EMR Musculoskeletal Injuries and Splinting 2 — Questions and Answers
Question 1: A patient has an angulated forearm fracture with intact distal pulse, motor function, and sensation. The EMR should:
- Attempt to straighten the arm before splinting
- Splint the extremity in the position found (Correct answer)
- Apply a traction splint to realign the bone
- Leave the arm unsplinted to avoid increasing pain
Correct answer: Splint the extremity in the position found
EMRs should splint extremity fractures in the position found when distal PMS is intact, as attempting realignment may cause further neurovascular injury.
Question 2: A dislocation is best defined as:
- A crack or break in the continuity of a bone
- Displacement of a bone end from its normal joint position (Correct answer)
- Tearing of muscle fibers surrounding a joint
- Stretching or tearing of ligaments supporting a joint
Correct answer: Displacement of a bone end from its normal joint position
A dislocation occurs when the bone end is displaced from its normal anatomical position within the joint capsule.
Question 3: Which joint is most commonly dislocated in the human body?
- Hip
- Knee
- Shoulder (Correct answer)
- Elbow
Correct answer: Shoulder
The shoulder (glenohumeral joint) is most frequently dislocated due to its extremely wide range of motion and relatively shallow socket.
Question 4: An EMR should consider gentle realignment of an angulated extremity fracture when:
- The patient requests realignment to reduce pain
- Distal pulse is absent and transport time is prolonged (Correct answer)
- The fracture appears to be a simple closed fracture
- Realignment is always indicated before splinting
Correct answer: Distal pulse is absent and transport time is prolonged
Realignment may be attempted when there is an absent distal pulse because restoring circulation is critical to limb survival, especially with prolonged transport.
Question 5: A patient with a splinted forearm reports pain that is out of proportion to the original injury, worsening with passive finger extension. The EMR should suspect:
- Allergic reaction to the splint material
- Compartment syndrome (Correct answer)
- Improper fracture positioning
- Nerve damage from the original injury
Correct answer: Compartment syndrome
Pain out of proportion to the injury and pain with passive stretch are classic early warning signs of compartment syndrome, a limb-threatening emergency.
Question 6: After splinting a lower leg fracture, the EMR should position the injured limb:
- In a dependent position to promote circulation
- Elevated above the level of the heart when possible (Correct answer)
- Flat at chest level during transport
- In the position of greatest comfort regardless of elevation
Correct answer: Elevated above the level of the heart when possible
Elevating an injured extremity above heart level reduces edema and pain by promoting venous and lymphatic drainage away from the injury.
Question 7: A sprain is best defined as:
- A partial or complete tear of a muscle belly
- An avulsion of a tendon from its bony attachment
- A stretching or tearing of ligaments at a joint (Correct answer)
- Inflammation of a tendon sheath from overuse
Correct answer: A stretching or tearing of ligaments at a joint
A sprain is an injury to the ligaments at a joint caused by excessive stretching or tearing forces beyond their normal range.
EMR Musculoskeletal Injuries and Splinting 2
A patient has an angulated forearm fracture with intact distal pulse, motor function, and sensation.
The EMR should: