EMT Chapter 28 - Head and Spine Injuries

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An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is: A. a rapid deterioration of neurologic signs. B. an acute increase in the patient's pulse rate. C. a progressively lowering blood pressure. D. acute unilateral paralysis following the injury.

A. a rapid deterioration of neurologic signs.

The Glasgow Coma Scale (GCS) is used to assess: A. eye opening, verbal response, and motor response. B. mental status, eye opening, and respiratory rate. C. verbal response, eye opening, and mental status. D. sensory response, pupil reaction, and heart rate.

A. eye opening, verbal response, and motor response.

Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless: A. it causes a problem managing the airway. B. the patient adamantly denies neck pain. C. sensory and motor functions remain intact. D. lateral immobilization has been applied.

A. it causes a problem managing the airway.

You should be MOST suspicious that a patient has experienced a significant head injury if his or her pulse is: A. slow. B. rapid. C. irregular. D. weak.

A. slow.

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: A. suction his oropharynx for up to 15 seconds. B. pack his nostrils to stop the drainage of blood. C. immobilize his spine and transport immediately. D. assist his ventilations with a BVM.

A. suction his oropharynx for up to 15 seconds.

The ideal procedure for moving an injured patient from the ground to a backboard is: A. the four-person log roll. B. the clothes drag. C. the direct patient carry. D. the use of a scoop stretcher.

A. the four-person log roll.

Which of the following breathing patterns is MOST indicative of increased intracranial pressure? A. Increased rate and depth with the distinct odor of acetone on the patient's breath B. Irregular rate, pattern, and volume of breathing with intermittent periods of apnea C. Increased rate with a normal inspiratory time and a prolonged expiratory time D. Slow, shallow, occasional gasps that progress to prolonged periods of apnea

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

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: A. hyperextension. B. axial loading. C. distraction. D. hyperflexion.

B. axial loading.

When immobilizing a trauma patient's spine, the EMT manually stabilizing the head should not let go until: A. the patient has been secured to the ambulance stretcher. B. the patient has been completely secured to the backboard. C. the head has been stabilized with lateral immobilization. D. an appropriately sized cervical collar has been applied.

B. the patient has been completely secured to the backboard.

Which of the following statements regarding secondary brain injury is correct? A. Signs are often present immediately after an impact to the head. B. Because cerebral edema develops quickly, it is considered to be a primary brain injury. C. Hypoxia and hypotension are the two most common causes of secondary brain injury. D. It results from direct brain trauma following an impact to the head.

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

What part of the nervous system controls the body's voluntary activities? A. Autonomic B. Central C. Somatic D. Sensory

C. Somatic

Common signs and symptoms of a serious head injury include all of the following, EXCEPT: A. CSF leakage from the ears. B. decerebrate posturing. C. a rapid, thready pulse. D. widening pulse pressure.

C. a rapid, thready pulse.

The central nervous system (CNS) is composed of the: A. cerebellum and brain. B. meninges and spinal cord. C. brain and spinal cord. D. cerebrum and meninges.

C. brain and spinal cord.

The five sections of the spinal column, in descending order, are the: A. thoracic, cervical, lumbar, coccygeal, and sacral. B. cervical, coccygeal, thoracic, sacral, and lumbar. C. cervical, thoracic, lumbar, sacral, and coccygeal. D. coccygeal, sacral, lumbar, thoracic, and cervical.

C. cervical, thoracic, lumbar, sacral, and coccygeal.

A tight-fitting motorcycle helmet should be left in place unless: A. the patient complains of severe neck or back pain. B. the patient must be placed onto a long backboard. C. it interferes with your assessment of the airway. D. the helmet is equipped with a full face shield or visor.

C. it interferes with your assessment of the airway.

When activated, the sympathetic nervous system produces all of the following effects, EXCEPT: A. dilation of the bronchiole smooth muscle. B. shunting of blood to vital organs. C. pupillary constriction. D. increase in heart rate.

C. pupillary constriction.

When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear. This indicates: A. significant pressure and bleeding in between the skull and dura mater. B. a linear skull fracture and a significant increase in intracranial pressure. C. rupture of the tympanic membrane following diffuse impact to the head. D. fractures to the internal structures of the ear following direct trauma.

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

A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response? A. 5 B. 4 C. 2 D. 3

D. 3

Hyperextension injuries of the spine are MOST commonly the result of: A. compression. B. diving. C. falls. D. hangings.

D. hangings.

In contrast to a cerebral concussion, a cerebral contusion: A. results from a laceration to the brain tissue. B. usually does not cause a loss of consciousness. C. does not cause pressure within the skull. D. involves physical injury to the brain tissue.

D. involves physical injury to the brain tissue.


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