1
Q
What is the musculoskeletal system composed of?
A
Bones, joints and muscles as well as cartilage, tendons, ligaments
2
Q
Divisions of the skeletal system
A
Axial skeleton and appendicular skeleton
3
Q
Bones
A
Hard but flexible, living structures that provide support for the body and protection of vital organs
4
Q
Joints
A
The places where bones articulate or meat and are a critical element in the body’s ability to move
5
Q
Classifications of bones
A
Long short flat or a regular
6
Q
examples of a regular bones
A
Vertebrae
7
Q
Examples of long bones
A
Humerus and femur
8
Q
Examples of short bones
A
Metatarsal and metacarpals
9
Q
Examples of flat bones
A
Sternum shoulder blades and ribs
10
Q
Periosteum
A
Strong white fibrous material that covers bones
11
Q
The site of red blood cell production
A
Bone marrow
12
Q
First effects of bone injury
A
Swelling of soft tissue in the formation of a blood clot in the area of the fracture due to destruction of blood vessels in the perineum and the bone
13
Q
Muscles
A
Tissues or fibers that cause movement of body parts and organs
14
Q
Three kinds of muscles
A
Smooth, cardiac and skeletal
15
Q
Smooth muscles
A
Involuntary. Found in the walls of organs and digestive structures.
16
Q
Cardiac muscle
A
Myocardial. found in the walls of the heart
17
Q
Skeletal muscles
A
Voluntary. Control all conscious and deliberate motions. They are connected to bones as well as muscles in the tongue pharynx and upper esophagus.
17
Q
Cartilage
A
Is connective tissue that covers the outside of the bone and an ax as a surface for articulation, allowing for smooth movements at joints
18
Q
Epiphysis
A
Bone end
19
Q
Tendons
A
Bands of connected tissue that bind muscles to bones. Allow for the power of movement across the joints.
20
Q
Ligaments
A
connective tissues, that support joints by attaching the bone ends and allowing for stable range of motion
21
Q
MTB
A
Muscle tendon bone
22
Q
BLB
A
Bone ligament bone
23
Q
Three mechanisms that caused musculoskeletal injuries
A
Direct force, twisting force, and indirect force
24
Twisting or rotational forces
Cause stretching or tearing of muscle muscles and ligaments as well as broken bones.
25
Signs and symptoms of a fracture
Painful, swollen, bruised or deformed extremity
26
Traction splint
A splint that applies constant pull, along the length of the leg to help stabilize the fractured bone and reduce muscle spasms. They are primarily used on femoral shaft fractures.
27
Four types of muscular skeletal injury
Fracture
dislocation,
sprain
strain
28
Indirect forces
Usually cause injury to knees, femur, pelvis, and spinal common column.
Example, when someone falls on their feet, the direct force injures the feet the indirect force injures the knees and pelvis.
29
Fracture
A break in a bone
30
Comminuted fracture
A fracture in which the bone is broken in several places
31
Greenstick fracture
An incomplete fracture
32
Angulated fracture
A fracture in which the broken bone segments are at an angle to each other
33
Dislocation
The disruption or coming apart of a joint. The soft tissue of the joint capsule and ligaments are stretched beyond the normal range of motion and torn.
33
Sprain
The stretching and tearing of ligaments
34
Strain
A muscle injury caused by overstretching or over exertion of the muscle
35
Closed extremity injury
An injury to an extremity with no associated opening in the skin
36
Open extremity injury
An extremity injury in which the skin has been broken or torn through from the inside by an injured bone
37
Compartment syndrome
Injury caused when tissues, such as blood vessels and nerves are constricted with a space as from swelling or from a tight dressing or cast
38
How does compartment syndrome progress?
1. fracture a crushed injury causes, bleeding and swelling.
2. Pressure and swelling caused by bleeding within. The muscle compartment becomes so great that the body can no longer use the tissue against the pressure.
3. Cell cellular damage occurs and causes additional swelling
4. Blood flow to the area is lost. The limit itself may be lost at the pressure is not relieved
39
Signs and symptoms of compartment syndrome
Pain and swelling. The patient may complain of a pressure sensation extremity may feel hard on palpation. Distal circulation, sensation and motor function may be reduced or absent.
40
Crepitus
A grating sensation or sound made one fractured bone ends rubbed together
41
Ecchymosis
Bruising, large black - and-blue discoloration of the skin
42
Six Ps
Pain
Pallor
Paresthesia
Pulses
Paralysis
Pressure
43
How splints are effective?
It must immobilize adjacent joints and bone ends
minimize the movement of disrupted joints in broken bone ends
Decreases patients pain
44
Why do we realign a more extremity?
Two assist in restoring effective circulation to the extremity in to simplify splinting
45
Manual traction
The process of applying tension to straighten and realign a fracture, limb before splinting also called tension
46
Three basic types of splints
Rigid
formable
traction
47
Contraindications of a traction splint
Pelvis, hip, knee injury,
aversion, or a partial amputation
injury to the lower third of the leg
48
Functions of the blood
Transportation of gases
Nutrition
Excretion
protection
Regulation
49
Perfusion
The adequate circulation of blood throughout the body which fills the capillaries and supplies of cells and tissues with oxygen
50
Four causes of shock
Volume loss
pump failure,
loss of blood vessel tone,
obstruction of blood flow
51
Septic shock is caused by which root cause of shock
Blood vessel tone problem
52
Hypovolemia
Low volume
53
Hypovolemic shock
Shock resulting from blood or fluid loss
54
Absolute hypovolemia
Blood physically leaves the circulatory system like an internal or external hemorrhage
55
Relative hypovolemia
Blood is not lost from the circulatory system, but conditions like hydration are burns shift the plasma out of the blood cells and out of the circulatory system
56
Hemorrhagic shock
Shock resulting from blood loss
57
Cardiogenic shock
Shock or lack of perfusion brought by the hearts inadequate pumping action often from a heart attack or CHF
58
Distributive shock
Hypoperfusion due to a lack of blood vessel tone. Blood vessel dilation leads to decrease blood pressure within the circulatory system. Example: septic shock.
59
Neurogenic shock
Result of a spinal cord injury that results in systemic vasodilation. Blood pressure can drop rapidly.
60
Obstructive shock
Different conditions that block the flow blood and cause hypoperfusiion. Examples: pulmonary embolism, cardiac tamponade and a tension pneumothorax
61
The bodies flight or fight reactions
Blood vessels constrict
Skin is cool, pale and sweaty
Kidneys produce less urine
Nausea and vomiting
Increased heart rate and contractibility
62
Compensation
Predictable steps, the body takes to restore perfusion and its measures occur both locally in systemically
63
What do you baroreceptors do
Sense rising and falling pressure within large vessels and provide feedback to the brain.
also known as Stretch receptors
64
Chemoreceptors
Senses changes in oxygen and carbon dioxide and body acid base status pH
65
The bodies shock compensatory measures
Regulation of volume
Vasoconstriction
Cardio pulmonary response
66
Most effective immediate compensatory step
Vasoconstriction
67
“Shunt to the core”
Ensures that vital organs like the heart, lungs and brain maintain blood flow while reducing blood flow to areas that can tolerate hyper perfusion longer
68
Signs of vasoconstriction
Pale skin and delayed capillary refill
68
Pediatric patients in shock rely mostly on
Increased heart rate
68
Compensated shock
. When the patient is developing shock, but the body is still able to maintain perfusion.
68
Two organs vulnerable to vasoconstriction if left uncorrected
Liver and kidneys
69
Decompensated shock
The body can no longer compensate for a low blood volume or lack of perfusion weight signs such as decreasing blood pressure become evident
69
Indicators of decompensation in regards to the heart and lungs
Bradycardia and slow/ irregular breathing
70
Irreversible shock
Organ systems begin to fail, and even if the patient survives the underlying problem of organ damage will likely be uncorrectable
71
Peri-arrest state
Cardiac arrest is approaching
72
EMTs role in shock
Recognize the problem
Support perfusion
Rapid transport
73
Heart rate during compensated shock
Increases
74
Heart rate during decompensated shock
Decreases
75
Respiratory rate during compensated shock
Increases
76
Blood pressure during compensated shock
Is good
77
Respiratory rate during decompensated shock
Decreases
78
Blood pressure during decompensated shock
Decreases
79
Deadly triad of trauma
Acidosis
Hypothermia
Coagulopathy
80
General treatment steps that address, the deadly triad of trauma
Initiate transport to an appropriate destination
Prevent hypoxia
Prevent heat loss
Consider shock positioning
Consider ALS
81
Key intervention for hypovolemic shock
Bleeding control and rapid transport
82
Key in intervention for cardiogenic shock
Request ALS
Because certain medications and efforts to support blood pressure may be critical
83
Key interventions for distributive shock ( anaphylaxis)
Administration of epinephrine
84
Key intervention for distributive shock (sepsis)
Recognize and notify receiving hospital
Rapid transport
85
Organs most sensitive to inadequate perfusion
Brain
spinal cord,
heart
kidneys
86
Hemorrhage
bleeding, especially severe bleeding. Major cause of shock and trauma.
87
Arterial bleeding
Bleeding from an artery, which is characterized by bright red blood that is often burning, profuse, and difficult to control
88
Venous bleeding
Bleeding for a vein which is characterized by dark red or maroon blood in a steady easier to control flow
89
Junctional hemorrhage
The appendages of the body have massive bleeding
90
Capillary bleeding
91
What does direct pressure do?
Compresses tissue around the wound and diverse blood flow from effective blood vessels
92
Major methods of controlling, massive, external bleeding
Direct pressure
Hemostatic agents
Wound packing
Tourniquet
Compression devices for junctional relating
93
Pressure dressing
A bulky dressing held in position with a tightly wrapped bandage, which applies pressure to help bleeding control
94
Hemostatic agents
Substances applied as powders dressing, gauze, or bandages to open wings to stop bleeding by way a various biochemical reactions
95
The national Association of state EMS officials national model EMS clinical guidelines note that the tourniquet should be placed
2 to 3 inches proximal to the wound
96
Epistaxis
Nosebleeds
97
Major skin function
Protection
Water balance
Temperature regulation
Excretion
Shock absorption
98
Subcutaneous layers of the skin
Layers of fat and soft tissues found below the dermis. Shock absorption and insulation are major functions.
99
Major types of closed wounds
Contusions hematomas, crush injuries and primary blast injuries
100
Contusion
A bruise. The epidermis remains intact, but blood vessels and cells in the dermis are damaged.
101
Hematoma
Swelling caused by the collection of blood under the skin or in damaged tissues as a result of an injured or broken blood vessel. They involve a larger amount of tissue damage.
102
Crush injury
Injury caused when a force is transmitted from the bodies exterior to his internal structures
103
In trauma, coughing up blood indicates
Injury to the respiratory system
104
Types of open wounds
Abrasions, lacerations, punctures, avulsions, amputations, crush injuries, blast injuries, and high pressure injection injuries
105
Abrasion
Scratch or scrape. Outer layer of the skin is damaged.
106
Laceration
A cut. Often caused by an object with a sharp edge or severe blow with a blunt object.
107
Quaternary injuries
Blast injuries
108
Primary blast injury (pressure waves)
Intense, high pressure wave and blast winds. Damage to air/fluid filled organs.
109
The soft tissue of the body
Skin
Fatty tissue
Muscle
Blood vessels
Connective tissue
Membranes
Glands
Nerves
110
Hard tissues of the body
Teeth
Bones
Cartilage
111
Secondary injury (blast wave)
Projectile debris, causing open and penetrating wounds
112
tertiary injury (patient displacement)
Patient is thrown from the blast, causing fractures, aversions amputations
113
Quaternary injury (hazardous material/structure collapse)
Patient exposed to harmful chemical chemicals or toxins or injured by structural collapse
114
EMT treatment for high-pressure injection
Elevating and splinting the limb. DO NOT apply cold.
115
General guidelines for care of open wounds
Expose the wound
Clean the wound surface
Control bleeding
Treat for shock
Prevent further contamination
Bandage the dressing in place
Keep patient still
Reassurance
116
How Burns can be classified and evaluated
By agent and source
Depth
Severity
117
Superficial burn
Involves only the epidermis characterized by running of the skin and swelling, sometimes called first-degree burn
118
Partial thickness burn
Second-degree burn
The epidermis is burned through and the dermis is damaged. Burns of this type caused reddening, mottling And blistered appearance.
119
Full thickness burn
Third-degree burn
A burn in which all the layers of the skin are damaged. Usually areas that are charred or areas that are dry and white.
120
Rule of nines
Each area of the body represents 9% of the body surface: head and neck, each upper extremity, chest, abdomen, upper back, lower back, Butt, front and back of each lower extremity
121
Rule of palm
Using the patient’s own hand, which makes up about 1% of the body surface area are compared with the patient’s burned to estimate its size
122
Pressure dressing
Dressing applied tightly to Control bleeding
123
Occlusive dressing
 Any dressing that forms an airtight seal. This is done when caring for open wounds to the abdomen, external bleeding from large neck veins or open wounds to the chest.
124
Trauma score
A system of evaluating trauma patients, according to a numerical rating system to determine the severity of a patient’s trauma
125
Trauma score includes
Glasgow coma scale
Systolic blood pressure
Respiratory rate,
126
Serous fluid
Small amount of a clear lubricating liquid that help adhere lungs tissue to the chest
127
Organs that tolerate trauma well
Hollow organs, including the stomach intestine and urinary bladder.
128
Danger of hollow organ damage
The organs often spill their contents into the abdominal cavity and caused severe inflammation and infection later
129
Organs that do not tolerate trauma well at all
Solid organs like the liver spleen and kidneys because they have little capacity to stretch or compress
130
The three categories of the pathophysiology of the abdomen and chest and trauma
Disruption of breathing
Hemorrhage and shock
Disruption of organ function
Infection
131
Flail chest
Fracture of two or more adjacent ribs, and two or more places that allows for free movement of the fractured segment
132
Paradoxical motion
Movement of ribs in a flail segment that is opposite to the direction of movement of the rest of the chest wall
133
Treatment for foil chest
CPAP for patients with an adequate breathing
request ALS for pain management
134
What happens when air enters the chest cavity through an open wound?
The pressure balance within the chest cavity is destroyed. This causes the lung on the injured side to collapse.
135
Sucking chest wound
A penetrating chest wound in which air is sucked into the chest cavity
136
Flutter valve occlusive dressing
Designed to allow air to escape from the chest if pressure builds as a Nemo thorax develops
137
Pneumothorax
Air in the chest cavity where the lung tissue adheres to the chest wall, pushing lung tissue away from the chest, causing collapse of a lung
138
Tension pneumothorax
A type of pneumothorax in which air accumulation puts pressure on the heart and the vena cava and causes shock
139
Signs and symptoms of a pneumothorax
Diminished or absent lung sounds on the affected side signs of shock
140
Hemothorax
Chest cavity fills with blood
141
Hemopneumothorax
The chess cavity fills with both blood and air
142
Traumatic asphyxia
Sudden compression of the chest
143
Cardiac tamponade
When an injury to the heart causes blood to flow into the surrounding pericardial sac and to compress the heart
144
Signs and symptoms of cardiac tamponade
Signs of shock
Distended neck veins
Narrowed pulse pressure
Muffled heart sounds
145
Aortic dissection
The inner layer of the wall of the aorta begins to tear and blood from the interior of the vessel leaks into the outer layer, causing blood to flow between layers of the aorta wall
146
Commotio cordis
Disturbance of the heart after being hit in the chest
147
Evisceration
An intestine or other internal organ protruding through a wound in the abdomen
148
149
150
Neurons
Nerve cells that transmit nervous system impulses through the body
151
Messages from the body to the brain are carried by
Sensory nerves
152
Messages from the brain to muscles are carried by
Motor nerves
153
Cranium
The bunny sharks are making up the forehead, top, back and upper sides of the skull
154
Temporomandibular joint
The immovable joint between the mandible and the temporal bone also called the TMJ
155
Foremen magnum
Where the spinal cord exits the base of the brain and leaves the skull through a large hole
156
Cauda equina
Lower end of the spiral cord
157
Meninges
First layer of protection for the spiral cord consisting of tough fibrous membranes
158
Open skull injury
Bones of the cranium arefractured
159
Indirect brain injury
Shock of impact on the skull is referred to the brain. Include concussions and contusions
160
Traumatic brain injury (TBI)
Injury that disrupts the normal functioning of the brain
161
Concussion
Mild closed head injury without detectable damage to the brain
162
Signs and symptoms of a concussion
Loss of consciousness
Feeling sluggish
Difficulty concentrating
Slurred speech, nausea, blurred vision
Light sensitivity
163
Brain contusion
Bruised brain, can occur with closed head injuries when the force of the blow is great enough to rupture blood vessels
164
Contrecoup injury
When bruising occurs on the opposite side of the blow
165
Intracerebral hematoma
Blood pools within the brain
166
Intracranial pressure
Pressure inside the skull, ICP builds and compresses brain tissue, progressive neurological abnormalities : AMS and one-sided weakness
167
How does the body respond to rising intracranial pressure
Increase blood pressure, slowing heart rate
168
Cushing reflex
Increased BP
Decreased HR
169
Other signs and symptoms of ICP
AMS, dilated pupils, sluggish pupil reaction, increased systolic BP, abnormal respirations
170
Cheyne-stokes breathing
Quickening and deepening respirations followed by apnea
171
Central neurogenic hyperventilation
A pattern of rapid and deep breathing caused by brain injury
172
Ataxic respirations
Irregular and unpredictable breathing
173
Herniation
Pushing down a portion of the brain towards the foramen magnum. Patient may exhibit decorticate or decerebrate posturing
174
Decorticate posturing
Flexing arms and wrists and extending legs and feet
175
Decerebrate posturing
Extension of arms with shoulders rotated inwards and wrists flexed and legs extended
176
Glasgow coma scale
eye opening
Verbal response
Motor response
177
GCS : Eye opening
4 - spontaneous
3 - to voice
2 - to pain
1 - none
178
GCS - verbal
5- oriented
4 - confused
3 - inappropriate words
2 - incomprehensible sounds
1 - none
179
GCS - motor response
6 - obeys commands
5 - localizes pain
4 - withdraw from pain
3 - flexion
2 - extension
1 - none
180
Axial loading
Spine excessively compressed
181
Distraction injury
Spine is excessively stretched
182
Ankylosing spondylitis
Vertebrae of the spine fuse together
183
Dermatome
An area of a skin that is innervated by a single spinal nerve and can be used to identify loss of function that is associated with a particular area of the spinal cord
184
Key indicators of a spinal injury
Paralysis of the extremities
Changes in neurologic function
Pain with movement
Tenderness anywhere along the midline spine
Impaired breathing
Priapism
Loss of bowel or bladder control
Deformity
Neurogenic shock
185
Paresthesia
Pins and needles
186
Initial presentation of shock symptoms include
pale, cool, clammy skin; tachycardia; and tachypnea. As shock progresses, vital signs will deteriorate, with low blood pressure, thirst, dilated pupils, and cyanosis as late signs.
187
Revised trauma score rates
the Glasgow Coma Scale, systolic blood pressure, and respiratory rate.
FWFD Class 100/1 - EMT
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Decks in class (6)
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