Chapter 32 - Spinal Injuries

While performing the primary assessment on a patient with an isolated spinal cord​ injury, you note that he is in severe respiratory distress and struggling to breathe. Where should you suspect the spinal cord injury has​ occurred? A. Diaphragm B. Thoracic spine C. Lumbar spine D. Cervical spine

Cervical spine

A restrained driver was in a car that struck another car from behind at a low rate of speed. The driver has a bruise to her forehead and complains of tingling in her left leg. She is lying on the side of the​ road, and another EMT has established manual cervical spine motion restriction precautions. A quick scan of her as you approach indicates that the patient is in little to no distress. What should you do​ first? A. Perform a secondary assessment B. Administer​ high-concentration oxygen C. Check her breathing and radial pulse D. Palpate her cervical spine and apply a cervical collar

Check her breathing and radial pulse

Which device can be used to replace the long spine board when providing full spine motion restriction precautions to an​ adult? A. Full vacuum mattress B. Folding stair chair C. ​Full-body air splints D. Half spine board

Full vacuum mattress

The EMT is caring for a patient who has a problem with the autonomic component of his nervous system. Which sign or symptom would most likely be caused by this​ condition? A. Inability to move facial muscles B. Inability to swallow C. Trouble remembering his name D. Slowing of the heart rate

Slowing of the heart rate

A male patient fell 20 feet from a cliff to a trail below while hiking with his girlfriend. The primary assessment shows him to be​ confused, with an open airway and shallow breathing. His pulse is 72​ beats/min and his blood pressure is​ 78/50 mmHg. The skin is warm and flushed. The patient has no motor ability or sensation in his legs. What is the most likely cause of this​ patient's presentation? A. Hemorrhagic shock B. Internal bleeding C. Spinal shock D. Hypoglycemia

Spinal shock

A patient who was involved in a diving accident is found with his head positioned so that his left cheek is touching his left shoulder. He states that he has severe pain in his neck and it hurts to move his head. He denies​ numbness, tingling, or decreased strength in his arms or legs. What is the​ EMT's best course of​ action? A. Stabilize and maintain the head in the position in which the patient is holding it B. Carefully straighten the head and neck so that a cervical collar can be placed C. Avoid palpation of the cervical spine and apply a short​ vest-type device D. Straighten his​ neck, and position the patient on his left side on a long spinal board

Stabilize and maintain the head in the position in which the patient is holding it

A teenage boy was found by friends as he attempted to hang himself in a garage using chains suspended from the ceiling. As you​ approach, you note that the patient is​ conscious, struggling significantly to​ breathe, is ashen in color around the mouth and to the​ hands, and has contusions and swelling that encircle his neck from the chains. After taking manual cervical spine motion restriction and opening the​ airway, your next action would be​ to: A. Log roll the patient onto a long spine board B. Perform a secondary assessment C. Size and apply a cervical collar D. Start positive pressure ventilation

Start positive pressure ventilation

The EMT should recognize a possible spinal column injury with no spinal cord involvement when he discovers which assessment​ finding? A. Tenderness to the thoracic spine with intact motor and sensory abilities to each extremity B. Intact motor ability to all four extremities with loss of sensation to the legs C. Intact sensation to all four extremities with loss of motor ability to the arms D. Pain to the cervical spine with loss of sensation to the right arm and leg

Tenderness to the thoracic spine with intact motor and sensory abilities to each extremity

Which statement is most accurate regarding the processes needed for a patient to clench the hand into a​ fist? A. The muscles must signal the brain to send a message through the autonomic nervous system B. The central nervous system must send a message through the spinal cord and then to the autonomic nervous system C. The central nervous system must send a message through the spinal cord and then to the peripheral nerves D. The peripheral nervous system must send a message to the brain and then back through the peripheral nervous system

The central nervous system must send a message through the spinal cord and then to the peripheral nerves

Which statement shows that the EMTs are correctly using a​ vest-type device while removing a patient from an entrapped vehicle​ location? A. The cervical collar is applied after the torso and legs have been secured to the device B. The head is secured​ first, followed by the torso and legs C. The head is secured to the device after the torso has been secured D. The head is secured to the device immediately after the cervical collar is placed

The head is secured to the device after the torso has been secured

Research by the American College of Surgeons Committee on Trauma has shown a higher death rate for patients who were immobilized to a backboard​ when: A. The injury resulted from a lateral impact automobile accident B. The patient was intoxicated at the time of injury C. The patient was ambulatory upon EMS arrival D. The injury was the result of penetrating trauma to the head or torso

The injury was the result of penetrating trauma to the head or torso

Prior to the revisions in prehospital spinal assessment and​ care, the primary criterion for determining the need for spine motion restriction​ was: A. Evidence of multisystem trauma B. The mechanism of injury C. Decided by medical command D. A patient history of kyphosis

The mechanism of injury

A patient was struck in the back by a heavy piece of wood that was being bent to make a form for a concrete arch. He is​ responsive, but cannot feel or move his legs. He has bruising to his back and is incontinent of urine. The skin below the injury site is red and warm. As a knowledgeable​ EMT, you should realize​ that: A. A cervical collar is unnecessary B. The paralysis is permanent C. The paralysis may resolve D. The ability to feel will return

The paralysis may resolve

Based on the structure of the nervous​ system, which statement is​ true? A. A stroke represents an injury to the peripheral nervous system B. A deep laceration to the arm can sever peripheral nerves C. Numbness in a fractured leg indicates damage to the autonomic nervous system fibers D. A gunshot wound to the spinal cord will directly damage the peripheral nerves

A deep laceration to the arm can sever peripheral nerves

You are maintaining manual cervical spine motion restriction for a patient who is being log​ rolled, transferred, and secured to a long backboard. At which point will you release the manual spine motion restriction​ hold? A. After the chest has been secured with a head immobilization device B. After the patient has been properly secured with straps to the long board C. After the patient has been secured to the backboard and transferred to the wheeled stretcher D. Once the patient has been log rolled onto the long backboard

After the patient has been properly secured with straps to the long board

An elderly patient fell down a flight of basement stairs and is found at the bottom by family members about 20 minutes later. Your assessment reveals that the patient cannot feel painful stimuli to his hips and​ legs, nor can he move his​ legs, but he can feel you lightly touching the skin of his legs. Which type of injury may this​ be? A. Anterior cord syndrome B. Central cord syndrome C. Lateral cord syndrome D. Posterior cord syndrome

Anterior cord syndrome

You have been called for an​ 87-year-old male who fell in his kitchen while making breakfast. The patient states that he hit his forehead but managed to catch himself on the way down and did not hit the ground​ "too hard." Your assessment reveals him to have kyphosis of the thoracic and cervical​ spine, but no neurologic deficits. His​ legs, however,​ "feel weaker." Which action is appropriate given these assessment​ findings? A. Place a soft cervical collar instead of the rigid cervical collar B. Disregard application of a cervical collar since the patient has no neurologic deficits C. Avoid application of a cervical collar due to the natural deformity of the cervical spine D. Apply a cervical collar and prepare the patient for any discomfort that the collar may cause

Apply a cervical collar and prepare the patient for any discomfort that the collar may cause

A patient complains of lower back pain after falling down five stairs. Assessment of the​ patient's cervical spine reveals no​ displacement, tenderness, or instability. The patient does state that each leg has feelings of​ "electrical shocks" shooting through them. How should the EMT care for this​ patient? A. Apply a properly sized cervical collar after initiating manual spine motion restriction B. Inform the team that spine motion restriction precautions are not needed C. Secure the patient to a backboard without a cervical collar D. Release manual spine motion restriction precautions

Apply a properly sized cervical collar after initiating manual spine motion restriction

A patient complains of back pain and numbness to both legs after being thrown from a bicycle. When should the EMT first check the motor​ function, sensory​ function, and pulses in the legs of this​ patient? A. During the primary assessment B. Immediately after taking manual spine motion restriction precautions C. Immediately after applying a cervical collar D. As the secondary assessment is performed

As the secondary assessment is performed

The EMT is properly assessing for a spinal cord injury when​ she: A. Asks the patient if he has pain anywhere along his spinal column B. Palpates the entire spinal column for tenderness C. Checks for distal pulses in all four extremities D. Asks the patient to spread his fingers apart on both hands

Asks the patient to spread his fingers apart on both hands

A high school football player was hit from behind and now complains of severe back pain and numbness to his right leg. Manual spine motion restriction is being maintained by an assistant coach. The trainer has already removed the face mask from the helmet. Once at the​ patient's side, what should you do​ next? A. Carefully remove the helmet B. Apply a cervical collar C. Assess the airway and breathing D. Remove the shoulder pads as you prepare to place the patient on a backboard

Assess the airway and breathing

As you approach a motorcyclist who was thrown from his​ bike, you hear him saying that he cannot feel or move his legs. You note obvious deformity to both femurs as well as to his left wrist and forearm. Emergency Medical Responders are holding manual cervical spine motion restriction and have already assessed the PMS in the extremities. Given this​ information, which assessment should be done​ next? A. Check the​ patient's rate and effort of breathing B. Check for motor function and sensation in the feet C. Apply the pulse oximeter D. Expose the legs and look for bleeding

Check the​ patient's rate and effort of breathing

You are securing a patient to the long backboard. Of the options​ listed, which has the elements of securing the patient in the correct​ order? A. ​Legs, head, chest and pelvis B. ​Head, chest and​ pelvis, legs C. ​Head, legs,​ chest, pelvis D. Chest and​ pelvis, head, legs

Chest and​ pelvis, head, legs

An elderly patient fell down a flight of stairs and now complains of neck and back pain as well as weakness to both legs. The primary assessment reveals no life threats to the​ airway, breathing, or circulation. Manual cervical spine motion restriction is being maintained. What should the EMT do​ next? A. Place an oral airway and begin positive pressure ventilation B. Apply​ high-concentration oxygen and move the patient to the stretcher for transport C. Place a cervical collar and secure the patient to the long spine board D. Complete the secondary​ assessment, looking for additional injuries

Complete the secondary​ assessment, looking for additional injuries

A young intoxicated male patient cannot move his left arm and leg after diving into the shallow end of a pool and hitting the bottom head first. The EMT would recognize which mechanism as most likely responsible for this​ injury? A. Compression B. Distraction C. Rotation D. Penetration

Compression

The​ "EMS Management of Patients with Potential Spinal​ Injury" document published by the American College of Emergency Physicians in 2015 discusses which principle regarding the immobilization of​ patients? A. Only a licensed and​ board-certified emergency department physician is capable of determining whether spine motion equipment is necessary B. A review of the related literature has demonstrated clinical support for ongoing use of spine motion restriction equipment in all patients with either a minor or major mechanism of injury C. Current​ out-of-hospital management of potential spinal injury lacks evidentiary scientific support D. The use of a long spine board without a cervical collar is recommended because cervical collars do not achieve a full degree of immobilization

Current​ out-of-hospital management of potential spinal injury lacks evidentiary scientific support

Which injury is possible based on the anatomy of the​ spine? A. Disk injury between thoracic vertebrae 11 and 12 B. Dislocation of lumbar vertebra number 6 C. Compression fracture to lumbar vertebra 12 D. Fracture to the ninth cervical vertebra

Disk injury between thoracic vertebrae 11 and 12

Which of the following findings in a patient with a traumatic mechanism of injury is sufficient to prevent the EMT from​ "clearing the​ spine" and necessitate the implementation of spine motion restriction​ precautions? A. GCS score of 12 B. Pulse oximeter of​ 96% on 2 lpm oxygen C. Blood glucose of 90​ mg/dL D. Pulse pressure of 24 mmHg

GCS score of 12

A male patient experienced an injury that completely severed his spinal cord in the thoracic spine. Which presentation would be associated with this​ injury? A. He will feel pain below the injury in his legs B. He will have no sensation in his arms C. He will have decreased motor ability above the injury D. He will experience paralysis to the legs

He will experience paralysis to the legs

When it is necessary to secure a patient to a long spine board during a spine motion restriction​ process, which of these regions is typically secured last to the spine​ board? A. Chest region B. Head and neck region C. Pelvic region D. Abdominal region

Head and neck region

A​ 43-year-old male fell from a roof and cannot move or feel his arms or legs. When assessing the​ patient, which sign would lead the EMT to suspect the patient is developing spinal​ shock? A. Cool and moist skin B. Seizure activity C. Heart rate of 62​ beats/min D. Cyanosis to the fingertips

Heart rate of 62​ beats/min

While transporting a​ 38-year-old female who fell from a​ second-story window, you note that she is becoming confused and her pulse rate is increasing.​ Additionally, her blood pressure has dropped and her skin is now cool and clammy. Based on these assessment​ findings, you would​ recognize: A. Spinal shock B. Head injury C. Neurogenic shock D. Hypovolemic shock

Hypovolemic shock

Which statement is most accurate concerning spine motion restriction of an ambulatory​ patient? A. If the patient is​ reliable, he can​ self-restrict while the cervical collar is applied B. ​Self-restriction is not permitted if a rigid cervical collar is used C. If the patient is​ unconscious, self-restriction cannot be used D. The patient should be reminded to continue​ self-restriction while being seated on the stretcher

If the patient is​ reliable, he can​ self-restrict while the cervical collar is applied

You arrive on the scene of a motor vehicle collision. Walking toward you is the unrestrained driver of the vehicle that sustained moderate​ front-end damage. The patient complains of some back​ pain, but is walking around after the crash and does not appear to be suffering from any neurologic deficits. Although he answers your questions​ appropriately, he keeps asking​ you, "What​ happened?" What is your initial action in caring for this​ patient? A. Obtain the​ patient's vital signs B. Look for injuries to the​ patient's head C. Perform the primary assessment D. Initiate spine motion restriction precautions

Initiate spine motion restriction precautions

You have arrived at the scene of a shooting where a​ middle-aged male sustained a single gunshot wound to the abdomen. As you approach the​ patient, you note that he is sitting up and attempting to talk with the police officers while holding a​ blood-soaked towel over the left upper quadrant of his abdomen. Once you get beside the​ patient, you realize he is speaking in a different language that neither you nor the officers understand. Your initial action in caring for this patient is​ to: A. Obtain a pulse​ rate, respiratory​ rate, blood​ pressure, and SpO2 B. Initiate spine motion restriction precautions C. Determine the need for airway management D. Expose the abdomen to assess the gunshot wound

Initiate spine motion restriction precautions

At a scene where a vehicle was involved in a​ single-car accident, you find the driver walking around at the scene. As you​ approach, the driver states that he felt fine when he exited the vehicle but is now concerned that his legs feel like they are​ "going to​ sleep." What is your first step in treating the​ driver? A. Assess his airway and circulation B. Assist him in sitting on the cot C. Instruct him to hold his head in a neutral inline position D. Place a backboard behind the​ driver, against his spine

Instruct him to hold his head in a neutral inline position

Which statement about removing a helmet in the prehospital setting is​ true? A. It is acceptable to leave the helmet on a patient if the patient has no airway or breathing problems B. Since helmets should never be​ removed, the EMT must be creative in providing care around the obstacle of a helmet C. Helmets should be removed only if they are too tight or if spine motion restriction will be required D. Any patient wearing a helmet should have it removed so the airway and breathing can be properly assessed

It is acceptable to leave the helmet on a patient if the patient has no airway or breathing problems

A football player was struck in the head during a hard​ tackle, and is reportedly demonstrating retrograde amnesia to the event. Currently the patient complains of a headache and nausea and reports that he has pain to his upper back and tingling in his left hand. The EMT is providing proper care for the patient when​ he: A. Removes the helmet to immediately assess the​ patient's head B. Does not place the patient on a long board due to the presence of shoulder pads C. Removes the shoulder pads to apply a cervical collar D. Leaves the helmet in place but removes the face mask first

Leaves the helmet in place but removes the face mask first

A patient was ejected from a car during a rollover collision at a moderate to high rate of speed. Which presentation in this patient is most characteristic of the incomplete spinal cord injury referred to as a​ "central cord​ syndrome"? A. Loss of motor function and sensation to one side of the body only B. Loss of sensation to one side of the​ body, and loss of motor function to the opposite side of the body C. Loss of motor function to the arms with intact motor function to the legs D. Loss of perfusion to the spinal cord that results in complete loss of motor function and sensation to both the arms and legs

Loss of motor function to the arms with intact motor function to the legs

An Emergency Medical Responder reports that a male​ patient, who was injured while playing​ football, has bruising to the lumbar region of the body. Based on this​ statement, the EMT should expect to find bruising in which​ area? A. Buttocks B. Lower back C. Lower neck D. Upper back

Lower back

You arrive on the scene of a​ two-car motor vehicle collision. The patient was the unrestrained driver of a car that struck another car from behind while moving at a speed of 25 mph. During the​ collision, the patient flew forward and struck the windshield with his head. No air bags were deployed. The patient extricated himself and denies​ head, neck, or back​ pain; however, you do note a small cut on his​ hand, which occurred as he was getting out of the car. When asked about preexisting medical​ problems, he tells you that he did have herniated disks in his lumbar spine that were surgically repaired several years ago. Based on this​ information, your strongest reason to initiate spine motion restriction precautions for this patient would​ be: A. Mechanism of injury B. History of back surgery C. ​Self-extrication of the patient D. Laceration to the hand

Mechanism of injury

A male driver was ejected from his vehicle after it rolled several times at a high rate of speed. As you approach the​ patient, you note that he is unresponsive and struggling to breathe. He also has a laceration to the left side of his face and multiple contusions to his legs. After assigning another EMT to take manual cervical spine motion​ restriction, what should you​ do? A. Apply a properly sized cervical collar B. Open the airway using the​ jaw-thrust maneuver C. Insert an oropharyngeal airway D. Start positive pressure ventilation

Open the airway using the​ jaw-thrust maneuver

A patient dove into a shallow pool and struck his head on the bottom. Your assessment findings indicate that he has no motor or sensation in his​ legs, but can move his arms. The EMT should recognize this condition to​ be: A. Hemiplegia B. Quadriplegia C. Paraplegia D. Tetraplegia

Paraplegia

A​ 42-year-old man has called 911 because of severe back pain. He informs you that his back pain is related to a recent fracture of his coccyx. Based on this​ information, where should the EMT expect the patient to be complaining of​ pain? A. Neck B. Lower back C. Upper back D. Pelvic area

Pelvic area

A minivan has struck a utility pole. The driver is unresponsive and has​ life-threatening injuries. Which option would be most appropriate when extricating the patient from the​ vehicle? A. Pull the patient from the car and provide spine motion restriction precautions away from the vehicle B. Apply a​ vest-type immobilization device C. Perform rapid extrication with a cervical collar applied This is the correct answer. D. Remove the patient and place him on a long spinal board in the ambulance during rapid transport

Perform rapid extrication with a cervical collar applied

When performing the secondary​ assessment, which sign is most suggestive of a spinal cord​ injury? A. Persistent penile erection B. Pain in the right leg C. Headache and nausea D. Bruising on the back

Persistent penile erection

A​ 25-year-old male jail inmate was pushed over the railing of a walkway 20 feet above the ground. He is unresponsive and has an open fracture of the left upper arm. How would you determine if the patient has sensation in his​ legs? A. Since the patient is​ unresponsive, this assessment would be impossible B. Lift his leg and look for a facial grimace C. Check for the presence and strength of a pedal pulse D. Pinch his foot and look for movement on the leg

Pinch his foot and look for movement on the leg

Which statement about the care and treatment of a patient with a spinal injury in the prehospital setting is​ true? A. It is important to identify the level of spinal injury so the proper prehospital care can be rendered B. If a patient has a possible spine injury but is in​ shock, it is permissible to forego spine motion restriction precautions since this takes time and keeps the patient from definitive care in the hospital C. Before transporting the critically injured patient with a spinal​ injury, the EMT must perform a​ detailed, head-to-toe neurologic assessment D. Prehospital care for the patient with a spine injury involves spine motion restriction precautions and the identification of​ life-threatening conditions

Prehospital care for the patient with a spine injury involves spine motion restriction precautions and the identification of​ life-threatening conditions

Assessment of a young girl who was hit by a car while riding her bike reveals her to be responsive to painful stimuli with flexion of the​ extremities; she is also in respiratory distress. There is marked deformity to her thoracic spine and bruising noted to her anterior chest and abdomen. She does not move her legs when a noxious stimulus is applied to the lower extremities. Manual cervical spine motion restriction is being maintained and a cervical collar has been applied by fire department EMRs. Given the critical nature of this​ patient, which action is most appropriate for her​ care? A. Transfer her to the long board already placed on the stretcher and secure with straps en route to the hospital B. Rapidly transfer her to the stretcher and secure her to the long board while en route to the hospital C. Quickly but carefully provide full spine motion restriction precautions on scene prior to rapid transport to the hospital D. Wait for family members to arrive and give consent for treatment prior to moving her to the stretcher for immediate transport

Quickly but carefully provide full spine motion restriction precautions on scene prior to rapid transport to the hospital

When applying a cervical collar to a young boy who fell out of a​ tree, the EMT realizes the main purpose of the collar is​ to: A. Increase the blood flow to the spinal cord in the cervical region B. Prevent the head and neck from moving C. Maintain spine motion restriction D. Remind the patient not to move his head or neck

Remind the patient not to move his head or neck

A motorcyclist wearing a full helmet was thrown from his motorcycle after hitting a patch of oil on the road. The bike had been traveling at a high rate of speed. Manual spine motion restriction is being maintained by an​ off-duty EMT. The primary assessment reveals the patient to be responsive to painful stimuli and breathing rapidly with slight sonorous airway sounds. His radial pulse is weak and fast. As you quickly scan his​ body, you note deformity to the left femur and lower leg. Your immediate action should be​ to: A. Remove his helmet B. Place a nonrebreather oxygen mask C. Expose his left lower extremity D. Apply a cervical collar

Remove his helmet

A patient is being extricated from a car using a short​ vest-type device. After the patient has been​ extricated, the EMT​ should: A. Secure the patient with the vest device in a supine position on the stretcher with the legs flexed B. Secure the patient with the​ vest-type device to a long backboard C. Remove the​ vest-type device and secure the patient to a long backboard D. Place the patient in​ semi-Fowler's position on the stretcher for transport to the hospital

Secure the patient with the​ vest-type device to a long backboard

A patient has just been log rolled and positioned onto the long backboard. Which care measure should be performed​ next, assuming it was not previously​ completed? A. Secure the​ patient's head B. Secure the​ patient's torso with straps C. Release manual cervical spine motion restriction D. Apply a properly sized cervical collar

Secure the​ patient's torso with straps

You have been called for a patient with severe back pain. When you are obtaining a medical​ history, the patient tells you that he has a history of damaged disks in his vertebrae. As a knowledgeable​ EMT, you should recognize​ that: A. The ligaments on the side of the spinal column were overstretched B. The nerves making up the spinal cord have been damaged C. The​ fluid-filled structures between the vertebrae have been injured D. The vertebrae making up the spinal column were fractured

The​ fluid-filled structures between the vertebrae have been injured

A young female​ driver, who was involved in a motor vehicle​ collision, complains of cervical pain resulting from a​ lateral-type mechanism of neck injury. Based on this​ information, which type of collision most likely took​ place? A. The​ patient's car was struck from the side B. The​ patient's car​ rear-ended another car C. The​ patient's car was struck from behind D. The​ patient's car struck a utility pole​ head-on

The​ patient's car was struck from the side

A patient who was injured in a motor vehicle collision has a separation of the rib and its associated spinal vertebrae. Based on the anatomy of the​ spine, where has this injury​ occurred? A. Thoracic spine B. Middle spine C. Lumbar spine D. Cervical spine

Thoracic spine

In which area of the spinal column do the ribs​ originate? A. Thoracic spine B. Lumbar spine C. Cervical spine D. Sacral spine

Thoracic spine

Which sign or symptom best indicates the patient has experienced a spinal cord injury to the thoracic​ spine? A. Paralysis of the arms only B. Cool and diaphoretic skin C. Tingling in the legs D. Bruising to the back

Tingling in the legs

A window washer fell 20 feet from scaffolding while washing the windows on an office building. He is alert and​ oriented, but states that he cannot move or feel his legs.​ Additionally, because his blood pressure is​ 72/48 mmHg, you suspect spinal shock. Which other assessment finding reinforces your suspicion of spinal​ shock? A. Warm and dry skin B. SpO2 of​ 92% C. Pulse pressure of 24 mmHg D. Heart rate of 144​ beats/min

Warm and dry skin

A patient is lying under a tree after being involved in a motor vehicle collision. She states that immediately after the​ crash, she felt​ okay, but now her legs are numb and tingling. She also has lower back discomfort. Which question is it most important for the EMT to ask​ next? A. ​"How did you get out of the​ car?" B. ​"Do you have a history of back​ problems?" C. ​"Are you allergic to any​ medications?" D. ​"Do you think that you had a​ seizure?"

​"How did you get out of the​ car?"

Which response shows that the EMT is correctly assessing motor function in the arms of a patient with a potential spine​ injury? A. ​"I am going to move your​ arm; tell me if it​ hurts." B. ​"Can you tell me which finger I am​ touching?" C. ​"I need you to flex both arms across your​ chest." D. ​"I am going to feel for a pulse in your​ wrist."

​"I need you to flex both arms across your​ chest."

Which of the instructions from one EMT to another shows the correct application of a cervical​ collar? A. ​"I need you to extend the​ patient's chin backward a little so I can fit the collar under his​ chin." B. ​"Carefully flex his head forward a little so I can pass the collar underneath his​ neck." C. ​"Let's log roll the patient to one side so I can apply the cervical​ collar." D. ​"Keep his head in neutral position while I apply the cervical​ collar."

​"Keep his head in neutral position while I apply the cervical​ collar."

You pull up to the scene of a​ single-car motor vehicle collision. Emergency Medical Responders​ (EMRs) are maintaining inline manual cervical spine motion restriction of the​ 56-year-old driver, who was unrestrained when she struck a tree at a high rate of speed. As you approach the​ vehicle, you note that the patient appears​ unresponsive, with blood coming from her nose and ears. Which instruction to the EMRs is most​ appropriate? A. ​"Let's suction the airway and get the patient out of the car​ fast; we can put on a cervical collar once we are outside the​ vehicle." B. ​"Let me conduct the primary​ assessment, and then we can place a​ vest-type extrication device on the patient to get her outside the​ vehicle." C. ​"Let me conduct the primary assessment and place a cervical collar on the​ patient, and then we can start to get her out of this​ car." D. ​"After I do the primary and secondary​ assessment, we will need to get the patient onto the stretcher for immediate​ transport."

​"Let me conduct the primary assessment and place a cervical collar on the​ patient, and then we can start to get her out of this​ car."

Which instruction would you provide to your team immediately after securing a patient with​ head, neck, and back pain to the long backboard with appropriate spine motion restriction​ equipment? A. ​"Let's check for extremity PMS before we move the patient to the​ stretcher." B. ​"Maintain manual cervical spine motion restriction until the patient is on the​ stretcher." C. ​"Remove the chest strap so the patient can breathe more easily now that his head and legs are​ secured." D. ​"Loosen the collar so you can palpate the back of the​ neck."

​"Let's check for extremity PMS before we move the patient to the​ stretcher."

A​ 2-year-old boy fell down a flight of​ stairs, is crying​ loudly, and is very difficult to communicate with. Because you are unable to clear the​ spine, you elect to initiate spine motion restriction precautions. Which instruction would you provide to other EMTs who are initiating this care for the​ patient? A. ​"Let's place a folded towel under his shoulders and back to help maintain head​ alignment." B. ​"After he is on the​ board, place a towel behind his head to keep the airway​ open." C. ​"Use an adult​ 'no neck' collar since those fit almost​ everyone." D. ​"It is better if the collar is a little too​ big; that is more comfortable for​ him."

​"Let's place a folded towel under his shoulders and back to help maintain head​ alignment."

An injury to a hemisection of the spinal cord that disrupts the spinal tracts on only one side of the cord​ is: A. ​Brown-Sequard syndrome B. Posterior cord syndrome C. Anterior cord syndrome D. Central cord syndrome

​Brown-Sequard syndrome