Head and Spine Injuries - MH

Following head trauma injury, how should you conduct a secondary assessment?

1. assess integrity of skull by gently palpating it 2. Look in the ears for CSF or fluid drainage. Look behind the ears for battle sign 3. Assess the size size, equality, and reactivity of patients pupils. 4. Palpate facial bones for stability 5. Palpate the cervical spine.

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.

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

Which of the following acts as a shock absorber for the CNS? Pia mater Fascia CSF Dura mater

CSF The brain and spinal cord essentially float in this fluid, buffered from injury.

How many vertebrae compose each section of the spine?

Cervical: 7 Thorax: 12 Lumbar: 5 Sacrum: 5 Coccyx: 4

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? Cerebral Edema Concussion Cushing Triad C6 herniation

Cushing Triad

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.

Eighty person of the cranium is occupied by brain tissue.

When securing a patient to a backboard, what area of the body should you secure last? Pelvis Upper torso Head Upper Legs

Head

What does Cushing reflex signify?

Increased intracranial pressure

You are reassessing a patient and you find that her left pupil is dilated and fixed. What does this indicate? Increase intracranial pressure Decreased blood pressure Drug abuse Increased blood pressure

Increased intracranial pressure

What are the signs of Cushing reflex?

Increased systolic blood pressure, decreased pulse rate and irregular respirations.

Cushing Triad in a patient is a sign of which of the following? Blood clot in the brain Intracranial Pressure Concussion Spinal Cord Damage

Intracranial Pressure

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

Linear

Accounting for approximately 80% of all skull fractures, which of the following often present with no physical signs. Basilar skull fractures Open Skull fractures Depressed skull fractures Linear skull fractures

Linear skull fractures Linear skull fractures (nondisplaced skull fractures) account for approximately 80% of all skull fractures. Radiographs are required to diagnose a linear skull fracture because there are often no physical signs, such as deformity.

The time between an initial period of unconsciousness and a subsequent loss of consciousness is referred to as what? Danger Zone Lucid Interval Coherent Stage Recognition Period

Lucid Interval

From outer to inner, put these in order: Arachnoid Outer table of skull Inner table of skull Dura mater

Outer> inner > dura mater > arachnoid

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? Apply direct pressure and add a compression dressing. Place a clean dressing over the bloody one. Replace the dressing with a fresh one. Remove the dressing and apply an occlusive dressing.

Place a clean dressing over the bloody one.

Battle sign is an indication of which of the following? Contusion Secondary Injury Skull Fracture Concussion

Skull Fracture

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.

avoid excessive pressure when applying the bandage.

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. bacterial meningitis.

bacterial meningitis.

Which of the following sets of vital signs depicts Cushing's triad? BP: 90/50, pulse 120, respi 10 breaths BP: 200/100; pule 140, 28 breaths per minute BP 190/110, pule 55, 30 breaths BP 80/40, pulse 30, 32 breaths

blood pressure, 190/110 mm Hg; pulse, 55 beats/min; respirations, 30 breaths/min

Coordination of balance and body movement is controlled by the: medulla. cerebrum. cerebellum. brain stem.

cerebellum

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.

determine if the strength in all extremities is equal.

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? An epidural hematoma A subarachnoid hemorrhage An intracerebral hematoma A subdural hematoma

epidural hematoma An epidural hematoma is nearly always the result of a blow to the head that produces a linear fracture.

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.

establish an adequate airway.

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

head

During your primary assessment of a semiconscious 30-year-old female with closed head trauma, you note that she has slow, shallow 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 NRB mask and obtain baseline vital signs. immediately place her on a long backboard and prepare for rapid transport.

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

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 meneuver jaw-thrust maneuver

jaw-thrust maneuver

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.

leave his helmet and shoulder pads in place.

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.

level of consciousness.

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.

may be an indicator of deeper, more serious injuries.

The _________ nervous system consists of 31 pairs of spinal nerves and 12 pairs of cranial nerves. central somatic autonomic peripheral

peripheral

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.

place padding under the child's shoulders as needed.

A patient who cannot remember the events that preceded his or her head injury is experiencing: retrograde amnesia. anterograde amnesia. prograde amnesia. posttraumatic amnesia.

retrograde amnesia.