Chapter 34 Head/Spine Homework / Quiz

If signs of brain herniation are present, the paramedic should maintain an ETCO2 of:

30 to 35 mm Hg.

The paramedic should not cover a head-injured patient with a blanket if the ambient temperature is ___ degrees Fahrenheit or higher.

70

A male patient with a closed head injury opens his eyes in response to pain, makes incomprehensible sounds, and responds to pain with flexion of his arms. His Glasgow Coma Scale score is ___, and the MOST appropriate treatment for him involves:

7; intubation, ventilation performed at a rate of 12 breaths/min, IV fluids as needed to maintain s systolic blood pressure of at least 90 mm Hg, and maintaining his oxygen saturation at greater than 90%.

Which of the following signs of a basilar fracture would MOST likely be observed in the prehospital setting?

Cerebrospinal fluid drainage from the ear

Which of the following signs of basilar skull fracture would MOST likely be observed in the prehospital setting?

Cerebrospinal fluid drainage from the ear

Which of the following statments regarding a cerebral concussion is correct?

Concussions are usually not associated with structural brain injury.

The parietal lobe of the brain:

Controls the body's ability to perceive body limb movement.

Which of the following statements regarding the hangman's fracture is correct?

It is a fracture of C2 that is secondary to significant distraction of the neck.

When assessing the severity of a traumatic brain injury, the MOST important assessment parameter is the patient's:

Level of consciousness.

A patient with a possible spinal injury is acutely agitated. What type of medication, if any, should he or she receive after hypoxia has been ruled out?

Short-acting, reversible sedative

Proprioception defined as:

The ability to perceive the position and movement of one's body or limbs.

cerebrospinal fluid drainage from the ears is MOST indicative of:

a skull fracture.

Autoregulation is defined as:

an increase in mean arterial pressure to maintain cerebral blood flow.

The dura mater:

folds in to form the tentorium, a structure that separates the cerebral hemispheres from the cerebellum and brainstem.

A spinal cord concussion is:

caused by a short-duration shock or pressure wave within the cord

Paralysis of the extremities would MOST likely result from injury to the:

cerebral cortex.

The phrenic nerve arises from the ___ plexus and innervates the ___.

cervical, diaphragm

Patients with evidence of trauma above the ___ should be considered at risk for an associated spine injury.

clavicles

The main disadvantage of using a scoop stretcher to transfer a patient to a long backboard is:

inability to conduct a visual exam of the back for injuries.

The cerebellum is located in the ___ part of the brain and is responsible for ____.

inferoposterior, posture and equilibrium

You would MOST likely have to place several blankets or pillows under a patient's upper back prior to immobilization if he or she has:

kyphosis

When an unrestrained passenger's head strikes the windshield of a motor vehicle following rapid deceleration

compression injuries occur in the anterior portion of the brain, and stretchering or tearing injuries occur in the posterior portion of the brain.

Prehospital treatment of the patient with a traumatic brain injury must focus primarily on:

maintaining cerebral perfusion pressure.

A 45-year-old unrestrained man was ejected from his small truck when it struck a tree. The patient is found approximately 20 feet from the wreckage. Your primary assessment reveals that he is unresponsive and has sonorous respirations and a rapid pulse. Your initial actions should include:

manually stabilizing his head and opening his airway with a jaw-thrust maneuver.

The MOST effective method for decreasing morbidity and morality associated with spinal cord injury is:

public education and prevention strategies.

Flexion injuries to the spine would MOST likely result from:

rapid deceleration forces.

Common clinical findings associated with a subdural hematoma include all of the following, EXCEPT:

rapidly increasing intracranial pressure.

A motorcycle or football helmet should be removed if:

the patient is breathing shallowly and access to the airway is difficult.

A positive Babinski reflex is observed when the:

toes move upward in response to stimulation of the sole of the foot.

Death following a head injury is MOST often the result of:

trauma to the brain.

Beta receptor stimulation results in all of the following effects, EXCEPT:

vascular smooth muscle contraction.

The anterior weight-bearing structure of the vertebra is the:

vertebral body

A complete spinal cord injury to the upper cervical spine:

will result in permanent loss of all cord-mediated functions below the level of the injury.

A subdural hematoma is classified as acute clinical signs and symptoms develop:

within 48 hours following the injury.

An epidural hematoma typically causes rapid deterioration in the head-injured patient's condition because:

it is associated with brisk arterial bleeding.

The innermost meningeal layer that rests on the brain and spinal cord is the:

pia mater.

Which of the following statement regarding central cord syndrome is correct?

The patient typically presents with greater loss of function in the upper extremities than in the lower extremities.

The MOST disastrous consequence of severe traumatic brain injury is:

a decreased in cerebral perfusion pressure.

Open fracture of the cranial vault:

are associated with high risk of bacterial meningitis.

Unlike a cerebral concussion, a cerebral contusion is:

associated with physical brain damage and more pronounced neurologic deficits.

A 39-year-old man crashed his vehicle into a wooded area and was not found for approximately 8 hours. When you arrive at the scene and assess him, you note that he is conscious but anxious. He is unable to feel or move below his mid-thoracic area and complains of a severe headache. His blood pressure is 210/130mm Hg, heart rate 44 beats/min, and respiratory are 22 breaths/min. This patient's clinical presentation is MOST consistent with:

autonomic dysreflexia.

The ___ is the largest component of the the central nervous system and contains billions of neurons that serve a variety of functions.

brain

The ___ consists of eight bones that encase and protect the brain.

cranial vault

Signs of neurogenic shock include all of the following, EXCEPT:

diaphoresis.

Horner syndrome is identified when a patient with a spinal injury:

has drooping upper eyelid and small pupil.

Chronic subdural hematoma are most commonly seen in patients who:

have alcoholism.

Early signs and symptoms of increased intracranial pressure include:

headache and vomiting.

A skier wiped out while skiing down a large hill. He is conscious and alert and complains of being very cold; he also complains of neck stiffness and numbness and tingling in all of his extremities. A quick assessment reveals that his airway is patent and his breathing is adequate. You should:

immobilize his spine and quickly move him to a warmer environment.

A 19-year-old woman fell from a second-story window and landed on her head. She is unconscious with a blood pressure of 168/104 mm Hg, heart rate of 56 beats/min, and irregular respirations of 8 breaths/min. Further assessment reveals blood draining from her nose and bilaterally dilated pupils that are slow to react. In addition to employing full spinal precautions, the MOST appropriate treatment for this patient involves:

intubating her trachea after preoxygenation her 2 to 3 minutes with a bag-mask device, transporting immediately, starting at least one large-bore IV enroute, applying a cardiac monitor, and performing frequent neurologic assessments.

A diffuse axonal injury:

involves stretching, shearing, or tearing of the extension of the neuron that conducts electrical impulses away from the cell body.

A scalp laceration that occurs in conjunction with a nondisplaced skull fracture:

is considered to be an open skull fracture.

Spinal shock is a condition that:

is usually temporary and results from swelling of the spinal cord.

Bleeding from a scalp laceration with an underlying skull deformity:

may contribute to hypovolemia in adults.

You are dispatched to a senior citizen's center where an elderly woman fainted. When you arrive, you find the patient sitting in a chair. An employee of the center tells you that he caught the patient before she fell to the ground. Your primary assessment reveals that the patient is conscious and alert is breathing adequately. You shoud:

obtain vital signs and assess her blood glucose level.

A subluxation is defined as:

partial or incomplete dislocation.

Hyperventilation of the brain-injured patient:

shunts oxygen away from the brain and may result in decreased cerebral perfusion pressure.

A compression or burst fracture of the cervical spine would MOST likely occur following:

significant fall in which the patient lands head first.

The MOST effective way for the paramedic to minimize further injury in a patient with a spinal injury is:

spinal motion restriction and prevention of heat loss.

Following a traumatic injury, a 19-year-old woman presents with confusion, tachycardia, and hypotension. Her skin is cool, clammy, and pale. Further assessment reveals abdominal rigidity and deformity with severe pain over her thoracic vertebrae. In addition to administering high-flow oxygen and immobilizing her spine, you should:

start at least one large-bore IV line and give crystalloid boluses as needed to maintain adequate perfusion.

Nuchal rigidity is MOST commonly seen in patients with a(n):

subarachnoid hemorrhage.