ATLS Module 8 - Musculoskeletal
Trauma Exam Questions with
Correct Answers
when immobilized a knee injury... you dont want to immobilize in complete extension..
how is it done? - Answer-~10 degrees of flexion to reduce tension on neurovascular
structures
when should you not apply traction for femoral fractures? - Answer-presence of
concomitant tibia/fibula fracture due to risk of neurovascular injury
how much blood loss would you expect from a femur fracture and tibial fractures? -
Answer-femur fx = up to 2 L
tibial fx = up to 1.5 L
what is the best way to control hemorrhage from femur and tibial shaft fractures? -
Answer-fracture immobilization
*it will minimize blood loss and further soft tissue damage
*also, facilitate pain control in hemodynamically unstable patients
How should femur and tibial shaft fractures be stabilized? - Answer-long leg posterior
splint around lower leg to stabilize femur and tibia
what are the steps of extremity bleeding control in order? - Answer-1. manual pressure
to wound
2. pressure dressing
3. compression of artery proximal to injury
4. tourniquet application
what is the direction and deformity of an anterior and posterior shoulder joint
dislocation? - Answer-anterior: squared off
posterior: locked in internal rotation
what is the direction and deformity of an elbow joint dislocation? - Answer-posterior:
olecranon prominent posteriorly
what is the direction and deformity of an anterior and posterior hip joint dislocation? -
Answer-anterior: extended, abducted, externally rotated
posterior: flexed, adducted, internally rotated
, what is the direction and deformity of an knee joint dislocation? - Answer-
anteroposterior: loss of normal contour, extended
what is the direction and deformity of an ankle joint dislocation? - Answer-lateral is MC:
externally rotated, prominent medial malleolus
what is the direction and deformity of a subtalar joint dislocation? - Answer-lateral is
MC: laterally displaced os calcis
pt has pulsatile bleeding from right leg wound. direct pressure and gause packing
applied... but dressing was quickly saturated with blood. what is the next step in
management of uncontrolled extremity hemorrhage? - Answer-apply manual pressure
to artery proximal to the wound
*if bleeding persists, application of a tourniquet would be appropriate
in the initial assessment of vascular injuries, why might extremities have adequate flow
initially? - Answer-extremities often have collateral circulation providing adequate flow
what does splinting accomplish in patients with musculoskeletal trauma? - Answer-
control blood loss, prevent further neurovascular compromise and soft tissue injury, and
reduce patient's pain
25 yo male presents after motorcycle crash. vitals: BP 128/70, HR 124, GCS 15. He
complains of right leg pain. On exam, patient is found to have a significant proximal right
thigh deformity. his distal pulses are intact. What is the best initial management of this
patient's symptoms? - Answer-splint the extremity and administer a small dose of IV
narcotic such as fentanyl
what are the immobilization guidelines for femoral fractures? - Answer--immobilize
temporarily with traction splints
-avoid excessive traction, which can cause skin damage to the foot, ankle, and
perineum
-assess neurovascular status before and after splint application
-do not apply traction for ipsilateral tibia shaft fractures
what are the immobilization guidelines for tibial fractures? - Answer--immobilization
minimizes pain and soft tissue injury, and decreases risk of compartment syndrome
-if available, use plaster splints to immobilize the lower thigh, knee, and ankle
what could be missed or associated injuries to a fracture/dislocation of the elbow? -
Answer-brachial artery injury
median, ulnar, radial nerve injury
what could be missed or associated injuries to a posterior knee dislocation? - Answer-
femoral fracture
posterior hip dislocation
Trauma Exam Questions with
Correct Answers
when immobilized a knee injury... you dont want to immobilize in complete extension..
how is it done? - Answer-~10 degrees of flexion to reduce tension on neurovascular
structures
when should you not apply traction for femoral fractures? - Answer-presence of
concomitant tibia/fibula fracture due to risk of neurovascular injury
how much blood loss would you expect from a femur fracture and tibial fractures? -
Answer-femur fx = up to 2 L
tibial fx = up to 1.5 L
what is the best way to control hemorrhage from femur and tibial shaft fractures? -
Answer-fracture immobilization
*it will minimize blood loss and further soft tissue damage
*also, facilitate pain control in hemodynamically unstable patients
How should femur and tibial shaft fractures be stabilized? - Answer-long leg posterior
splint around lower leg to stabilize femur and tibia
what are the steps of extremity bleeding control in order? - Answer-1. manual pressure
to wound
2. pressure dressing
3. compression of artery proximal to injury
4. tourniquet application
what is the direction and deformity of an anterior and posterior shoulder joint
dislocation? - Answer-anterior: squared off
posterior: locked in internal rotation
what is the direction and deformity of an elbow joint dislocation? - Answer-posterior:
olecranon prominent posteriorly
what is the direction and deformity of an anterior and posterior hip joint dislocation? -
Answer-anterior: extended, abducted, externally rotated
posterior: flexed, adducted, internally rotated
, what is the direction and deformity of an knee joint dislocation? - Answer-
anteroposterior: loss of normal contour, extended
what is the direction and deformity of an ankle joint dislocation? - Answer-lateral is MC:
externally rotated, prominent medial malleolus
what is the direction and deformity of a subtalar joint dislocation? - Answer-lateral is
MC: laterally displaced os calcis
pt has pulsatile bleeding from right leg wound. direct pressure and gause packing
applied... but dressing was quickly saturated with blood. what is the next step in
management of uncontrolled extremity hemorrhage? - Answer-apply manual pressure
to artery proximal to the wound
*if bleeding persists, application of a tourniquet would be appropriate
in the initial assessment of vascular injuries, why might extremities have adequate flow
initially? - Answer-extremities often have collateral circulation providing adequate flow
what does splinting accomplish in patients with musculoskeletal trauma? - Answer-
control blood loss, prevent further neurovascular compromise and soft tissue injury, and
reduce patient's pain
25 yo male presents after motorcycle crash. vitals: BP 128/70, HR 124, GCS 15. He
complains of right leg pain. On exam, patient is found to have a significant proximal right
thigh deformity. his distal pulses are intact. What is the best initial management of this
patient's symptoms? - Answer-splint the extremity and administer a small dose of IV
narcotic such as fentanyl
what are the immobilization guidelines for femoral fractures? - Answer--immobilize
temporarily with traction splints
-avoid excessive traction, which can cause skin damage to the foot, ankle, and
perineum
-assess neurovascular status before and after splint application
-do not apply traction for ipsilateral tibia shaft fractures
what are the immobilization guidelines for tibial fractures? - Answer--immobilization
minimizes pain and soft tissue injury, and decreases risk of compartment syndrome
-if available, use plaster splints to immobilize the lower thigh, knee, and ankle
what could be missed or associated injuries to a fracture/dislocation of the elbow? -
Answer-brachial artery injury
median, ulnar, radial nerve injury
what could be missed or associated injuries to a posterior knee dislocation? - Answer-
femoral fracture
posterior hip dislocation
