Test IV Lane Questions Supplies
Musculoskeletal Injuries
Head and Spine
Eye injuries
Chest
Abdominal injuries
Questions
1. How many bones in the body? 206(Chand Ustokhan dar badan ast)
2. What produces red blood cells that carry O2 and nutrients to the body? Bone
marrow
(Che korave yaye sorkh khon ra tawled meekonad ke Aksejan wa Mawad ghezaaye ra ba
tamam badan enteqal meedehad?)
3. Define Joint-Two bones make contact ex knee, shoulder(Mafsal ra tareef koneed)
4. Define ligament-bone to bone(Ligament ra tareef koneed)
5. Give an example of a hinge joint: Allows movement in one plane ex knee, elbow
(Yak mesal az mafsal hinge ra bedehed)
6. Define tendons-connects bone to muscle(Tendon ra tareef koneed)
7. What are open fractures so dangerous? Infection and blood loss (Chura kasr haye
baz khatarnak astand?)
8. What is a displaced fracture? Bone has moved out from normal alignment
9. Define greenstick-incomplete one is bend other side is broken
10. Define comminuted: crushed or splintered
11. Define transverse: right angle
12. Define oblique: diagonal or slanted
13. Define spiral: coils around the bone and is caused by twisting
14. What are some signs of fractures? Bleeding, bruises, pulse rates , deformity,
swelling discoloration, crepitation
15. What are some symptoms? Pain
16. How do you assess distal neurovascular function? Pulse, capillary refill, skin
temperature, sensation, motor function
17. What is traction? Gentle manual traction to attempt to align the limb
18. Do you apply a securing device over the fracture site? No
19. What joints are commonly dislocated? Shoulder, elbow, fingers, hips, ankles
20. How do you treat dislocations: Traction, Elevation, Ice, After 24 hours heat, check
pulse, sensation and strength distal to injury
21. Define sprain-ligaments of two bones are stretched or torn (swelling, bruising,
tenderness, dec ROM)
22. Treatment for sprains: Rice
23. Demonstrate Forearm SAM splint, Humerous
24. Most shoulder dislocations will be in what position? Anterior
25. Apply a sling
26. Apply a Swathe-3-6 inches wide do not apply on fracture site
27. What is the most common hip dislocation? Posterior make up 70-80%
28. What does a posterior hip dislocation look like? The posterior leg looks adducted
29. What does an anterior dislocation look like? The hip is flexed with the leg
abducted and externally rotated.
30. How do immobilize a fractured hip, femur, knee, leg, ankle? Spine board make
sure to add padding and check circulation
31. Apply a recurrent wrap
32. Apply a traction splint
33. How many vertebrae? 7 cervical, 12 vertebrae, 5 lumbar, coccyx and sacrum
34. What acts as a cushion between the vertebrae? Intervertebral disc
35. What does leaking CSF fluid from ears mean? Serious head or spinal injury
36. What are signs of spinal injuries? Deformities, Head injury, pain in the spinal
region, laceration, numbness and paralysis, unconsciousness
37. Immobilize a Casualty’s neck? Traction method, Cervical collar
38. How do you check for a possible neck fracture? Step off, jugular vein distension,
tracheal deviation
39. Perform a log roll
40. Place a patient on a spine board and secure
41. Name several signs and symptoms of a closed head injury: Deformity, CSF leaking
from nose and ears, black eyes or raccoon eyes ( periorbital discoloration), Battle
sign, bruise behind ears, bradycardia, Altered mental status
42. Name signs and symptoms of increased intracranial pressure: Headache, NVD,
LOC, Dilated pupils do not constrict to light, Change is respiratory rate 12-20
adult, 20-40 child, Elevated temp, slurred speech, convulsions
43. What is AVPU (alert, responds to verbal commands, responds to pain,
unresponsive
44. What is the recovery position and when do you do it? If the casualty is choking,
Nauseous, vomiting or bleeding place patient on his/her side to promote
drainage.
45. How to you treat an open head wound? Expose, Replace flat, do not replace brain
matter, dress the wound.
46. Demonstrate how to apply dressing to top of the head, cheek or side of head
47. How do you treat a closed head injury? Monitor pt, hyperventilate pt reduces ICP,
elevate head 30 dec, do neuro exam, send to higher authority, c collar protocol
48. How do you treat epistaxis: sit patient and head tilt forward, apply pressure to
nostrils, apply ice, keep patient calm
49. What is the colored part of the eye? Iris
50. What is the opening in the center of the iris where light enters? Pupil
51. What is the anterior surface of the eye? Cornea
52. What is the white of the eye? Sclera
53. Where do tears come from? Lacrimal duct
54. Evaluate an eye patient using a snellen chart.
55. Demonstrate or explain irrigation of eye
56. What are some reasons to use an eye dressing? Protect eye from light, infection,
and further injury, limit movement and prevent usage, absorb secretion, hold
extrusions.
57. Do you remove a foreign body protruding from the eyeball or push an extruding
eyeball back in? No
58. How to you address an eye injury-cover both eyes with loose dressing due to
sympaythetic movement using sterile dressing
59. Demonstrate how to remove a foreign body
60. What are some signs and symptoms of an eye injury? Foreign object protruding
from globe, swollen or laceration, blood shot sclera, bleeding
61. What is located in the mediastinum space? The heart
62. What are signs and symptoms of chest wounds? Sucking and hissing sounds,
dyspnea, Cyanosis
63. When do you put a chest seal? Any wound from chin to umbilicus
64. Name signs and symptoms of a tension pneumothorax? Difficulty breathing, SOB,
Cyanosis, trachea deviation, abnormal breath sounds, abnormal rise and fall of
chest
65. Evaluate a flailed chest: three or more ribs broken, sternum broken-Signs and
symptoms (paradoxical movement, pt tries to breath deeply to compensate for
decreased lung capacity
66. What is a Hemothorax-blood enters the plaural cavity outside the lung and
becomes trapped.
67. Define the following:

Subcutaneous Emphysema - Subcutaneous emphysema is caused by air from a
damaged lung becoming trapped in the soft tissues of the chest wall. The trapped air
forms little bubbles that cause a crackling sensation when palpated. A casualty with
subcutaneous emphysema should be given respiratory support and EVACUATED
IMMEDIATELY.
 Pulmonary Contusion - A pulmonary contusion is a bruise of the lung, usually caused
by a blunt instrument or fall. Edema fluid and blood accumulates in the lung tissue. This
accumulation interferes with the respiratory process and results in hypoxia (oxygen
deficiency). A casualty with a pulmonary contusion should be given respiratory support
and EVACUATED IMMEDIATELY.
 Myocardial Contusion - A myocardial contusion is a bruise of the heart muscle and is
usually caused by a blunt injury to the chest. The casualty will have an irregular pulse
with occasional pauses between heartbeats at times and a very rapid pulse at other times.
A casualty with a suspected myocardial contusion should be EVACUATED
IMMEDIATELY.
 Pericardial Tamponade - Pericardial tamponade is caused by blood or other fluid
accumulating in the pericardial sac that surrounds the heart. The fluid compresses the
heart and interferes with its function. Pericardial tamponade is a lifethreatening condition
that requires respiratory support and EVACUATION IMMEDIATELY. Signs and
symptoms of pericardial tamponade include the following.
o Very soft, faint heart sounds, which may be hard to hear even with a stethoscope.
o Congested and distended veins in the head and neck.
o Difficulty in breathing.
o Tachycardia (weak and rapid pulse).
o Rapidly decreasing blood pressure with the systolic and diastolic readings coming
closer and closer together.
NOTE: The major differentiating factor between a tension pneumothorax and the
pericardial tamponade is the presence or absence of breath sounds. In pericardial
tamponade, the patient would still have equal and bi-lateral breath sounds.

Massive Internal Bleeding - Injury to the great blood vessels located within the chest
can cause a rapid loss of blood. The casualty will show signs and symptoms of
hypovolemic shock. EVACUATE IMMEDIATELY.

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Laceration of a Major Airway - Injury to the trachea or bronchi can result in tension
pneumothorax, hemoptysis (coughing up blood), and respiratory distress. Provide
respirator support and evacuate the casualty. This patient will need immediate aggressive
airway support that may not be feasible even during tactical field care. EVACUATE
IMMEDIATELY.
Abdominal Injuries - Injuries to the lower ribs may indicate abdominal injuries, such as
damage to the kidneys. Asses the area as you would abdominal wounds and then
evacuate.
68. Identify what quadrants the major abdominal organs are in:
69. Remember there is a high likely hood for shock in abdominal injures
70. What do you do with eviscerated organs? Cover
71. Define peritonitis-inflammation of the peritoneum the membrane lining the
abdominal cavity caused by a ruptured organ , digestive juices and food from the
stomach, fecal material from the intestine, urine from the bladder, bile from the
liver, pus from the appendix internal bleeding, contamination from an open
wound
72. Signs and symptoms of peritonitis-abdominal pain, tenderness, rigidity,
distension, Tachycardia, Fever, constipation, NV, Guarding
73. Define Hemoptysis (cough) Hematemesis (vomit) Hematochezia (stool)
74. How to you treat an Acute abdomen-back knees flexed, eval for shock, maintain
airway, remove vomit, give O2, Give IV, Keep the patient still, Evac
Equipment
1. Skeleton
2. Sams splint
3. Bamboo splint
4. Tape
5. Traction splint
6. Kerlix
7. ACE bandage
8. Crevats
9. Slings
10. Spine board
11. C spine
12. Snellen chart
13. Eye patch
14. Cotton swab for eyes
15. IV solution
16. Chest seal
17. Needle decompression
18. Abdominal or plastic dressing
Hands On
1. Apply splints-SAM Splint (Forearm, Humerous, elbow)-Use handout
Apply a sling
Apply spine board and c collars
Perform neurovascular exam

Cap refill

Sensation
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Evaluate strength and signs of cyanosis

Pulse
Address head wound
Apply a traction splint
2. Perform an eye exam-Snellen Chart-Visual acuity
a. The patient is seated twenty feet from the chart.
b. The chart has several rows of progressively smaller letters.
c. The patient is asked to read the letters down the chart as far as possible. A
patient who can read the letters on the "20/20" line from a distance of twenty
feet is said to have 20/20 vision in that eye.
d. The same process is repeated for the other eye. If the patient normally wears
glasses for distance, the test should be repeated with his glasses on. Results
should then be recorded as "uncorrected" and "corrected."
Identify the Anatomy of the eye
Irrigate the Eye
Remove a foreign body/Addressing eye injuries
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Pull down the lower lid of the patients injured eye
Tell patient to look upwards
Tell patient to look to one side then another
Pull patients lid up
Look down and both sides for foreign body
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Look horizontally along the center of the outer surface of the upper lid
Place a cotton tipped applicator horizontally along cnter of the outer surface of
the upper lid
Pull the lid forward and upward rolling or folding it over the applicator
Look for a foreign body or damage to eyeball while folding the lid over the
applicator
Apply water and allow water to flow from the inner canthus to outer canthus
using your thumb and forefinger to keep eye open
If you can not find foreign body patch the eye and send pt to a place with a slit
lamb
Do not put pressure on the eyeball
How to you address an eye injury-cover both eyes with loose dressing due to
sympathetic movement using sterile dressing
If patient has impaled object place padding around object
If patient has a globe injury moisten pad to prevent globe from becoming dry
and prevent ulcerations. Place dressing so that the injured globe protrudes and
place cup or cone shaped over eye. Do not replace eyeball
Chemical burns-Irrigate Irrigate Irrigate 20 minutes
3. Chest/Abdominal wounds
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Expose the wound
Do not remove impaled object-place bulky dressing
Check for exit wound
Place chest seal (improvised) chin to umbilicus at patients full exhaled
Tape in place
Have patient either sit up or lay injured side down (aid in maintaining an open
airway)
Tension pneumothorax signs and symptoms of a tension pneumothorax?
Difficulty breathing, SOB, Cyanosis, trachea deviation, abnormal breath sounds,
abnormal rise and fall of chest, paradoxical breathing, hemoptysis
14g needle 2-4 inches second intercostals space between and over the top
second and third rib midclavicular line on injured side of chest
Monitor patient and consider chest tube
Evaluate a flailed chest: three or more ribs broken, sternum broken Signs and
symptoms (paradoxical movement, pt tries to breath deeply to compensate for
decreased lung capacity

Treatment for flailed chest: Immobilize the fracture using a splint and have the
patient lie , maintain airway, Give O2
Check for other Conditions

Subcutaneous Emphysema - Subcutaneous emphysema is caused by air from a
damaged lung becoming trapped in the soft tissues of the chest wall. The trapped air
forms little bubbles that cause a crackling sensation when palpated. A casualty with
subcutaneous emphysema should be given respiratory support and EVACUATED
IMMEDIATELY.
 Pulmonary Contusion - A pulmonary contusion is a bruise of the lung, usually caused
by a blunt instrument or fall. Edema fluid and blood accumulates in the lung tissue. This
accumulation interferes with the respiratory process and results in hypoxia (oxygen
deficiency). A casualty with a pulmonary contusion should be given respiratory support
and EVACUATED IMMEDIATELY.
 Myocardial Contusion - A myocardial contusion is a bruise of the heart muscle and is
usually caused by a blunt injury to the chest. The casualty will have an irregular pulse
with occasional pauses between heartbeats at times and a very rapid pulse at other times.
A casualty with a suspected myocardial contusion should be EVACUATED
IMMEDIATELY.
 Pericardial Tamponade - Pericardial tamponade is caused by blood or other fluid
accumulating in the pericardial sac that surrounds the heart. The fluid compresses the
heart and interferes with its function. Pericardial tamponade is a lifethreatening condition
that requires respiratory support and EVACUATION IMMEDIATELY. Signs and
symptoms of pericardial tamponade include the following.
o Very soft, faint heart sounds,
which may be hard to hear
even with a stethoscope.
o Congested and distended veins
in the head and neck.
o Difficulty in breathing.
o Tachycardia (weak and rapid
pulse).
o Rapidly decreasing blood
pressure with the systolic and
diastolic readings coming
closer and closer together.
NOTE: The major differentiating
factor between a tension pneumothorax
and
the pericardial tamponade is the
presence or absence of breath sounds. In pericardial tamponade, the patient would still
have equal and bi-lateral breath sounds.



Massive Internal Bleeding - Injury to the great blood vessels located within the chest
can cause a rapid loss of blood. The casualty will show signs and symptoms of
hypovolemic shock. EVACUATE IMMEDIATELY.
Laceration of a Major Airway - Injury to the trachea or bronchi can result in tension
pneumothorax, hemoptysis (coughing up blood), and respiratory distress. Provide
respirator support and evacuate the casualty. This patient will need immediate aggressive
airway support that may not be feasible even during tactical field care. EVACUATE
IMMEDIATELY.
Abdominal Injuries - Injuries to the lower ribs may indicate abdominal injuries, such as
damage to the kidneys. Asses the area as you would abdominal wounds and then
evacuate.
Abdominal Injuries Have soldier identify the major quadrants and structures in each:
 Expose the injury
 Look for entry and exit wounds
 High likely hood for shock must evaluate
 Do not remove debris or clean wound
 Leave protruding object
 Cover any eviscerated organs-Use abdominal dressing, plastic
 Evaluate and Identify these terms:
 Acute abdomen- Define peritonitis-inflammation of the peritoneum the membrane
lining the abdominal cavity caused by a ruptured organ , digestive juices and food from
the stomach, fecal material from the intestine, urine from the bladder, bile from the
liver, pus from the appendix internal bleeding, contamination from an open wound
 Signs and symptoms of peritonitis-abdominal pain, tenderness, rigiditydistension,
Tachycardia, Fever, constipation, NV, Guarding
 Define Hemoptysis (cough) Hematemesis (vomit) Hematochezia (stool)
How to you treat an Acute abdomen-back knees flexed, eval for shock, maintain airway,
remove vomit, give O2, Give IV, Keep the patient still, Evac