to the abdomen.
referred to as Cullen sign and may take several hours to develop following abdominal trauma.
usually seen in conjunction with flank bruising and is highly suggestive of injury to the liver or spleen.
also called Grey Turner sign and manifests almost immediately following blunt abdominal trauma.
Referred pain to the left shoulder following blunt abdominal trauma should lead you to suspect injury to the:
intestines.
stomach.
spleen.
diaphragm.
Which of the following is NOT a function of the pancreas?
Enzyme secretion
Secretion of insulin
Glucagon secretion
Reservoir for bile
Compartment syndrome occurs when:
metabolic waste products accumulate within a large hematoma that develops near a fracture site.
yellow and red bone marrow seep from a fractured bone, resulting in excessive soft tissue swelling.
pressure in the fascial compartment leads to impaired circulation, sensory changes, and progressive muscle death.
blood accumulates in the medullary canal of a bone, resulting in decreased oxygenation of the bone tissue.
Closed bilaterally fractured femurs can result in internal blood loss of up to:
1,000 mL.
3,000 mL.
2,000 mL.
1,500 mL.
What type of fracture occurs at an angle across the bone and is typically caused by direct or twisting force?
Spiral
Oblique
Linear
Transverse
In females, a decrease in bone density is accelerated:
over age 35.
after menopause.
by obesity.
after childbirth.
A 40-year-old woman has an unstable pelvis following a motor vehicle crash. She is conscious but confused. Her blood pressure is 80/50 mm Hg, pulse is 120 beats/min and weak at the radial arteries, and respirations are 24 breaths/min and shallow. After starting at least one large-bore IV line, you should:
run it wide open until her systolic blood pressure is greater than 100 mm Hg.
administer a 250-mL normal saline bolus and then reassess her blood pressure.
set the IV flow rate to keep the vein open unless her systolic blood pressure falls below 70 mm Hg.
give enough isotonic crystalloid fluids to improve her mental status and radial pulse quality.
An open-book pelvis fracture has the potential for massive blood loss because:
the femoral vein is often injured.
the femur is usually also fractured.
the volume of the pelvis is increased.
the abdominal aorta is often injured.
When assessing distal pulses in a patient with a lower extremity injury, it is MOST important to:
suspect severe shock if a unilateral pulse deficit is present.
compare the strength of the pulses in both lower extremities.
remember that most people do not have a palpable pedal pulse.
count the pedal pulse rate and compare it to the radial pulse rate.
You have applied board splints to a suspected lower leg fracture in a young woman and have given her fentanyl for pain. En route to the hospital, the patient states that the pain is excruciating. Further narcotics fail to relieve the pain. Reassessment of the injured area reveals that the overlying skin is taut and the pedal pulse is weak. You should:
start a second IV line and administer 1 mEq/kg of sodium bicarbonate.
remove the splint to prevent excessive swelling of the extremity.
loosen the splint, elevate the leg, apply ice, and notify the hospital.
remove the board splints, apply an air splint, and then reassess her.
