question

Coordination of balance and body movement is controlled by the:

answer

cerebellum.

question

The _________ nervous system consists of 31 pairs of spinal nerves and 12 pairs of cranial nerves.

answer

peripheral

question

The body's functions that occur without conscious effort are regulated by the _________ nervous system.

answer

autonomic

question

Which of the following statements regarding the cranium is correct?

answer

Eighty percent of the cranium is occupied by brain tissue.

question

The cervical spine is composed of _____ vertebrae.

answer

7

question

Lacerations to the scalp:

answer

may be an indicator of deeper, more serious injuries.

question

Which of the following skull fractures would be the LEAST likely to present with palpable deformity or other outward signs?

answer

Linear

question

A patient who cannot remember the events that preceded his or her head injury is experiencing:

answer

retrograde amnesia.

question

When caring for a patient with a possible head injury, it is MOST important to monitor the patient's:

answer

level of consciousness.

question

During your primary assessment of a semiconscious 30-year-old female with closed head trauma, you note that she has slow, irregular breathing and a slow, bounding pulse. As your partner maintains manual in-line stabilization of her head, you should:

answer

instruct him to assist her ventilations while you perform a rapid assessment.

question

When assessing a conscious patient with an MOI that suggests spinal injury, you should:

answer

determine if the strength in all extremities is equal.

question

Following a head injury, a 20-year-old female opens her eyes spontaneously, is confused, and obeys your commands to move her extremities. You should assign her a GCS score of:

answer

14

question

The MOST important immediate treatment for patients with a head injury, regardless of severity, is to:

answer

establish an adequate airway.

question

When controlling bleeding from a scalp laceration with a suspected underlying skull fracture, you should:

answer

avoid excessive pressure when applying the bandage.

question

When placing a patient onto a long backboard, the EMT at the patient's _________ is in charge of all patient movements.

answer

head

question

Which of the following statements regarding cervical collars is correct?

answer

A cervical collar is used in addition to, not instead of, manual immobilization.

question

When immobilizing a child on a long backboard, you should:

answer

place padding under the child's shoulders as needed.

question

A high school football player was injured during a tackle and complains of neck and upper back pain. He is conscious and alert and is breathing without difficulty. The EMT should:

answer

leave his helmet and shoulder pads in place.

question

You are assessing a man who has a head injury and note that cerebrospinal fluid is leaking from his ear. You should recognize that this patient is at risk for:

answer

bacterial meningitis.

question

When opening the airway of a patient with a suspected spinal injury, you should use the:

answer

jaw-thrust maneuver.

question

A man jumped from the roof of his house and landed on his feet. He complains of pain to his heels, knees, and lower back. This mechanism of injury is an example of:

answer

axial loading.

question

A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response?

answer

3

question

A tight-fitting motorcycle helmet should be left in place unless:

answer

it interferes with your assessment of the airway.

question

An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is:

answer

a rapid deterioration of neurologic signs.

question

Common signs and symptoms of a serious head injury include all of the following, EXCEPT:

answer

a rapid, thready pulse.

question

During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should:

answer

suction his oropharynx for up to 15 seconds.

question

Hyperextension injuries of the spine are MOST commonly the result of:

answer

hangings.

question

In contrast to a cerebral concussion, a cerebral contusion:

answer

involves physical injury to the brain tissue.

question

Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless:

answer

it causes a problem managing the airway.

question

The central nervous system (CNS) is composed of the:

answer

brain and spinal cord.

question

The five sections of the spinal column, in descending order, are the:

answer

cervical, thoracic, lumbar, sacral, and coccygeal.

question

The Glasgow Coma Scale (GCS) is used to assess:

answer

eye opening, verbal response, and motor response.

question

The ideal procedure for moving an injured patient from the ground to a backboard is:

answer

the four-person log roll.

question

What part of the nervous system controls the body's voluntary activities?

answer

Somatic

question

When activated, the sympathetic nervous system produces all of the following effects, EXCEPT:

answer

pupillary constriction.

question

When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear. This indicates:

answer

rupture of the tympanic membrane following diffuse impact to the head.

question

Which of the following breathing patterns is MOST indicative of increased intracranial pressure?

answer

Irregular rate, pattern, and volume of breathing with intermittent periods of apnea

question

Which of the following statements regarding secondary brain injury is correct?

answer

Hypoxia and hypotension are the two most common causes of secondary brain injury.

question

You should be MOST suspicious that a patient has experienced a significant head injury if his or her pulse is:

answer

slow

question

When immobilizing a trauma patient's spine, the EMT manually stabilizing the head should not let go until:

answer

the patient has been completely secured to the backboard

question

The brain is divided into three major areas

answer

The cerebrum; The cerebellum;The brainstem

question

The cerebrum

answer

Contains about 75% of the brain's total volume Controls a wide variety of activities, including most voluntary motor function and conscious thought The main part of the brain Divided into two hemispheres with four lobes

question

The cerebellum

answer

Located underneath the cerebrum Coordinates balance and body movements

question

The brainstem

answer

The most primitive part of the CNS Controls virtually all the functions that are necessary for life, including the cardiac and respiratory systems and nerve function transmissions The brainstem is the best-protected part of the CNS.

question

meninges

answer

Three distinct layers of tissue that surround and protect the brain and the spinal cord within the skull and the spinal canal.

question

voluntary activities

answer

Actions that we consciously perform, in which sensory input or conscious thought determines a specific muscular activity.

question

involuntary activities

answer

Actions of the body that are not under a person's conscious control.

question

somatic nervous system

answer

regulates voluntary activities

question

Autonomic nervous system

answer

controls the functions of many of the body's vital organs, over which the brain has no voluntary control.

question

The autonomic nervous system is divided into two sections:

answer

sympathetic nervous system and parasympathetic nervous system

question

sympathetic nervous system

answer

reacts to stress with the fight-or-flight response: pupils dilate, heart rate increases, blood pressure rises.

question

parasympathetic nervous system

answer

causes blood vessels to dilate, slowing the heart rate, and relaxing the muscle sphincters.

question

spinal column has 33 bones (vertebrae) and is divided into five sections:

answer

Cervical, Thoracic, Lumbar, Sacral, and Coccygeal

question

intervertebral disks

answer

The cushion that lies between two vertebrae.

question

The most prominent and most easily palpable spinous process is at the seventh cervical vertebra at the base of the neck.

answer

TRUE

question

Central nervous system structures are very strong even though they are not well protected.

answer

FALSE

question

The structure of the skull and the presence of the meninges in effect reduce the likelihood of problems in closed head injuries.

answer

FALSE

question

closed head injuries

answer

Injury in which the brain has been injured but the skin has not been broken and there is no obvious bleeding.

question

open head injury

answer

Injury to the head often caused by a penetrating object in which there may be bleeding and exposed brain tissue.

question

raccoon eyes

answer

Bruising under the eyes that may indicate a skull fracture.

question

Battle sign

answer

Bruising behind an ear over the mastoid process that may indicate a skull fracture

question

linear skull fractures

answer

Account for 80% of skull fractures; also referred to as nondisplaced skull fractures; commonly occur in the temporal-parietal region of the skull; not associated with deformities to the skull.

question

basilar skull fractures

answer

Usually occur following diffuse impact to the head (such as falls, motor vehicle crashes); generally result from extension of a linear fracture to the base of the skull and can be difficult to diagnose with a radiograph.

question

traumatic brain injuries (TBIs)

answer

A traumatic insult to the brain capable of producing physical, intellectual, emotional, social, and vocational changes.

question

primary (direct) injury

answer

An injury to the brain and its associated structures that is a direct result of impact to the head.

question

secondary (indirect) injury

answer

The after effects of the primary injury; includes abnormal processes such as cerebral edema, increased intracranial pressure, cerebral ischemia and hypoxia, and infection; onset is often delayed following the primary brain injury.

question

cerebral edema

answer

Swelling of the brain.

question

coup-contrecoup injury

answer

A brain injury that occurs when force is applied to the head and energy transmission through brain tissue causes injury on the opposite side of original impact; coup injury occurs at the point of impact; contrecoup injury occurs on the opposite side of impact, as the brain rebound

question

intracranial pressure (ICP)

answer

The pressure within the cranial vault.

question

Intracranial hemorrhage

answer

The closed compartment of the skull has no extra room for an accumulation of blood, so bleeding inside the skull also increases the ICP.

question

epidural hematoma

answer

An accumulation of blood between the skull and the dura mater.

question

subdural hematoma

answer

An accumulation of blood beneath the dura mater but outside the brain.

question

intracerebral hematoma

answer

Bleeding within the brain tissue (parenchyma) itself; also referred to as an intraparenchymal hematoma.

question

subarachnoid hemorrhage

answer

Bleeding into the subarachnoid space, where the cerebrospinal fluid circulates.

question

retrograde amnesia

answer

The inability to remember events leading up to a head injury.

question

anterograde (posttraumatic) amnesia

answer

Inability to remember events after an injury.

question

In a(n) ________, CSF flows freely from the patient's ear; this type of injury can be difficult to diagnose with a radiograph.

answer

basilar skull fracture

question

axial loading injuries

answer

Injuries in which load is applied along the vertical or longitudinal axis of the spine, which results in load being transmitted along the entire length of the vertebral column; for example, falling from a height and landing on the feet in an upright position.

question

When assessing a patient with a suspected head or spine injury, which of the following should you do?

answer

Administer high flow oxygen and assess the patient in the position found.

question

Signs of Cushing triad include:

answer

Increased blood pressure (hypertension) Decreased heart rate (bradycardia) Irregular respirations such as Cheyenne-Stokes respiration and Biot respiration

question

Which of the following are signs of Cushing triad?

answer

Bradycardia, hypertension, irregular respirations

question

four-person log roll

answer

The recommended procedure for moving a patient with a suspected spinal injury from the ground to a long backboard or other spinal immobilization device.

question

Which of the following acts as a shock absorber for the CNS?

answer

Cerebrospinal fluid (CSF)

question

Accounting for approximately 80% of all skull fractures, which of the following often present with no physical signs?

answer

linear skull fractures

question

You are treating a patient who might have a skull fracture. What should you do if a dressing you have applied to a head wound becomes soaked?

answer

simply apply a clean dressing over the soaked dressing

question

Cushing triad in a patient is a sign of which of the following?

answer

intracranial pressure.

question

While performing a secondary assessment of a patient who was hit with a tire iron on the side of the head, you find a depressed area above the patient's left ear. This indicates that the patient could have which of the following?

answer

Epidural hematoma

question

When securing a patient to a backboard, what area of the body should you secure last?

answer

Head

question

The time between an initial period of unconsciousness and a subsequent loss of consciousness is referred to as what?

answer

Lucid interval

question

You are reassessing a patient and you find that her left pupil is dilated and fixed. What does this indicate?

answer

A fixed, dilated pupil indicates increased ICP.

question

Battle sign is an indication of which of the following?

answer

skull fracture

question

You are treating a patient who went face-first through a windshield. She has extensive head injuries and is displaying hypertension, bradycardia, and Cheyne-Stokes respirations. Which of the following should you suspect?

answer

Cushing triad

Chapter 28 Head and Spine Injuries – Flashcards

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