Chapter 28 - Head & Spine Injuries

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

A. A rapid, thready pulse.

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

A. Pupillary constriction.

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

A. a rapid deterioration of neurologic signs

You respond to a 38-year-old man who fell while rock climbing. He is unconscious with an open airway. The respiration and pulse rates are within normal limits. His distal pulses are intact. You check his pupils and find that they are unequal. You know this could be a sign of: Select one: A. increased intracranial pressure. B. hypoxia. C. seizure activity. D. chronic hypertension.

A. increased intracranial pressure.

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

A. it interferes with your assessment of the airway.

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

A. slow.

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

B. 3

Which of the following breathing patterns is MOST indicative of increased intracranial pressure? Select one: A. Increased rate with a normal inspiratory time and a prolonged expiratory time B. Irregular rate, pattern, and volume of breathing with intermittent periods of apnea C. Increased rate and depth with the distinct odor of acetone on the patient's breath 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: Select one: A. distraction. B. axial loading. C. hyperextension. D. hyperflexion.

B. axial loading.

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

B. brain and spinal cord.

The nervous system is divided into the central nervous system and the: Select one: A. autonomic nervous system. B. peripheral nervous system. C. sympathetic nervous system. D. somatic nervous system.

B. peripheral nervous system.

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

B. suction his oropharynx for up to 15 seconds.

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

B. the four-person log roll.

In supine patients with a head injury, the head should be elevated _____ to help reduce intracranial pressure. Select one: A. 10 degrees B. 20 degrees C. 30 degrees D. 40 degrees

C. 30 degrees

Which of the following statements regarding secondary brain injury is correct? Select one: A. It results from direct brain trauma following 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. Signs are often present immediately after an impact to the head.

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

Which of the following is NOT a symptom of a concussion? Select one: A. Dizziness B. Weakness C. Muscle tremors D. Visual changes

C. Muscle tremors

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

C. Somatic

Injury to the head and neck may indicate injury to the: Select one: A. thoracic spine. B. lumbar spine. C. cervical spine. D. sacral spine.

C. cervical spine.

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

C. hangings

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

C. 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: Select one: A. the patient adamantly denies neck pain. B. lateral immobilization has been applied. C. it causes a problem managing the airway. D. sensory and motor functions remain intact.

C. it causes a problem managing the airway.

Helmets must be removed in all of the following cases, EXCEPT: Select one: A. when cardiac arrest is involved. B. when the helmet allows for excessive movement. C. when there are no impending airway or breathing problems. D. when a shield cannot be removed for access to the airway.

C. when there are no impending airway or breathing problems.

Neck rigidity, bloody cerebrospinal fluid, and headache are associated with what kind of bleeding in the brain? Select one: A. Epidural hematoma B. Subdural hematoma C. Intracerebral hematoma D. Subarachnoid hemorrhage

D. Subarachnoid hemorrhage

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

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

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

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

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

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