Trauma ch6

What is the most common outcome of blunt head​ trauma?

A diffuse injury

What accurately reflects the pathophysiology of anterior cord​ syndrome?

A flexion dash-extension injury that results in damage to the vertebral artery through either disruption or compression by​ edema, leading to subsequent ischemia and infarction

What might a victim suffering a concussion and epidural hematoma concurrently present with prior to an increase in intracranial​ pressure?

A lucid interval

What results from compression of the nerve roots at the lower end of the spinal​ cord?

Cauda equina syndrome

When the​ brain, floating in cerebrospinal fluid inside the​ cranium, "sloshes" toward the impact and then away from​ it, again impacting the cranial​ interior, what is the second injury​ called?

Contrecoup injury

While monitoring the victim of a brain injury during the secondary​ assessment, you should be especially watchful​ for:

Cushing's triad.

What do the signs and symptoms of​ Cushing's triad​ include?

Increasing systolic blood​ pressure, slowing​ pulse, and irregular respirations

What would blunt trauma to the neck that damages the cartilaginous rings of the trachea​ and/or the vocal cords not​ cause?

Injury to the​ T-12/L-1 transition point

Which statement is true regarding pediatric head​ trauma?

Intracranial hemorrhage in the pediatric patient can contribute significantly to hypovolemia.

What causes the tissue edema resulting from an intracerebral​ hemorrhage?

Irritation of nervous tissue

What population is most at risk for head or spinal column​ injury?

Males aged 15 dash-24

What injury would be classified as a diffuse brain​ injury?

Mild axonal injury

What are the discrete tissues and muscles of the body that are controlled by specific spinal nerve​ roots?

Myotomes

What accurately reflects the pathophysiology of ​Brown-Séquard ​syndrome?

Penetrating injury that hemitransects the​ cord, resulting in sensory and motor loss to the ipsilateral side of the body

Which meningeal layer is closest to the​ brain?

Pia mater

You are dispatched for a fall at the local mall. When you arrive you are led by security to a location on the sidewalk where a​ 43-year-old male patient is lying on his back. He is alert and oriented and tells you that he was running to cross in front of a car when he tripped on the​ curb, striking his head on the sidewalk. He then rolled onto his back and can no longer move his​ hands, legs, or​ trunk, although he can still move his arms. You suspect a low cervical or high thoracic spinal injury. At what point in the assessment would you apply spinal stabilization to this​ patient?

Primary assessment

You suspect the driver of a car in a motor vehicle collision​ (MVC) with airbag​ deployment, despite having no complaint of​ injury, might still have sustained a spinal injury based on the​ high-force mechanism of injury. At which point in the assessment would you develop this​ suspicion?

Scene​ size-up

Which part of the inner ear is responsible for​ equilibrium?

Semicircular canals

Which term is defined as a significant mechanical disruption of axons in both cerebral hemispheres with extension into the​ brainstem?

Severe diffuse axonal injury

What is bleeding called that occurs within the​ meninges, specifically beneath the dura mater and within the subarachnoid​ space?

Subdural hematoma

Which of the statements regarding the Glasgow Coma Scale is​ accurate?

The GCS is not a​ "perfect" means to accurately represent a​ patient's level of consciousness.

What is the fibrous connective tissue sheet directly beneath the skin and covering the most superior surface of the​ head?

The galea aponeurotica

What is not a reason that the​ atlas/axis joint is the site of the majority of fatal spine​ injuries?

The spinal cord roots exit the spinal column at this point.

How many layers of connective tissue are there between the cranium and the​ brain?

Three

You are dispatched to a residence for a​ 32-year-old female complaining of a severe headache and blurry vision in her left eye. When you question​ her, she tells you that the headache began the previous day and got worse as the day went​ on, forcing her to leave work early. When she awoke this​ morning, she noticed the dizziness and vision change in her eye and decided not to drive herself to the doctor. As you perform your​ exam, you notice that she winces when you touch the left parietal area of her head. When​ asked, she remembers that she was struck on the left side of the head by an object she believed was thrown by a lawn mower she walked past three days prior as she was walking the dog. She stated that the object​ didn't hurt very much so she​ didn't stop and subsequently forgot about it. You decide to expedite transport for this patient. Which mode of transport is​ best?

Transport at reduced speed using lights and sirens sparingly

Decorticate posturing as a response to painful stimuli is indicative​ of:

Upper brainstem disruption.

When an injury occurs directly at the point of impact as the brain moves toward and collides with the interior of the​ skull, this is called​ a(n):

coup injury.

The portion of the skull that protects the brain is called​ the:

cranium.

Bulging fontanelles in the infant patient who has suffered a traumatic event may be indicative​ of:

increasing intracranial pressure.

A large region of cortical disruption may cause confusion and affect the​ patient's mental​ status, such as the patient forgetting the circumstances leading up​ (before) the incident​ itself, which is​ called:

retrograde amnesia.

When developing a spinal clearance​ policy, age:

should be​ considered, as the very old may not be able to describe their symptoms accurately.

What results from penetrating injury that affects one side of the​ cord?

​Brown-Sequard syndrome

You are dispatched to the scene of a shallow water diving accident. While en​ route, what would you consider to be the most likely result of this method of​ injury?

Axial loading of the cervical spine

What is the white matter of the spinal cord composed​ of?

Axons

Which injury would you be likely to encounter while treating the driver of a motor vehicle that has been struck from​ behind?

Fracture of the posterior vertebral elements

Which type of head injury carries a 75 percent or higher mortality rate and is second in lethality after head injuries from auto​ crashes?

Gunshot wounds

What trauma injury is the most frequent cause of​ death?

Head injury

The use of which adjunct has reduced the occurrence of head injury in​ sports?

Helmets

You find significant hypoglycemia is an unresponsive patient with a head injury. You​ administer:

25 mg of glucose and 100 mg of thiamine.

How does the progression of signs and symptoms of pediatric head injury differ from an​ adult?

An infant is more prone to direct injury but has a slower progression of increasing ICP.

You suspect increased intracranial pressure in a patient with penetrating chest trauma. Which of the following is appropriate​ treatment?

Administer fluid resuscitation to maintain a systolic blood pressure of 90 mmHg

You suspect increased intracranial pressure in a patient with penetrating chest trauma. Which of the following is appropriate​ treatment?

Administer fluid resuscitation to maintain a systolic blood pressure of 90 mmHg.

Which syndrome results from bony fragments or pressure compressing arteries that perfuse the ventral aspect of the spinal​ cord?

Anterior cord syndrome

When clearing the cervical​ spine, what would a distracting injury​ include?

Any injury that produces clinically apparent pain that might distract the patient from the pain of a spine injury

How do superficial scalp wounds provide a risk of infection that can involve the​ brain?

Emissary veins from the dural sinuses drain into superficial venous circulation.

You are called to the scene of an automobile accident in which the driver was wearing his shoulder belt improperly and struck his face on the steering wheel. As you approach the​ vehicle, you see the door has been opened and the driver is​ unconscious, with his head still against the wheel and blood flowing freely from his nose and mouth. His respirations are 18 and shallow and his pulse is 102 radially. To extricate this​ patient, how should you​ proceed?

Ensure that any providers assisting you are coordinated and understand what movement is to take place.