West Coast EMT Chapter 28 -- Head and Spine Injuries, West Coast EMT Chapter 27 -- Face and Neck Injuries

Which of the following statements regarding the vitreous humor is correct? Select one: A. It is a clear, jellylike fluid near the back of the eye that cannot be replaced if it is lost. B. It is a clear fluid that is produced by the lacrimal glands and cannot be replaced if it is lost. C. It is a clear, watery fluid that is located in front of the lens and can be replaced if it is lost. D. It is a clear, watery fluid surrounding the eye and can be replaced if it is lost.

A. It is a clear, jellylike fluid near the back of the eye that cannot be replaced if it is lost.

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

A. Somatic

Following blunt trauma to the face, a 21-year-old male complains of a severe headache and decreased ability to move his eyes. This patient's clinical presentation is MOST consistent with: Select one: A. a blowout fracture. B. optic vessel compression. C. a lacerated globe. D. a ruptured eyeball.

A. a blowout fracture.

Bleeding from soft-tissue injuries to the face is MOST effectively controlled with: Select one: A. direct pressure using dry, sterile dressings. B. digital pressure to an adjacent pulse point. C. ice packs and elevation of the patient's head. D. pressure dressings and chemical ice packs.

A. direct pressure using dry, sterile dressings.

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

A. involves physical injury to the brain tissue.

When a light is shone into the pupil: Select one: A. it should become smaller in size. B. both pupils should dilate together. C. it should become larger in size. D. the opposite pupil should dilate.

A. it should become smaller in size.

The superficial temporal artery can be palpated: Select one: A. just anterior to the tragus. B. slightly above the ear. C. at the angle of the jaw. D. over the mastoid process.

A. just anterior to the tragus.

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

A. pupillary constriction.

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. rupture of the tympanic membrane following diffuse impact to the head. B. fractures to the internal structures of the ear following direct trauma. C. a linear skull fracture and a significant increase in intracranial pressure. D. significant pressure and bleeding in between the skull and dura mater.

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

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

A. the four-person log roll.

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

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

When caring for a patient with an open facial injury, the EMT's immediate priority should be to: Select one: A. wear gloves and facial protection. B. consider the mechanism of injury. C. manually stabilize the patient's head. D. closely assess the patient's airway.

A. wear gloves and facial protection.

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. 5 B. 3 C. 2 D. 4

B. 3

Which of the following statements regarding secondary brain injury is correct? Select one: A. Because cerebral edema develops quickly, it is considered to be a primary brain injury. B. Hypoxia and hypotension are the two most common causes of secondary brain injury. C. Signs are often present immediately after an impact to the head. D. It results from direct brain trauma following an impact to the head.

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

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

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

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

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

B. hangings.

Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless: Select one: A. sensory and motor functions remain intact. B. it causes a problem managing the airway. C. lateral immobilization has been applied. D. the patient adamantly denies neck pain.

B. it causes a problem managing the airway.

Significant trauma to the face should increase the EMT's index of suspicion for a(n): Select one: A. displaced mandible. B. spinal column injury. C. airway obstruction. D. basilar skull fracture.

B. spinal column injury.

The Adam's apple is: Select one: A. the lower part of the larynx that is formed by the cricoid cartilage. B. the upper part of the larynx that is formed by the thyroid cartilage. C. below the thyroid cartilage and forms the upper part of the trachea. D. the small indentation in between the thyroid and cricoid cartilages.

B. the upper part of the larynx that is formed by the thyroid cartilage.

If your patient swallows blood following facial trauma, there is an increased risk of ________. Select one: A. altered LOC B. vomiting C. hypotension D. GI trauma

B. vomiting

When performing a full body scan, you should assess for ________. Select one: A. SAMPLE B. OPQRST C. DCAP-BTLS D. AVPU

C. DCAP-BTLS

Which of the following statements regarding anterior nosebleeds is correct? Select one: A. They are usually caused by a fracture of the basilar skull. B. They are usually severe and require aggressive treatment to control. C. They usually originate from the septum area and bleed slowly. D. They cause blood to drain into the posterior pharynx.

C. They usually originate from the septum area and bleed slowly.

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

C. a rapid deterioration of neurologic signs.

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

C. a rapid, thready pulse.

The MOST significant complication associated with facial injuries is: Select one: A. damage to the eyes. B. cervical spine injury. C. airway compromise. D. mandibular immobility.

C. airway compromise.

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. hyperflexion. C. axial loading. D. hyperextension.

C. axial loading.

A 30-year-old female presents with redness, inflammation, and pain to her left eye. During your assessment, you note that she is having difficulty keeping her eyes open. You should suspect that she is experiencing: Select one: A. acute retinitis. B. a detached retina. C. conjunctivitis. D. a corneal abrasion.

C. conjunctivitis.

A 52-year-old unrestrained female struck the steering wheel with her face when her truck collided with another vehicle. She has obvious swelling to her face and several dislodged teeth. A visual exam of her mouth reveals minimal bleeding. She is conscious and alert with a blood pressure of 130/80 mm Hg, a pulse of 110 beats/min, and respirations of 22 breaths/min with adequate tidal volume. You should: Select one: A. assist ventilations with a BVM device, immobilize her spine, suction her oropharynx for 30 seconds, and transport. B. apply oxygen via a nonrebreathing mask, suction her airway as needed, disregard the dislodged teeth, and transport. C. fully immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport. D. fully immobilize her spine, irrigate her empty tooth sockets, attempt to locate the dislodged teeth, and transport.

C. fully immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport.

You are assessing a 59-year-old male and note that his pupils are unequal. He is conscious and alert. When obtaining his medical history, it is MOST pertinent to ask him if he: Select one: A. noticed the change during a meal. B. regularly sees a family physician. C. has a history of eye surgeries. D. is allergic to any medications.

C. has a history of eye surgeries.

A factory worker was splashed in the eyes with a strong acid chemical. He complains of intense pain and blurred vision. Your ambulance does not carry bottles of sterile saline or water. You should: Select one: A. neutralize the acid chemical in his eye with an alkaline chemical. B. mix baking soda with water and irrigate his eyes with the solution. C. irrigate both eyes continuously for 20 minutes with plain water. D. flush both eyes with an alcohol-based solution and transport.

C. irrigate both eyes continuously for 20 minutes with plain water.

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

C. it interferes with your assessment of the airway.

A 6-year-old female was riding her bicycle and struck a clothesline with her throat. She is breathing, but with obvious difficulty. Your assessment reveals a crackling sensation in the soft tissues of her neck and facial cyanosis. In addition to the appropriate airway management, the intervention that will MOST likely improve her chance of survival is: Select one: A. requesting a paramedic ambulance. B. careful monitoring her vital signs. C. rapidly transporting her to the hospital. D. quickly immobilizing her spinal column.

C. rapidly transporting her to the hospital.

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. pack his nostrils to stop the drainage of blood. C. suction his oropharynx for up to 15 seconds. D. immobilize his spine and transport immediately.

C. suction his oropharynx for up to 15 seconds.

When transporting a patient with a facial injury, it is MOST important to be as descriptive as possible with the hospital regarding the patient's injuries because: Select one: A. most patients with facial trauma will need surgery. B. it saves time on repeat assessments at the hospital. C. they may need to call a specialist to see the patient. D. they must make arrangements for an ICU bed.

C. they may need to call a specialist to see the patient.

The five sections of the spinal column, in descending order, are the: Select one: A. thoracic, cervical, lumbar, coccygeal, and sacral. B. cervical, coccygeal, thoracic, sacral, and lumbar. C. coccygeal, sacral, lumbar, thoracic, and cervical. D. cervical, thoracic, lumbar, sacral, and coccygeal.

D. cervical, thoracic, lumbar, sacral, and coccygeal.

The upper jawbones are called the: Select one: A. mastoid. B. mandible. C. zygoma. D. maxillae.

D. maxillae.

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

D. slow.

A 4-year-old female has a peanut lodged in the external auditory canal of her right ear. You should: Select one: A. thoroughly flush her ear with sterile saline. B. use tweezers to try to remove the object. C. remove the peanut with a cotton-tipped swab. D. transport her to the emergency department.

D. transport her to the emergency department.