AEMT Ch 29 Face and Neck injuries

Abnormal variations in pupil size and reaction would MOST likely be observed in a patient with:

A brain injury

The term "hyphema" is defined as: A. blood in the anterior chamber of the eye. B. inflammation of the iris, cornea, and lens. C. compression of one or both optic nerves. D. an acute rupture of the globe of the eye.

A. blood in the anterior chamber of the eye.

A 39-year-old female experienced a severe closed head injury. She is unconscious with her eyes slightly open; her pupils are bilaterally dilated and slow to react. In addition to managing problems with airway, breathing, and circulation, you should: A. close her eyes and cover them with a moist dressing. B. secure her eyes open so you can reassess her pupils. C. irrigate her eyes with water to prevent mucosal drying. D. inspect her eyes and gently remove impaled objects.

A. close her eyes and cover them with a moist dressing.

A factory worker was splashed in the eyes with a strong acid chemical. He complains of intense pain and blurred vision. Your ambulance does not carry bottles of sterile saline or water. You should: A. irrigate both eyes continuously for 20 minutes with plain water. B. mix baking soda with water and irrigate his eyes with the solution. C. flush both eyes with an alcohol-based solution and transport. D. neutralize the acid chemical in his eye with an alkaline chemical.

A. irrigate both eyes continuously for 20 minutes with plain water.

A 22-year-old male was walking on the beach and had sand blown into his eyes. He complains of pain and decreased vision to his right eye. Treatment should include: A. irrigating his right eye laterally. B. flushing his eye starting laterally. C. covering both eyes and transporting. D. irrigating both eyes simultaneously.

A. irrigating his right eye laterally.

The conjunctiva are kept moist by fluid produced by the: A. lacrimal gland. B. optic chiasma. C. corneal duct. D. posterior orbit.

A. lacrimal gland.

Significant trauma to the face should increase the EMT's index of suspicion for a(n): A. spinal cord injury. B. basilar skull fracture. C. displaced mandible. D. airway obstruction.

A. spinal cord injury.

A 30-year-old female was robbed and assaulted by a gang as she was leaving a nightclub. She has massive facial trauma and slow, gurgling respirations. As your partner manually stabilizes her head, you should: A. suction her oropharynx for 15 seconds. B. visualize her mouth for obvious wounds. C. apply oxygen via a nonrebreathing mask. D. begin immediate ventilatory assistance.

A. suction her oropharynx for 15 seconds.

You are dispatched to a convenience store where the clerk sustained a laceration to the side of his neck during a robbery attempt. During your assessment, you note bright red blood spurting from the laceration. You should:

Apply direct pressure above and below the wound

A young female was involved in a motor vehicle crash. She complains of pain to her left eye, which appears to have a piece of glass impaled in it. Further assessment reveals a large laceration to her left forearm with active venous bleeding. As your partner manually stabilizes the patient's head, you should: stabilize the impaled glass in her eye. administer 100% supplemental oxygen. apply direct pressure to her arm wound. carefully remove the glass from her eye

Apply direct pressure to her arm wound

The mastoid process is located approximately: A. ½″ anterior to the external opening of the ear. B. 1″ posterior to the external opening of the ear. C. 1″ posterior to the angle of the mandible. D. 1″ inferior to the external opening of the ear.

B. 1″ posterior to the external opening of the ear.

Which of the following statements regarding the vitreous humor is correct? A. It is a clear, watery fluid that cannot be replaced if it is lost during an eye injury. B. It is a clear, jellylike fluid near the back of the eye that cannot be replaced if it is lost. C. It is a clear fluid that is produced by the lacrimal glands and cannot be replaced if it is lost. D. It is a clear, watery fluid that is located in front of the lens and can be replaced if it is lost.

B. It is a clear, jellylike fluid near the back of the eye that cannot be replaced if it is lost.

Following blunt trauma to the face, a 21-year-old male complains of a severe headache and decreased ability to move his eyes. This patient's clinical presentation is MOST consistent with: A. a ruptured eyeball. B. a blowout fracture. C. optic vessel compression. D. a lacerated globe.

B. a blowout fracture.

A 30-year-old female presents with redness, inflammation, and pain to her left eye. During your assessment, you note that she is having difficulty keeping her eyes open. You should suspect that she is experiencing: A. a detached retina. B. conjunctivitis. C. acute retinitis. D. a corneal abrasion.

B. conjunctivitis.

The lower jawbone is called the: A. mastoid. B. mandible. C. zygoma. D. maxillae.

B. mandible.

Which of the following findings would be LEAST suggestive of a head injury? One pupil larger in size than the other pupil Failure of the eyes to move in the same direction Briskly constricting pupils when exposed to light Failure of the eyes to follow movement of an object

Briskly constricting pupils when exposed to light

Abnormal variations in pupil size and reaction would MOST likely be observed in a patient with: A. contact lenses. B. conjunctivitis. C. a brain injury. D. retinitis.

C. a brain injury.

When transporting a patient with a facial injury, it is MOST important to be as descriptive as possible with the hospital regarding the patient's injuries because: A. they must make arrangements for an ICU bed. B. most patients with facial trauma will need surgery. C. a specialist may need to be called. D. it saves time on repeat assessments at the hospital.

C. a specialist may need to be called.

The inner surface of the eyelids and the exposed surface of the eye itself are covered by a delicate membrane called the: A. cornea. B. sclera. C. conjunctiva. D. retina.

C. conjunctiva.

A 40-year-old male was in his woodworking shop when he felt a sudden, sharp pain in his left eye. Your assessment reveals a small splinter of wood embedded in his cornea. You should: A. remove the object with a cotton-tipped applicator. B. scrape the splinter away with moist, sterile gauze. C. cover both of his eyes and transport to the hospital. D. cover his right eye and flush the left eye with saline.

C. cover both of his eyes and transport to the hospital

When a light is shone into the pupil: A. both pupils should dilate together. B. the opposite pupil should dilate. C. it should become smaller in size. D. it should become larger in size.

C. it should become smaller in size.

Following direct trauma to the upper part of the anterior neck, a young male presents with labored breathing, loss of voice, and subcutaneous emphysema in the soft tissues around his neck. You should suspect a(n): A. crushed cricoid. B. collapsed trachea. C. laryngeal fracture. D. esophageal tear.

C. laryngeal fracture.

A 29-year-old male has an anterior nosebleed after he was accidentally elbowed in the nose. His is conscious and alert with adequate breathing. The MOST appropriate care for this patient includes: A. placing him supine and pinching his nostrils together. B. applying a gauze pad in between his lower lip and gum. C. leaning him forward and pinching his nostrils together. D. packing the nasopharynx with moist, sterile dressings.

C. leaning him forward and pinching his nostrils together.

The small, rounded, fleshy bulge immediately anterior to the ear canal is called the: A. pinna. B. incus. C. tragus. D. stapes.

C. tragus.

You are transporting an immobilized patient with severe facial trauma. As you are preparing to give your radio report to the hospital, the patient begins vomiting large amounts of blood. You should: A. quickly suction his oropharynx. B. alert the hospital of the situation. C. turn the backboard onto its side. D. reassess his breathing adequacy.

C. turn the backboard onto its side.

When caring for a patient with an open facial injury, the EMT must: A. manually stabilize the patient's head. B. consider the mechanism of injury. C. wear gloves and facial protection. D. closely assess the patient's airway.

C. wear gloves and facial protection.

A 50 year old male was splashed in the eyes with radiator fluid when he was working on a car. During your assessment, he tells you that he wears soft contact lenses: You should:

Carefully remove the contact lenses and then irrigate his eyes with saline

A young female was involved in a motor vehicle crash. She complains of pain to her left eye, which appears to have a piece of glass impaled in it. Further assessment reveals a large laceration to her left forearm with active venous bleeding. As your partner manually stabilizes the patient's head, you should: A. carefully remove the glass from her eye. B. administer 100% supplemental oxygen. C. stabilize the impaled glass in her eye. D. apply direct pressure to her arm wound.

D. apply direct pressure to her arm wound.

A 52-year-old unrestrained female struck the steering wheel with her face when her truck collided with another vehicle. She has obvious swelling to her face and several dislodged teeth. A visual exam of her mouth reveals minimal bleeding. She is conscious and alert with a blood pressure of 130/80 mm Hg, a pulse of 110 beats/min, and respirations of 22 breaths/min with adequate tidal volume. You should: A. fully immobilize her spine, attempt to locate the dislodged teeth, tilt the backboard to

D. apply supplemental oxygen, immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport.

You are assessing a 59-year-old male and note that his pupils are unequal. He is conscious and alert. When obtaining his medical history, it is MOST pertinent to ask him if he: A. regularly sees a family physician. B. noticed the change during a meal. C. is allergic to any medications. D. has a history of eye surgeries.

D. has a history of eye surgeries.

A 44-year-old male sustained a laceration to his left ear during a minor car accident. Your assessment reveals minimal bleeding. Appropriate care for this injury includes: A. packing the ear with sterile gauze pads. B. covering the wound with a moist dressing. C. applying a tight pressure dressing. D. padding between the ear and the scalp.

D. padding between the ear and the scalp.

The opening in the center of the iris, which allows light to move to the back of the eye, is called the: A. cornea. B. conjunctiva. C. sclera. D. pupil.

D. pupil.

The white portion of the eye is called the: A. iris. B. cornea. C. retina. D. sclera.

D. sclera.

Which semicircular bone "floats" in the superior aspect of the neck just below the mandible?

Hyoid

A 29 year old male has an anterior nosebleed after he was accidentally elbowed in the nose. He is conscious and alert with adequate breathing. The MOST appropriate care for this patient includes: leaning him forward and pinching his nostrils together. packing the nasopharynx with moist, sterile dressings. applying a gauze pad in between his lower lip and gum. placing him supine and pinching his nostrils together.

Leaning him forward and pinching his nostrils together

What is the most common type of facial fracture? Orbit Mandible Maxille Nasal

Nasal

Which of the following injuries is characterized by loss of sensation below the orbit, visual disturbance, and flattening of patient's cheek?

Zygomatic fracture

You are dispatched to a convenience store, where the clerk sustained a laceration to the side of his neck during a robbery attempt. During your assessment, you note bright red blood spurting from the laceration. You should:

apply direct pressure above and below the wound.

The term "hyphema" is defined as:

blood in the anterior chamber of the eye

A 30-year-old female presents with redness, inflammation, and pain to her left eye. During your assessment, you note that she is having difficulty keeping her eyes open. You should suspect that she is experiencing:

conjunctivitis.

Bleeding from soft-tissue injuries to the face is most effectively controlled with:

direct pressure using dry, sterile dressings.

The skin and underlying tissues of the face: have a rich blood supply and bleed profusely. swell minimally when exposed to blunt trauma. are well protected by the maxillae and mandible. contain a relatively small number of nerve fibers.

have a rich blood supply and bleed profusely.

An 82-year-old man experienced a minor facial injury when he tripped and fell. He is conscious and alert and complains of slight pain to his cheekbones. His medical history includes hypertension, blood clots in his legs, hypothyroidism, and type 2 diabetes. During your assessment, it is important to remember that:

he is at an increased risk for severe posterior epistaxis.

A factory worker was splashed in the eyes with a strong acid chemical. He complains of intense pain and blurred vision. If you do not have sterile saline or water, you should:

irrigate both eyes continuously for 20 minutes with plain water.

A 22-year-old male was walking on the beach and had sand blown into his eyes. He complains of pain and decreased vision to his right eye. Treatment should include: irrigating his right eye laterally. flushing his eye starting laterally. irrigating both eyes simultaneously. covering both eyes and transporting.

irrigating his right eye laterally.

Following direct trauma to the upper part of the anterior neck, a young male presents with labored breathing, loss of voice, and subcutaneous emphysema in the soft tissues around his neck. You should suspect a(n): esophageal tear. crushed cricoid. collapsed trachea. laryngeal fracture.

laryngeal fracture

A 29-year-old male has an anterior nosebleed after he was accidentally elbowed in the nose. He is conscious and alert with adequate breathing. The most appropriate care for this patient includes:

leaning him forward and pinching his nostrils together.

The lower jawbone is called the:

mandible.

Facial injuries must be identified and treated as soon as possible because:

of the risk for airway problems.

Significant trauma to the face should increase the AEMT's index of suspicion for a(n):

spinal cord injury.

One of the three small bones in the middle ear is the:

stapes.

Frequent reassessments of the patient with face or neck injuries are MOST important because: they lend credibility to your documentation. such injuries can affect the respiratory system. hospital staff require frequent patient updates. rapid facial swelling may mask hidden injuries.

such injuries can affect the respiratory system.

The MOST significant complication associated with facial injuries is: A. airway compromise. B. cervical spine injury. C. mandibular immobility. D. damage to the eyes.

A. airway compromise

What is the function of the sternocleidomastoid muscle? Allows flexion of the neck Provides respiration Connects the scapulae together Allows movement of the head

Allows movement of the head

The eyeball itself is referred to as the: A. cornea. B. globe. C. orbit. D. sclera.

B. globe.

What term is used to describe the process of bleeding out?

Exsanguination

The maxilla and zygoma are components of the ________.

Face

Horizontal fracture of the maxilla that separates the hard palate from and the lower maxilla from the remainder of the skull is called a

Le Fort I

Which Le Fort fracture is classified as a fracture involving the nasal bone and inferior maxilla?

Le Fort II

Facial injuries should be identified and treated as soon as possible because: of the risk for airway problems. bleeding must be controlled early. the spine may be injured as well. swelling may mask hidden injuries.

Of the risk for airway problems

The opening in the center of the iris, which allows light to move to the back of the eye, is called the: Pupil Sclera Cornea Conjunctiva

Pupil

Which of the following statements regarding anterior nosebleeds is correct?

They usually originate from the septum area and bleed slowly.

The small, rounded, fleshy bulge immediately anterior to the ear canal is called the:

Tragus

You are transporting an immobilized patient with severe facial trauma. As you are preparing to give your radio report to the hospital, the patient begins vomiting large amounts of blood. You should: quickly suction his oropharynx. turn the backboard onto its side. reassess his breathing adequacy. alert the hospital of the situation.

Turn the backboard on its side

The term "hyphema" is defined as:

blood in the anterior chamber of the eye.

The eyeball itself is called the:

globe

Clinical findings associated with a laryngeal injury include:

hemoptysis, subcutaneous emphysema, and cyanosis.

Te conjunctiva are kept moist by fluid produced by the: corneal ducts. posterior orbit. optic chiasma. lacrimal glands

lacrimal glands

When assessing a patient with a mandibular fracture, you would most likely encounter:

misalignment of the teeth.

A 44 year old male sustained a laceration to his left ear during a car accident. Your assessment reveals minimal bleeding. Appropriate care for this patient includes: applying a tight pressure dressing. padding between the ear and the scalp. packing the ear with sterile gauze pads. covering the wound with a moist dressing.

padding between the ear and the scalp

Frequent reassessments of patients with face or neck injuries are most important because:

such injuries can affect the respiratory system.