Ch. 32
Conflicting or confusing signs of spinal cord injury are typically the result of: A. Brown-Séquard syndrome. B. incomplete cord injury. C. central cord syndrome. D. anterior cord syndrome.
B. incomplete cord injury.
The steps in immobilizing a supine patient to a long backboard include: A. not placing padding on the board, as it might move the spine out of alignment. B. securing the patient's torso to the board before securing the head. C. removing the cervical collar once the patient is immobilized on the board. D. using the logroll, a move ideally performed by at least two rescuers---one at the head, the other at the hips.
B. securing the patient's torso to the board before securing the head.
There are some situations in which you may move the patient with a suspected spinal injury before immobilizing him to a long or short spinal device. These situations include when: A. you have enough help to do so. B. you have other patients to care for at the scene. C. the patient's condition is stable, with no signs of neurologic deficit. D. the scene is not safe.
D. the scene is not safe.
All of the following would indicate the need of spinal motion restriction for a trauma patient, EXCEPT: A. numbness in hands and feet. B. tenderness along the vertebral column. C. Glasgow Coma Scale (GCS) is 15. D. deformity to the vertebral column.
C. Glasgow Coma Scale (GCS) is 15.
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. Cyanosis to the fingertips B. Seizure activity C. Heart rate of 62 beats/min D. Cool and moist skin
C. Heart rate of 62 beats/min
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. Middle spine B. Cervical spine C. Lumbar spine D. Thoracic spine
D. Thoracic spine
The vertebrae that combine to form the lower back are called the: A. cervical spine. B. thoracic spine. C. sacral spine. D. lumbar spine.
D. lumbar spine.
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. Lower back B. Buttocks C. Upper back D. Lower neck
A. Lower back
It is more common for spine injuries to cause paralysis: A. to all four extremities (quadriplegia) or to only the lower body and legs (paraplegia). B. to only one leg or only one arm. C. to only the upper extremities. D. on only the right side or only the left side (hemiplegia).
A. to all four extremities (quadriplegia) or to only the lower body and legs (paraplegia).
Telling a trauma patient to "flex your arms" tests motor function at: A. S1. B. T1. C. C6. D. L5.
C. C6.
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 patient has been properly secured with straps to the long board B. After the chest has been secured with a head immobilization device C. Once the patient has been log rolled onto the long backboard D. After the patient has been secured to the backboard and transferred to the wheeled stretcher
A. After the patient has been properly secured with straps to the long board
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. Apply a cervical collar and prepare the patient for any discomfort that the collar may cause B. Place a soft cervical collar instead of the rigid cervical collar C. Avoid application of a cervical collar due to the natural deformity of the cervical spine D. Disregard application of a cervical collar since the patient has no neurologic deficits
A. Apply a cervical collar and prepare the patient for any discomfort that the collar may cause
The EMT is caring for a patient who sustained a spinal cord injury in a motor vehicle collision. Which assessment finding would indicate a spinal cord versus a spinal column injury? A. Bilateral motor/sensory loss B. Loss of muscle tone C. Protruding palpable vertebrae D. Pain upon palpation
A. Bilateral motor/sensory loss
After sustaining a fall from a roof, your patient presents with an inability to move his arms, but he can still move his legs just fine. What type of partial cord injury is this? A. Central cord syndrome B. Posterior cord syndrome C. Lateral cord syndrome D. Anterior cord syndrome
A. Central cord syndrome
Which injury is possible based on the anatomy of the spine? A. Disk injury between thoracic vertebrae 11 and 12 B. Compression fracture to lumbar vertebra 12 C. Fracture to the ninth cervical vertebra D. Dislocation of lumbar vertebra number 6
A. Disk injury between thoracic vertebrae 11 and 12
The medical director for EMS is providing a presentation regarding stabilizing spinal cord injuries. Which information should be included to prevent further trauma to the spinal cord? A. Focus on spinal motion restriction techniques. B. Immobilize the patient with a penetrating injury. C. Stabilize the patient using a long backboard. D. Turn the patient to one side prior to transport.
A. Focus on spinal motion restriction techniques.
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. Half spine board C. Folding stair chair D. Full-body air splints
A. Full vacuum mattress
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 pressure of 24 mmHg C. Blood glucose of 90 mg/dL D. Pulse oximeter of 96% on 2 lpm oxygen
A. GCS score of 12
Spine motion restriction may not be indicated in which of the following? A. Glasgow Coma Scale (GCS) of 15 B. Spinal tenderness C. Language barrier D. Distracting injury
A. Glasgow Coma Scale (GCS) of 15
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. Initiate spine motion restriction precautions B. Look for injuries to the patient's head C. Obtain the patient's vital signs D. Perform the primary assessment
A. Initiate spine motion restriction precautions
What has studying the historical approach to spinal immobilization revealed? A. Numerous patients without spinal injury were immobilized. B. Spinal immobilization is harmless. C. It is possible to completely immobilize the spine. D. Mechanism of injury should be the sole indicator for spinal immobilization.
A. Numerous patients without spinal injury were immobilized.
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. Pelvic area B. Upper back C. Lower back D. Neck
A. Pelvic area
The EMS crew has decided that an unresponsive patient who was involved in an MVC needs to be rapidly extricated. What should the EMS providers do first? A. Provide manual in-line stabilization of the head. B. Place the patient on a backboard. C. Roll the patient out of the open door laterally onto a backboard. D. Apply a properly sized cervical collar.
A. Provide manual in-line stabilization of the head.
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. Quickly but carefully provide full spine motion restriction precautions on scene prior to rapid transport to the hospital B. Rapidly transfer her to the stretcher and secure her to the long board while en route to the hospital C. Wait for family members to arrive and give consent for treatment prior to moving her to the stretcher for immediate transport D. Transfer her to the long board already placed on the stretcher and secure with straps en route to the hospital
A. Quickly but carefully provide full spine motion restriction precautions on scene prior to rapid transport to the hospital
What is a temporary concussion-like insult to the spinal cord that causes effects below the level of the injury? A. Spinal shock B. Neurogenic hypotension C. Brown-Séquard syndrome D. Cord transection
A. Spinal shock
What is NOT considered to be an indication for providing rapid extrication to a patient who was involved in an MVC? A. Suspected high-impact collision speed B. The patient is hypotensive and tachycardic. C. The engine compartment is smoking. D. The patient blocks your access to a second patient in the car who is critically injured.
A. Suspected high-impact collision speed
Which of the following was the original thought behind spinal immobilization? A. The backboard would protect against any further injury. B. It would facilitate increased patient comfort. C. The backboard would provide for rapid extrication. D. It would protect providers from potential litigation.
A. The backboard would protect against any further injury.
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 was the result of penetrating trauma to the head or torso B. The injury resulted from a lateral impact automobile accident C. The patient was ambulatory upon EMS arrival D. The patient was intoxicated at the time of injury
A. The injury was the result of penetrating trauma to the head or torso
Which type of alternative to a long backboard may be used for spine motion restriction? A. Vacuum mattress B. Short backboard C. Traction splint D. Pneumatic antishock garment
A. Vacuum mattress
A patient is ambulatory after a motor vehicle collision. Spinal tenderness is noted during the assessment. After placing a cervical collar, you should next: A. direct the patient to sit on the stretcher. B. direct the patient to sit on the ground. C. place a short backboard behind the patient. D. place a long backboard behind the patient.
A. direct the patient to sit on the stretcher.
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 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." 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. "After I do the primary and secondary assessment, we will need to get the patient onto the stretcher for immediate transport." D. "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."
A. "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."
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."
A. "Let's place a folded towel under his shoulders and back to help maintain head alignment."
In order from top to bottom, how many vertebrae are in each section of the spinal column? A. 7, 12, 5, 5, 4 B. 7, 12, 5, 4, 5 C. 5, 12, 5, 7, 4 D. 5, 12, 7, 5, 4
A. 7, 12, 5, 5, 4
What desired minimal pulse oximeter reading does the EMT want to maintain in a patient with a spinal cord injury? A. 94% or more B. 90% or more C. 96% or more D. 88% or more
A. 94% or more
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. Posterior cord syndrome B. Anterior cord syndrome C. Lateral cord syndrome D. Central cord syndrome
B. Anterior cord syndrome
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. Release manual spine motion restriction precautions B. Apply a properly sized cervical collar after initiating manual spine motion restriction C. Inform the team that spine motion restriction precautions are not needed D. Secure the patient to a backboard without a cervical collar
B. Apply a properly sized cervical collar after initiating manual spine motion restriction
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. Asks the patient to spread his fingers apart on both hands C. Checks for distal pulses in all four extremities D. Palpates the entire spinal column for tenderness
B. Asks the patient to spread his fingers apart on both hands
Which choice best describes what the underlying pathophysiology is in a patient with spinal shock? A. Paralysis to only one side of the body that does not resolve B. Dilation of the blood vessels resulting in reduction of perfusion to tissues C. Inadequate circulation indicated by a rapid pulse and cool, clammy skin D. Paralysis of the respiratory muscles, occurring with injury to the thoracic spine
B. Dilation of the blood vessels resulting in reduction of perfusion to tissues
Which injury that may result in spinal cord damage would you be most likely to encounter while treating a teenager who attempted to hang himself in his garage? A. Lateral bending of the spine B. Distraction injury to the cervical spine C. Rotation injury of the axis D. Rupturing of disks of the cervical vertebrae
B. Distraction injury to the cervical spine
Assuming no evidence of spinal injury, a patient who has suffered which of the following should not be immobilized on a backboard? A. Struck by a baseball bat B. Gunshot wound to the neck C. Struck by a vehicle at high speed D. Fall from 20 feet
B. Gunshot wound to the neck
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. Expose the abdomen to assess the gunshot wound B. Initiate spine motion restriction precautions C. Obtain a pulse rate, respiratory rate, blood pressure, and SpO2 D. Determine the need for airway management
B. 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. Assist him in sitting on the cot B. Instruct him to hold his head in a neutral inline position C. Place a backboard behind the driver, against his spine D. Assess his airway and circulation
B. Instruct him to hold his head in a neutral inline position
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. Laceration to the hand B. Mechanism of injury C. Self-extrication of the patient D. History of back surgery
B. Mechanism of injury
You are assessing distal pulses on a trauma patient. Which pulse should be assessed in the lower extremity? A. Radial B. Pedal C. Femoral D. Carotid
B. Pedal
Choosing to apply full spinal immobilization on a patient with a significant MOI but no sign of spinal column injury will not protect the patient from: A. a herniated disk. B. SCIWORA. C. the formation of scar tissue. D. arthritis.
B. SCIWORA.
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. Internal bleeding B. Spinal shock C. Hemorrhagic shock D. Hypoglycemia
B. Spinal shock
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
B. The mechanism of injury
Which patient should be rapidly extricated from a car after an MVC? A. The patient who is sitting closest to a door if there are multiple patients in the car B. The patient who is unresponsive C. The pediatric patient who is found properly restrained in an infant seat in the vehicle D. The patient who is tachycardic and complaining of neck pain
B. The patient who is unresponsive
A spinal column injury typically and primarily damages which of the following (but as a result may also damage one or more of the other three)? A. Light touch sensation B. The vertebrae C. The spinal cord D. Ambulation
B. The vertebrae
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 rear-ended another car B. The patient's car was struck from the side C. The patient's car was struck from behind D. The patient's car struck a utility pole head-on
B. The patient's car was struck from the side
In which area of the spinal column do the ribs originate? A. Sacral spine B. Thoracic spine C. Cervical spine D. Lumbar spine
B. Thoracic spine
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. SpO2 of 92% B. Warm and dry skin C. Heart rate of 144 beats/min D. Pulse pressure of 24 mmHg
B. Warm and dry skin
The first seven vertebrae are referred to as the A. sacral spine. B. cervical spine. C. thoracic spine. D. lumbar spine.
B. cervical spine.
When immobilizing infants and children, it is important to remember: A. that if you do not have a cervical collar that fits, use one that is slightly larger. B. that if an automobile collision involves a child in a car seat, you cannot use that car seat to stabilize the child for transport. C. that adult-sized backboards and cervical collars can be modified to use with children. D. to pad from the shoulders to the heels of an infant or child to maintain neutral in-line immobilization.
B. that if an automobile collision involves a child in a car seat, you cannot use that car seat to stabilize the child for transport.
Until recently, the indication to provide spinal immobilization was solely based on: A. a patient's complaint. B. the mechanism of injury. C. a thorough assessment. D. obvious injury.
B. the mechanism of injury.
An injury to a hemisection of the spinal cord that disrupts the spinal tracts on only one side of the cord is: A. Posterior cord syndrome B. Brown-Sequard syndrome C. Anterior cord syndrome D. Central cord syndrome
B. Brown-Sequard syndrome
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. Immediately after applying a cervical collar B. During the primary assessment C. As the secondary assessment is performed D. Immediately after taking manual spine motion restriction precautions
C. As the secondary assessment is performed
What is the MOST common cause of spinal injury? A. Falls B. Gunshot wounds C. Automobile accidents D. Sports
C. Automobile accidents
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. Lumbar spine C. Cervical spine D. Thoracic spine
C. Cervical spine
Which of the following is an accurate statement regarding spine motion restriction (SMR)? A. A patient with penetrating neck trauma should routinely receive SRM. B. A patient with penetrating head trauma should routinely receive SRM. C. Decisions to utilize SMR should be based on the assessment. D. SMR should be placed based on mechanism alone.
C. Decisions to utilize SMR should be based on the assessment.
The EMT arrives at a call for a patient who sustained injuries after being ejected from a motorcycle. Which assessment finding indicates the need for spine motion restriction (SMR)? A. Reports absence of spinal pain B. Lack of numbness and tingling C. Glasgow Coma Scale score of 7 D. No evidence of intoxication
C. Glasgow Coma Scale score of 7
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. Does not place the patient on a long board due to the presence of shoulder pads B. Removes the helmet to immediately assess the patient's head C. Leaves the helmet in place but removes the face mask first D. Removes the shoulder pads to apply a cervical collar
C. Leaves the helmet in place but removes the face mask first
Which presentation would MOST likely be consistent with a patient possibly having a spinal injury? A. Male patient found in a tripod position in his garage, complaining of dyspnea B. Elderly female patient found lying in bed wearing pajamas C. Male patient found lying unresponsive under a tree D. Conscious female patient with a history of dropping a bowling ball on her foot
C. Male patient found lying unresponsive under a tree
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. Tetraplegia B. Quadriplegia C. Paraplegia D. Hemiplegia
C. Paraplegia
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. Remove the patient and place him on a long spinal board in the ambulance during rapid transport B. Apply a vest-type immobilization device C. Perform rapid extrication with a cervical collar applied D. Pull the patient from the car and provide spine motion restriction precautions away from the vehicle
C. Perform rapid extrication with a cervical collar applied
Which statement about the care and treatment of a patient with a spinal injury in the prehospital setting is true? A. 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 B. Before transporting the critically injured patient with a spinal injury, the EMT must perform a detailed, head-to-toe neurologic assessment C. Prehospital care for the patient with a spine injury involves spine motion restriction precautions and the identification of life-threatening conditions D. It is important to identify the level of spinal injury so the proper prehospital care can be rendered
C. Prehospital care for the patient with a spine injury involves spine motion restriction precautions and the identification of life-threatening conditions
Which of the following tools is NOT recommended for removing the face mask from a football helmet? A. Pruning shears B. PVC pipe cutter C. Screwdriver D. FM extractor
C. Screwdriver
A neurological deficit is an indicator of which injury? A. A rotational injury B. A neck fracture C. Spinal cord injury D. Spinal column injury
C. Spinal cord injury
As a backup unit on a multiple-car collision, you are assigned to care for an infant who is still in his car seat, locked into the backseat of the car. As you prepare this patient for transport, which statement is MOST accurate? A. The infant can be secured and transported in the car seat if the infant presents without any life threats. B. The infant should be immobilized on the same backboard as a parent to keep the infant calm. C. The infant should be removed from the car seat and immobilized to a backboard. D. The infant should be transported to the hospital via air transport, since infants often deteriorate rapidly.
C. The infant should be removed from the car seat and immobilized to a backboard.
What is the MOST accurate statement about the ability of a patient to breathe when she has suffered a spinal cord injury? A. The patient will be apneic if there is a spinal cord injury. B. The patient will have slow and shallow breathing that will likely be inadequate to sustain life. C. The patient may be able to breathe adequately or inadequately or may not be able to breathe at all. D. The patient will have rapid and shallow breathing, but it will be adequate.
C. The patient may be able to breathe adequately or inadequately or may not be able to breathe at all.
Injury to the sensory and motor tracts located in the anterior portion of the spinal cord is called: A. posterior cord syndrome. B. Brown-Séquard syndrome. C. anterior cord syndrome. D. central cord syndrome.
C. anterior cord syndrome.
Which of these assessments must be done BEFORE the others? A. sensation B. pain C. mental status D. numbness
C. mental status
A 32-year-old male patient has a penetrating injury to the neck. The assessment reveals no indication of spinal injury. You should: A. apply a backboard only. B. initiate full spinal immobilization. C. not place the patient on a backboard. D. utilize a short backboard.
C. not place the patient on a backboard.
An involuntary erection of the penis, caused by a spinal cord injury, is called A. neurologism. B. neurologic hypotension. C. priapism. D. spinal shock.
C. priapism.
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. "Remove the chest strap so the patient can breathe more easily now that his head and legs are secured." B. "Maintain manual cervical spine motion restriction until the patient is on the stretcher." C. "Let's check for extremity PMS before we move the patient to the stretcher." D. "Loosen the collar so you can palpate the back of the neck."
C. "Let's check for extremity PMS before we move the patient to the stretcher."
After an injury to the spinal cord a patient has differing effects on each side of the body. This is known as: A. central cord syndrome. B. anterior cord syndrome. C. Brown-Séquard syndrome. D. posterior cord syndrome.
C. Brown-Séquard syndrome.
A 47-year-old male patient has been involved in motor vehicle collision. He denies symptoms and has no signs of spinal injury. In which of the following situations would spine motion restriction be required? A. Blunt trauma to the head B. Femur fracture C. Penetrating chest injury D. Altered mental status
D. Altered mental status
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. Apply a cervical collar B. Carefully remove the helmet C. Remove the shoulder pads as you prepare to place the patient on a backboard D. Assess the airway and breathing
D. Assess the airway and breathing
Which of the following should be done when applying spine motion restriction to the ambulatory patient? A. Lift the patient onto the stretcher. B. Immediately hold inline stabilization of the patient's neck. C. Apply a head immobilization device. D. Bring the stretcher to the patient.
D. Bring the stretcher to the patient.
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. Distraction B. Rotation C. Penetration D. Compression
D. Compression
A 22-year-old woman dove into the shallow end of the pool and injured her neck. Which of the following spinal injuries is most likely? A. Flexion B. Rotation C. Hyperextension D. Compression
D. Compression
Which form of spinal injury is most common in hangings? A. Rotation B. Lateral bending C. Compression D. Distraction
D. Distraction
Which statement about removing a helmet in the prehospital setting is true? A. Any patient wearing a helmet should have it removed so the airway and breathing can be properly assessed 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. It is acceptable to leave the helmet on a patient if the patient has no airway or breathing problems
D. It is acceptable to leave the helmet on a patient if the patient has no airway or breathing problems
A 24-year-old male patient fell from a roof. He denies neck or back pain. Which of the following would indicate the need for spine motion restriction (SMR)? A. No tenderness upon palpation of the spine B. Glasgow Coma Scale (GCS) of 15 C. Denies the use of drugs D. Open femur fracture
D. Open femur fracture
When performing the secondary assessment, which sign is most suggestive of a spinal cord injury? A. Headache and nausea B. Pain in the right leg C. Bruising on the back D. Persistent penile erection
D. 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. Check for the presence and strength of a pedal pulse B. Since the patient is unresponsive, this assessment would be impossible C. Lift his leg and look for a facial grimace D. Pinch his foot and look for movement on the leg
D. Pinch his foot and look for movement on the leg
A trauma patient is unable to push down with his feet. This may indicate damage in the area of: A. T2. B. C4. C. L5. D. S1.
D. S1.
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. Release manual cervical spine motion restriction C. Apply a properly sized cervical collar D. Secure the patient's torso with straps
D. Secure the patient's torso with straps
How many vertebrae form the cervical spine? A. Eight B. Five C. Six D. Seven
D. Seven
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 swallow B. Inability to move facial muscles C. Trouble remembering his name D. Slowing of the heart rate
D. Slowing of the heart rate
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. Carefully straighten the head and neck so that a cervical collar can be placed B. Avoid palpation of the cervical spine and apply a short vest-type device C. Straighten his neck, and position the patient on his left side on a long spinal board D. Stabilize and maintain the head in the position in which the patient is holding it
D. Stabilize and maintain the head in the position in which the patient is holding it
Which statement shows that the EMTs are correctly using a vest-type device while removing a patient from an entrapped vehicle location? A. The head is secured first, followed by the torso and legs B. The head is secured to the device immediately after the cervical collar is placed C. The cervical collar is applied after the torso and legs have been secured to the device D. The head is secured to the device after the torso has been secured
D. The head is secured to the device after the torso has been secured
When should the EMT remove the helmet of an injured patient? A. The helmet is a sports-type helmet. B. The helmet does not have a chin strap. C. The patient presents with significant neck and back pain. D. The helmet interferes with your ability to assess the airway.
D. The helmet interferes with your ability to assess the airway.
You determine that an ambulatory patient requires spine motion restriction. You should first: A. place a cervical collar on the patient. B. direct the patient to sit on the stretcher. C. place a backboard behind the patient. D. instruct the patient to maintain self-restriction.
D. instruct the patient to maintain self-restriction.
When performing spine motion restriction, the patient should be: A. strapped down. B. placed in Trendelenburg position. C. laid supine. D. made comfortable.
D. made comfortable.
You are in the process of applying spine motion restriction to a patient who was ambulatory upon your arrival. After the patient lies down on the stretcher, you should: A. place rolled towels around the head. B. place a single piece of tape across the cervical collar. C. secure the patient's head with tape. D. secure the patient to the stretcher.
D. secure the patient to the stretcher.
The application of spine motion restriction usually requires securing the patient to a(n) A. extrication device. B. short backboard. C. long backboard. D. stretcher.
D. stretcher.
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 am going to feel for a pulse in your wrist." D. "I need you to flex both arms across your chest."
D. "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. "Let's log roll the patient to one side so I can apply the cervical collar." B. "Carefully flex his head forward a little so I can pass the collar underneath his neck." C. "I need you to extend the patient's chin backward a little so I can fit the collar under his chin." D. "Keep his head in neutral position while I apply the cervical collar."
D. "Keep his head in neutral position while I apply the cervical collar."
The vertebrae are divided into five areas. From top to bottom, these areas are: A. thoracic, lumbar, sacral, cervical, and coccygeal. B. cervical, lumbar, thoracic, coccygeal, and sacral. C. coccygeal, sacral, lumbar, thoracic, and cervical. D. cervical, thoracic, lumbar, sacral, and coccygeal.
D. cervical, thoracic, lumbar, sacral, and coccygeal.