Chapter 12: Traumatic Disease Test Bank

Multiple Choice

1. Which of the following types of trauma centers require prompt access to orthopedic and neurologic services?

1. Level I

2. Level II

3. Level III

4. Level IV a. 1 only b. 1 and 2 c. 4 only d. All of the above

ANS: B REF: p. 361 a. Pulse b. Blood pressure c. Respiration d. Range of motion of the head and neck

2. Which of the following is not a secondary assessment or vital sign of the patient who has sustained a traumatic injury?

ANS: D REF: p. 360 a. Monocloidal b. Bimodal c. Trimodal d. Bell curve

3. What type of distribution pattern do most deaths from trauma assume?

ANS: C REF: p. 359 a. 1-44 years b. 45-50 years c. 40-65 years d. 60-75 years

4. Trauma is the leading cause of death for which of the following age groups?

ANS: A REF: p. 359 a. 1-5 b. 6-10 c. 10-13 d. 15

5. What is the Glasgow Coma Scale number recommended by the New Orleans helical computed tomography rule (HCT) to order a CT head examination for a traumatic head injury in conjunction with a headache or intoxication?

ANS: D REF: p. 361 a. Computed tomography b. Nuclear medicine c. Sonography d. Angiography

6. Which imaging modality has superseded the use of cervical spine radiography for trauma patients?

ANS: A REF: p. 361

7. Which medical organization(s) has/have determined that CT of the cervical spine has greater than 99% sensitivity for the detection of a fracture?

1. American College of Radiology

2. American College of Surgeons

3. National Emergency X-Radiography Utilization Study (NEXUS)

4. Canadian C-Spine Review (CCR) a. 1 and 2 b. 2 and 3 c. 3 and 4 d. All of the above

ANS: C REF: p. 361 a. Radiography b. Magnetic resonance c. Computed tomography d. Sonography

8. What is the preferred modality for imaging trauma to the abdomen and pelvis?

ANS: C REF: p. 362 a. Burst fracture b. Compression fracture c. Spondylolisthesis d. Pars defect

9. What is the most common type of fracture associated with the vertebrae?

ANS: B REF: p. 363 a. Prevertebral fat stripe b. Size and shape of vertebral structures c. Nucleus pulposus d. Alignment of spinolaminal lines

10. When analyzing cervical spine radiographs of the trauma patient, what is not a significant consideration?

ANS: C REF: p. 365 a. Sphenoid sinus b. Ethmoid sinuses c. Maxillary sinuses d. Frontal sinuses

11. With a basilar skull fracture, what anatomic structure is important radiographically?

ANS: A REF: p. 367 a. Contusion b. Coup lesion c. Contrecoup lesion d. Concussion

12. What pathologic condition following trauma to the head is characterized by headache, vertigo, and vomiting?

ANS: D REF: p. 368 a. Intracerebral hematoma b. Subdural hematoma c. Epidural hematoma d. Subarachnoid hematoma

13. Which type of cerebral hematoma has the highest mortality rate?

ANS: C REF: p. 370 a. Intracerebral hematoma b. Subdural hematoma c. Epidural hematoma d. Subarachnoid hematoma

14. Which type of cerebral hematoma often demonstrates a midline shift on CT or MR images?

ANS: B REF: p. 370 a. Radiography b. CT c. MR d. Nuclear medicine

15. What imaging modality is best utilized for skeletal trauma?

ANS: A REF: p. 372 a. Delayed union b. Poor union c. Malunion d. Nonunion

16. What classification is given to a fracture that fails to heal?

ANS: D REF: p. 376 a. Closed b. Buckle c. Open d. Impacted

17. Which fracture classification generally requires surgical intervention such as an irrigation and debridement?

ANS: C REF: p. 378 a. Transverse fracture b. Spiral fracture c. Impacted fracture d. Comminuted fracture

18. What type of fracture classification often occurs as a twisting or rotary movement to a long bone?

ANS: B REF: p. 378 a. Glasgow scale b. Trauma scale c. Salter-Harris d. Fracture scale

19. What is the term commonly used to describe fractures involving the epiphysis of children?

ANS: C REF: p. 388 a. Avascular necrosis b. Buckle fracture c. Colles fracture d. SCFE

20. Which of the following is an example of a growth plate injury?

ANS: D REF: p. 388 a. Metatarsals b. Metacarpals c. Distal radius d. Distal tibia

21. What anatomic structures are common areas for fatigue fractures?

ANS: A REF: p. 390 a. Maxilla b. Mandible c. Malar d. Nasal

22. Which bone is involved with a tripod fracture?

ANS: C REF: p. 393 a. Maxilla b. Mandible c. Malar d. Nasal

23. Which bone has the slowest healing time following traumatic injury?

ANS: B REF: p. 398

24. Which of the following structures form the bony nasal septum?

1. Vomer

2. Perpendicular plate of the ethmoid

3. Cribriform plate a. 1 and 2 only b. 1 and 3 only c. 2 and 3 only d. 1, 2, and 3

ANS: A REF: p. 399 a. Impacted fracture of the hip b. Bone bruise of the medial femoral condyle c. Salter-Harris fracture of the distal fibula d. Avascular necrosis of the proximal femur

25. A high school football player sustained a stress injury to his right knee and was diagnosed with a medial meniscal tear. What additional pathology may be demonstrated on the MRI exam?

ANS: B REF: p. 375 a. Impacted radial fracture b. Multiple rib fractures c. Spiral fracture of a long bone d. Skull fracture

26. Which of the following is not a radiographic sign of battered child syndrome?

ANS: A REF: p. 403 a. CT b. MRI c. Nuclear medicine d. Radiography

27. Which imaging modality best demonstrates avascular necrosis?

ANS: B REF: p. 404

28. Which radiographic chest projections are generally obtained for the diagnosis of a pneumothorax?

1. PA with inspiration

2. PA with expiration

3. Lateral with inspiration a. 1 and 2 only b. 1 and 3 only c. 2 and 3 only d. 1, 2, and 3

ANS: D REF: p. 406 a. Lobar bibasilar atelectasis b. Pleurisy c. Pneumonia d. Rib fracture

29. What pathology can cause a mediastinal shift on a chest radiograph?

ANS: A REF: p. 406 a. CT b. MRI c. Radiography d. Sonography

30. According to the ACR, which of the following imaging modalities is most appropriate in assessing abdominal trauma?

ANS: A REF: p. 408 a. Ileus b. Perforated ulcer c. Pneumoperitoneum d. Pneumothorax

31. The radiographic “football sign” is usually indicative of what pathologic condition?

ANS: C REF: p. 410

MATCHING Fracture Pseudonyms a. Fracture of the distal radius with posterior displacement of the distal fragment b. Fracture of the distal radius with anterior displacement of the distal fragment c. Fracture of the medial and lateral malleoli with ankle dislocation d. Fracture of the proximal shaft of the fibula with disruption of the syndesmosis e. Fracture of the fourth or fifth metacarpal f. Fracture of the proximal third of the ulnar shaft with radial head dislocation g. Fracture dislocation of the first CMC joint

Directions: Match the fracture pseudonym to the appropriate description.

1. Smith fracture

2. Boxer fracture

3. Monteggia fracture

4. Colles fracture

5. Pott fracture

6. Maisonneuve fracture

7. Bennett fracture

1. ANS: B REF: p. 391

2. ANS: E REF: p. 391

3. ANS: F REF: p. 391

4. ANS: A REF: p. 391

5. ANS: C REF: p. 392

6. ANS: D REF: p. 392

7. ANS: G REF: p. 391