chapter 26

The MOST reliable sign of a head injury is:

a decreased level of consciousness.

An epidural hematoma is MOST accurately defined as:

bleeding between the skull and dura mater.

The _________ contain(s) about 75% of the brain's total volume.

cerebrum

Which of the following nerves carry information from the body to the brain via the spinal cord?

sensory

Moderate elevation in intracranial pressure with middle brain stem involvement is characterized by:

sluggishly reactive pupils, widened pulse pressure, bradycardia, and posturing.

What part of the nervous system controls the body's voluntary activities?

somatic

Common signs of a skull fracture include all of the following, EXCEPT:

superficial scalp lacerations.

A short backboard or vest-style immobilization device is indicated for patients who:

are in a sitting position and are clinically stable.

The _________ nervous system consists of 31 pairs of spinal nerves and 12 pairs of cranial nerves.

peripheral

Which of the following statements regarding motor nerves is correct?

They carry information from the CNS to the muscles.

Following a head injury, a 20-year-old female opens her eyes spontaneously, is confused, and obeys your commands to move her extremities. You should assign her a GCS score of:

14

A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response?

3

The cervical spine is composed of _____ vertebrae.

7

Which of the following statements regarding cervical collars is correct?

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

If you do not have the appropriate size cervical collar, you should:

use rolled towels to immobilize the patient's head.

In contrast to a cerebral concussion, a cerebral contusion:

involves physical injury to the brain tissue.

Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless:

it causes a problem managing the ABCs.

When immobilizing a trauma patient's spine, the EMT manually stabilizing the head should not let go until:

the patient has been completely secured to the backboard.

Which of the following statements regarding the cranium is correct?

Eighty percent of the cranium is occupied by brain tissue.

Which of the following statements regarding secondary brain injury is correct?

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

Which of the following statements regarding a basilar skull fracture is correct?

The absence of raccoon eyes or Battle's sign does not rule it out.

The _________ is the best-protected part of the CNS and controls the functions of the cardiac and respiratory systems.

brain stem

Coordination of balance and body movement is controlled by the:

cerebellum.

A temporary loss or alteration of part or all of the brain's abilities to function without physical damage to the brain MOST accurately describes a(n):

cerebral concussion.

The MOST common and serious complication of a significant head injury is:

cerebral edema.

The five sections of the spinal column, in descending order, are the:

cervical, thoracic, lumbar, sacral, and coccygeal.

The ideal procedure for moving an injured patient from the ground to a backboard is:

the four-person log roll.

When the parasympathetic nervous system is activated:

the heart rate decreases and the blood vessels dilate.

Bleeding within the brain tissue itself is called a(n):

intracerebral hematoma.

The central nervous system (CNS) is composed of the:

brain and spinal cord.

An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is:

a rapid deterioration of neurologic signs.

A reflex arc occurs when:

a sensory nerve detects an irritating stimulus and bypasses the brain by sending a direct message to the motor nerve.

The meninges, along with the cerebrospinal fluid (CSF) that circulates in between each meningeal layer, function by:

acting as a shock absorber for the brain and spinal cord.

When immobilizing a seated patient with a short backboard or vest-style immobilization device, you should apply a cervical collar:

after assessing distal neurovascular functions.

Any unresponsive trauma patient should be assumed to have:

an accompanying spinal injury.

After your partner assumes manual in-line stabilization of the patient's head, you should:

assess distal neurovascular status in the extremities.

A female patient with a suspected spinal injury is breathing with a marked reduction in tidal volume. The MOST appropriate airway management for her includes:

assisting ventilations at an age-appropriate rate.

The body's functions that occur without conscious effort are regulated by the _________ nervous system.

autonomic

When controlling bleeding from a scalp laceration with a suspected underlying skull fracture, you should:

avoid excessive pressure when applying the bandage.

Which of the following sets of vital signs depicts Cushing's triad?

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

The frontal and parietal bones of the skull are especially susceptible to:

compressed skull fractures.

Rapid deceleration of the head, such as when it impacts the windshield, causes:

compression injuries or bruising to the anterior portion of the brain and stretching or tearing to the posterior portion of the brain.

Which of the following nerves allow sensory and motor impulses to be sent from one nerve directly to another?

connecting

Common signs and symptoms of a serious head injury include all of the following, EXCEPT:

constricted pupils.

When assessing a conscious patient with an MOI that suggests spinal injury, you should:

determine if the strength in all extremities is equal.

The tough, fibrous outer meningeal layer is called the:

dura mater.

When immobilizing a patient on a long backboard, you should:

ensure that you secure the torso before securing the head.

Which of the following head injuries would cause the patient's condition to deteriorate MOST rapidly?

epidural hematoma

The hormone responsible for the actions of the sympathetic nervous system is:

epinephrine.

The MOST important treatment for patients with a head injury, regardless of severity, is to:

establish an adequate airway.

The Glasgow Coma Scale (GCS) is used to assess:

eye opening, verbal response, and motor response.

It would be MOST appropriate to perform a focused secondary assessment on a patient who:

fainted and fell to the ground from a standing position.

When placing a patient onto a long backboard, the EMT at the patient's _________ is in charge of all patient movements.

head

The effectiveness of positive-pressure ventilations when treating a head-injured patient can ONLY be determined by:

immediate reassessment following the intervention.

A 45-year-old male was working on his roof when he fell approximately 12′,landing on his feet. He is conscious and alert and complains of an ache in his lower back. He is breathing adequately and has stable vital signs. You should:

immobilize his spine and perform a focused secondary exam.

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:

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:

jaw-thrust maneuver.

When caring for a patient with a possible head injury, it is MOST important to monitor the patient's:

level of consciousness.

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

linear

Lacerations to the scalp:

may be an indicator of deeper, more serious injuries.

When a patient experiences a severe spinal injury, he or she:

may lose sensation below the level of the injury.

When immobilizing a child on a long backboard, you should:

place padding under the child's shoulders as needed.

When activated, the sympathetic nervous system produces all of the following effects, EXCEPT:

pupillary constriction.

A patient who cannot remember the events that preceded his or her head injury is experiencing:

retrograde amnesia.

When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear. This indicates:

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

The spinal cord is encased in and protected by the:

spinal canal.

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:

suction his oropharynx for up to 15 seconds.