PHTLS Set| 140 QUESTIONS| WITH COMPLETE SOLUTIONS
If you see a cracked windshield in a MVC... what will the pt represent with? Correct Answer:
Bruised or lacerated head or face. Brain injury, *cervical spine injury (always until proven
otherwise), tracheal injury.
If you see a deformed steering column in a MVC... what will the pt represent with? Correct
Answer: Bruised neck, bruised chest. Sternal or rib fracture, flail chest, myocardial contusion,
*pericardial tamponade, pneumo/hemothorax, aortic tear.
If you see a deformed dashboard in a MVC... what will the pt represent with? Correct Answer:
Bruised abdomen, bruised knee, misplaced kneecap. Ruptured spleen, liver, bowel, diaphragm.
Fractured patella, dislocated knee, *femoral fracture, dislocated hip.
If you see the rear end of the vehicle is damaged in a MVC... what will the pt represent with?
Correct Answer: Secondary anterior injuries, esp if the pt wasn't restrained. "Wiplash" injuries,
*coup contrecoup injury.
Phases of Deceleration Correct Answer: 1) Deceleration of the vehicle, occurs when the vehicle
strikes another object & comes to a stop. 2) Deceleration of occupant, which starts during sudden
braking & continues through the whole crash. 3) Deceleration of internal organs, that consist of
internal organs that continue forward momentum until they're stopped by anatomical restraints.
4) Secondary collisions, which occur when a vehicle occupant is hit by objects moving within
the vehicle (loose objects). 5) Additional impacts, that the vehicle may receive when it is hit by a
second vehicle or is deflected into another.
Velocity Correct Answer: "Speed kills"- causes more damage than mass.
Seat Belt Use Correct Answer: All arguments against seat belt use are unfounded.
Airbag Injuries Correct Answer: Common injuries include abrasions to the face, chest and arms.
Minor corrosive effects can occur because of the cornstarch on the airbag, and it may irritate the
skin.
Down and Under Pathway Correct Answer: Occupant slides under the steering wheel or the
dash. The knees hit the dashboard, and transmit energy up the leg, to the femur/pelvis. If the feet
are locked in place, it can cause femur fractures.
Up and Over Pathway Correct Answer: Chest hits the steering wheel, head hits the windshield
and anterior portion of the throat hits the top of the steering wheel. Can cause significant head
and neck injuries.
Head on Impact in Motorcycle Crashes Correct Answer: Head on impact- motorcycle strikes
another object and stops its forward motion, while the rider continues forward motion until
stopped by outside force. This causes the rider to go over the handlebars, which causes femur
fractures, and tib fractures.
, Angular Impact in Motorcycle Crashes Correct Answer: The motorcycle strikes an object, or
another vehicle at an angel so that the rider sustains direct crushing injuries to the lower
extremity between the object and motorcycle.
Motorcycle Crashes Correct Answer: With any motorcycle crash, the helmet should be removed
carefully if airway management techniques cannot be performed with the helmet in place or the
helmet doesn't fit properly on the riders head.
Pedestrian Injuries Correct Answer: Most pedestrian injuries occur at an intersection, at night.
First, the pedestrian is hit in the lower extremities with the cars bumpers. Second, the pedestrian
is thrown on the top of the car (resulting in brain injuries, and pelvic fractures. Third, the
pedestrian hits the ground or some other object after rolling off the top or the side of the vehicle.
Waddell Triad Correct Answer: Refers to the pattern of automobile pedestrian injuries in
children and people of short stature; 1) bumper hits the pelvis/femur instead of the knees, 2) the
chest & abdomen hit the grill or low on the hood of the car (sternal & rib fractures), 3) the pt's
face hits the hood, then flies back, and hits the ground.
Fall Severity Factors Correct Answer: 1) Height- determines the velocity of the fall. A fall
greater than 15 feet or 2.5-3 times the pt's height will have a greater injury & higher rate of
death. 2) Position- children usually land on their heads (more mass), and adults tend to try to
land on their feet, cause spinal injuries "Don Juan Syndrome or Lovers Leap". 3) Surface- Snow
vs. Concrete.
Blunt Trauma Correct Answer: Refers to injuries in which the tissues are not penetrated by an
external object.
Penetrating Trauma Correct Answer: Involves a disruption of the skin and underlying tissues in
a small, focused area. Most common cause of penetrating trauma- GSW.
Stab Wounds Correct Answer: Severity of the stab wound depends on the anatomic area
involved, depth of penetration, blade length and angle of penetration.
GSW Correct Answer: The most important factor for the seriousness of a gunshot wound is the
type of tissue through which the projectile passes. Tissues of high elasticity like muscle, is better
able to tolerate stretch, rather than the liver.
Entry Wound Correct Answer: Characterized by the effects of initial contact & implosion. *As a
general rule, the entrance wound (usually funnel shaped), is always smaller than the exit wound.
Exit Wound Correct Answer: Occur when the projectile has sufficient energy that is not entirely
dissipated along its trajectory through the body.
If you see a cracked windshield in a MVC... what will the pt represent with? Correct Answer:
Bruised or lacerated head or face. Brain injury, *cervical spine injury (always until proven
otherwise), tracheal injury.
If you see a deformed steering column in a MVC... what will the pt represent with? Correct
Answer: Bruised neck, bruised chest. Sternal or rib fracture, flail chest, myocardial contusion,
*pericardial tamponade, pneumo/hemothorax, aortic tear.
If you see a deformed dashboard in a MVC... what will the pt represent with? Correct Answer:
Bruised abdomen, bruised knee, misplaced kneecap. Ruptured spleen, liver, bowel, diaphragm.
Fractured patella, dislocated knee, *femoral fracture, dislocated hip.
If you see the rear end of the vehicle is damaged in a MVC... what will the pt represent with?
Correct Answer: Secondary anterior injuries, esp if the pt wasn't restrained. "Wiplash" injuries,
*coup contrecoup injury.
Phases of Deceleration Correct Answer: 1) Deceleration of the vehicle, occurs when the vehicle
strikes another object & comes to a stop. 2) Deceleration of occupant, which starts during sudden
braking & continues through the whole crash. 3) Deceleration of internal organs, that consist of
internal organs that continue forward momentum until they're stopped by anatomical restraints.
4) Secondary collisions, which occur when a vehicle occupant is hit by objects moving within
the vehicle (loose objects). 5) Additional impacts, that the vehicle may receive when it is hit by a
second vehicle or is deflected into another.
Velocity Correct Answer: "Speed kills"- causes more damage than mass.
Seat Belt Use Correct Answer: All arguments against seat belt use are unfounded.
Airbag Injuries Correct Answer: Common injuries include abrasions to the face, chest and arms.
Minor corrosive effects can occur because of the cornstarch on the airbag, and it may irritate the
skin.
Down and Under Pathway Correct Answer: Occupant slides under the steering wheel or the
dash. The knees hit the dashboard, and transmit energy up the leg, to the femur/pelvis. If the feet
are locked in place, it can cause femur fractures.
Up and Over Pathway Correct Answer: Chest hits the steering wheel, head hits the windshield
and anterior portion of the throat hits the top of the steering wheel. Can cause significant head
and neck injuries.
Head on Impact in Motorcycle Crashes Correct Answer: Head on impact- motorcycle strikes
another object and stops its forward motion, while the rider continues forward motion until
stopped by outside force. This causes the rider to go over the handlebars, which causes femur
fractures, and tib fractures.
, Angular Impact in Motorcycle Crashes Correct Answer: The motorcycle strikes an object, or
another vehicle at an angel so that the rider sustains direct crushing injuries to the lower
extremity between the object and motorcycle.
Motorcycle Crashes Correct Answer: With any motorcycle crash, the helmet should be removed
carefully if airway management techniques cannot be performed with the helmet in place or the
helmet doesn't fit properly on the riders head.
Pedestrian Injuries Correct Answer: Most pedestrian injuries occur at an intersection, at night.
First, the pedestrian is hit in the lower extremities with the cars bumpers. Second, the pedestrian
is thrown on the top of the car (resulting in brain injuries, and pelvic fractures. Third, the
pedestrian hits the ground or some other object after rolling off the top or the side of the vehicle.
Waddell Triad Correct Answer: Refers to the pattern of automobile pedestrian injuries in
children and people of short stature; 1) bumper hits the pelvis/femur instead of the knees, 2) the
chest & abdomen hit the grill or low on the hood of the car (sternal & rib fractures), 3) the pt's
face hits the hood, then flies back, and hits the ground.
Fall Severity Factors Correct Answer: 1) Height- determines the velocity of the fall. A fall
greater than 15 feet or 2.5-3 times the pt's height will have a greater injury & higher rate of
death. 2) Position- children usually land on their heads (more mass), and adults tend to try to
land on their feet, cause spinal injuries "Don Juan Syndrome or Lovers Leap". 3) Surface- Snow
vs. Concrete.
Blunt Trauma Correct Answer: Refers to injuries in which the tissues are not penetrated by an
external object.
Penetrating Trauma Correct Answer: Involves a disruption of the skin and underlying tissues in
a small, focused area. Most common cause of penetrating trauma- GSW.
Stab Wounds Correct Answer: Severity of the stab wound depends on the anatomic area
involved, depth of penetration, blade length and angle of penetration.
GSW Correct Answer: The most important factor for the seriousness of a gunshot wound is the
type of tissue through which the projectile passes. Tissues of high elasticity like muscle, is better
able to tolerate stretch, rather than the liver.
Entry Wound Correct Answer: Characterized by the effects of initial contact & implosion. *As a
general rule, the entrance wound (usually funnel shaped), is always smaller than the exit wound.
Exit Wound Correct Answer: Occur when the projectile has sufficient energy that is not entirely
dissipated along its trajectory through the body.
