EMT Chapter 28- Head & Spine Injuries – Flashcards

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Cerebrum
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- Occupies nearly all of the cranial cavity - Controls sensation, thought, conscious movement, and associative memory
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Cerebellum
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Coordinates muscle activity, balance
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Brainstem
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Maintains basic vital life functions (respiratory, cardiac, vasomotor centers)
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Spinal Column
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33 bones (vertebrae) 7 Cervical (neck) 12 Thoracic (upper back, have ribs attached) 5 Lumbar (lower back) 5 Sacral (back pelvic wall) 4 Coccyx (tailbone)
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Types of spinal injuries
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Compression - E.g. Diving injuries, falls Distraction - Pulling apart - E.g. Hanging Lateral bending - E.g. MVC, blunt trauma Flexion and Extension - E.g. Whiplash (MVC) Rotation
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Head & Spine injury symptoms
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Pain and tenderness of head, neck or back Pain upon movement - Never move or allow a patient to move in order to elicit a pain response Loss of sensation or paralysis in extremities below level of injury The absence of pain does not rule out spinal injury!
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Cervical injury signs
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Respiratory distress Reduced or absent sensation or movement in all limbs Neurogenic shock Proximal muscles innervated by higher segments - Mid-cervical region biceps, triceps - Low-cervical hands, fingers Loss of function at lower levels - Thoracic, Lumbar, Sacral symptoms
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Thoracic injury signs
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- Respiratory Distress - Neurogenic shock - Reduced or absent sensation or movement below the level of the collarbones
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Signs of lumbar & sacral injury
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Reduced or absent sensation and movement in the legs Proximal muscles innervated by higher segments - Thighs innervated by upper lumbar region - Lower legs and feet by lower lumbar region Sacral nerves innervate lower leg and pelvic floor muscles - Incontinence - Priapism
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Diffuse Axonal Injury (DAI)
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Significant force causes injury that is diffuse rather than localized as in contusion - Injury to the brain results from shearing, tearing, and stretching of nerve fibers - Trauma interrupts normal nerve transmission and causes swelling Usually diagnosed by CT scan or MRI after a concussion or other head injury - May accompany contusion or intracranial bleeding
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Coordination of balance and body movement is controlled by the: medulla. cerebrum. cerebellum. brain stem.
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cerebellum
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The _________ nervous system consists of 31 pairs of spinal nerves and 12 pairs of cranial nerves. central somatic autonomic peripheral
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peripheral
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The body's functions that occur without conscious effort are regulated by the _________ nervous system. sensory somatic autonomic voluntary
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autonomic
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Which of the following statements regarding the cranium is correct? The skull is a subdivision of the cranium. Thirty percent of the cranium is occupied by blood. The cranium protects the structures of the face. Eighty percent of the cranium is occupied by brain tissue.
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Eighty percent of the cranium is occupied by brain tissue.
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The cervical spine is composed of _____ vertebrae. 5 6 7 8
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7
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Lacerations to the scalp: bleed minimally because the scalp has few vessels. uncommonly cause hypovolemic shock in children. may be an indicator of deeper, more serious injuries. are most commonly associated with skull fractures.
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may be an indicator of deeper, more serious injuries.
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Which of the following skull fractures would be the LEAST likely to present with palpable deformity or other outward signs? Linear Basilar Open Depressed
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Linear
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A patient who cannot remember the events that preceded his or her head injury is experiencing: retrograde amnesia. anterograde amnesia. prograde amnesia. posttraumatic amnesia.
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retrograde amnesia.
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When caring for a patient with a possible head injury, it is MOST important to monitor the patient's: pupil size. blood pressure. pulse regularity. level of consciousness.
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level of consciousness.
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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: perform a focused secondary assessment of the patient's head and neck. instruct him to assist her ventilations while you perform a rapid assessment. apply 100% oxygen via a nonrebreathing mask and obtain baseline vital signs. immediately place her on a long backboard and prepare for rapid transport.
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instruct him to assist her ventilations while you perform a rapid assessment.
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When assessing a conscious patient with an MOI that suggests spinal injury, you should: determine if the strength in all extremities is equal. rule out a spinal injury if the patient denies neck pain. defer spinal immobilization if the patient is ambulatory. ask the patient to move his or her head to assess for pain.
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determine if the strength in all extremities is equal.
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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: 12. 13. 14. 15.
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14.
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The MOST important immediate treatment for patients with a head injury, regardless of severity, is to: immobilize the entire spine. administer high-flow oxygen. establish an adequate airway. transport to a trauma center.
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establish an adequate airway.
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When controlling bleeding from a scalp laceration with a suspected underlying skull fracture, you should: elevate the patient's head and apply an ice pack. apply manual pressure and avoid applying a bandage. avoid excessive pressure when applying the bandage. apply firm compression for no longer than 5 minutes.
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avoid excessive pressure when applying the bandage.
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When placing a patient onto a long backboard, the EMT at the patient's _________ is in charge of all patient movements. head chest waist lower extremities
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head
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Which of the following statements regarding cervical collars is correct? Once a cervical collar is applied, you can cease manual head stabilization. A cervical collar is used in addition to, not instead of, manual immobilization. Cervical collars are contraindicated in patients with numbness to the extremities. The patient's head should be forced into a neutral position to apply a cervical collar.
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A cervical collar is used in addition to, not instead of, manual immobilization.
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When immobilizing a child on a long backboard, you should: secure the head prior to securing the torso and legs. defer cervical collar placement to avoid discomfort. place the child's head in a slightly extended position. place padding under the child's shoulders as needed.
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place padding under the child's shoulders as needed.
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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: remove his helmet and shoulder pads. leave his helmet and shoulder pads in place. remove his helmet, but leave his shoulder pads in place. leave his helmet in place, but remove his shoulder pads.
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leave his helmet and shoulder pads in place.
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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: bacterial meningitis. hypovolemic shock. sudden hypotension. permanent hearing loss.
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bacterial meningitis.
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When opening the airway of a patient with a suspected spinal injury, you should use the: tongue-jaw lift maneuver. head tilt-neck lift maneuver. head tilt-chin lift maneuver. jaw-thrust maneuver.
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jaw-thrust maneuver.
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