EMT - Chapter 26: Head and Spine Injuries - Questions (MFD)
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: a) ventilation assistance to maintain an oxygen saturation of 90%. b) administering oxygen via a nonrebreathing mask. c) assisting ventilations at an age-appropriate rate. d) hyperventilating her at 30 breaths/min.
assisting ventilations at an age-appropriate rate.
Which of the following statements regarding the cranium is correct? a) The skull is a subdivision of the cranium. b) Eighty percent of the cranium is occupied by brain tissue. c) Thirty percent of the cranium is occupied by blood. d) The cranium protects the structures of the face.
Eighty percent of the cranium is occupied by brain tissue.
Which of the following statements regarding secondary brain injury is correct? a) Hypoxia and hypotension are the two most common causes of secondary brain injury. b) Because cerebral edema develops quickly, it is considered to be a primary brain injury. c) It results from direct brain trauma following an impact to the head. d) Signs are often present immediately after an impact to the head.
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? a) Bloody CSF commonly leaks from the nose. b) In most cases, mastoid bruising occurs. c) They are typically the result of local, low-energy trauma to the head. d) The absence of raccoon eyes or Battle's sign does not rule it out.
The absence of raccoon eyes or Battle's sign does not rule it out.
Which of the following statements regarding motor nerves is correct? a) They perform special functions such as sight, smell, and hearing. b) They are part of the CNS and control reflexes. c) They transmit information from the body to the brain via the spinal cord. d) They carry information from the CNS to the muscles.
They carry information from the CNS to the muscles.
An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is: a) an acute increase in the patient's pulse rate. b) acute unilateral paralysis following the injury. c) a progressively lowering blood pressure. d) a rapid deterioration of neurologic signs.
a rapid deterioration of neurologic signs.
The meninges, along with the cerebrospinal fluid (CSF) that circulates in between each meningeal layer, function by: a) acting as a shock absorber for the brain and spinal cord. b) delivering oxygen directly to the CNS. c) regenerating brain cells after they have been damaged. d) producing leukocytes that protect the brain from infection.
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: a) after the torso has been adequately secured. b) after assessing distal neurovascular functions. c) before manually stabilizing the patient's head. d) after moving the patient to a long backboard.
after assessing distal neurovascular functions.
Any unresponsive trauma patient should be assumed to have: a) an accompanying spinal injury. b) a history of diabetes mellitus. c) a severe intracranial hemorrhage. d) internal bleeding in the abdomen.
an accompanying spinal injury.
A short backboard or vest-style immobilization device is indicated for patients who: a) are in a sitting position and are clinically stable. b) are found supine and have stable vital signs. c) require prompt extrication from an automobile. d) are sitting in their car and are clinically unstable.
are in a sitting position and are clinically stable.
When controlling bleeding from a scalp laceration with a suspected underlying skull fracture, you should: a) elevate the patient's head and apply an ice pack. b) avoid excessive pressure when applying the bandage. c) apply firm compression for no longer than 5 minutes. d) apply manual pressure and avoid applying a bandage.
avoid excessive pressure when applying the bandage.
An epidural hematoma is MOST accurately defined as: a) venous lacerations that occur within the brain. b) bleeding between the dura mater and brain c) an injury caused by a damaged cerebral artery. d) bleeding between the skull and dura mater.
bleeding between the skull and dura mater.
Which of the following sets of vital signs depicts Cushing's triad? a) blood pressure, 200/100 mm Hg; pulse, 140 beats/min; respirations, 28 breaths/min b) blood pressure, 90/50 mm Hg; pulse, 120 beats/min; respirations, 10 breaths/min c) blood pressure, 190/110 mm Hg; pulse, 55 beats/min; respirations, 30 breaths/min d) blood pressure, 80/40 mm Hg; pulse, 30 beats/min; respirations, 32 breaths/min
blood pressure, 190/110 mm Hg; pulse, 55 beats/min; respirations, 30 breaths/min
The central nervous system (CNS) is composed of the: a) cerebellum and brain. b) meninges and spinal cord. c) cerebrum and meninges. d) brain and spinal cord.
brain and spinal cord.
The _________ is the best-protected part of the CNS and controls the functions of the cardiac and respiratory systems. a) brain stem b) cerebral cortex c) spinal cord d) cerebellum
brain stem
The MOST common and serious complication of a significant head injury is: a) a hypoxic seizure. b) cerebral edema. c) a skull fracture. d) acute hypotension.
cerebral edema.
The five sections of the spinal column, in descending order, are the: a) cervical, thoracic, lumbar, sacral, and coccygeal. b) thoracic, cervical, lumbar, coccygeal, and sacral. c) cervical, coccygeal, thoracic, sacral, and lumbar. d) coccygeal, sacral, lumbar, thoracic, and cervical.
cervical, thoracic, lumbar, sacral, and coccygeal.
Rapid deceleration of the head, such as when it impacts the windshield, causes: a) primary impact to the posterior aspect of the brain, resulting in compression injuries, bruising, or torn blood vessels. b) stretching or tearing of the anterior aspect of the brain and compression injuries or bruising to the posterior aspect of the brain. c) compression injuries or bruising to the anterior portion of the brain and stretching or tearing to the posterior portion of the brain. d) compression injuries and contusions to the anterior, posterior, and lateral aspects of the brain.
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? a) somatic b) connecting c) peripheral d) autonomic
connecting
The tough, fibrous outer meningeal layer is called the: a) dura mater. b) arachnoid. c) pia mater. d) gray mater.
dura mater.
The hormone responsible for the actions of the sympathetic nervous system is: a) epinephrine. b) thyroxine. c) aldosterone. d) insulin.
epinephrine.
The Glasgow Coma Scale (GCS) is used to assess: a) eye opening, verbal response, and motor response. b) verbal response, eye opening, and mental status. c) sensory response, pupil reaction, and heart rate. d) mental status, eye opening, and respiratory rate.
eye opening, verbal response, and motor response.
Distraction injuries of the spine are MOST commonly the result of: a) hangings. b) falls. c) compression. d) diving.
hangings.
When placing a patient onto a long backboard, the EMT at the patient's _________ is in charge of all patient movements. a) lower extremities b) chest c) waist d) head
head
The effectiveness of positive-pressure ventilations when treating a head-injured patient can ONLY be determined by: a) reassessing the patient's blood pressure after at least 10 minutes. b) immediate reassessment following the intervention. c) noting a decrease in the heart rate during ventilations. d) a neurosurgeon or emergency department physician.
immediate reassessment following the intervention.
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: a) perform a focused secondary assessment of the patient's head and neck. b) immediately place her on a long backboard and prepare for rapid transport. c) apply 100% oxygen via a nonrebreathing mask and obtain baseline vital signs. d) instruct him to assist her ventilations while you perform a rapid assessment.
instruct him to assist her ventilations while you perform a rapid assessment.
Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless: a) lateral immobilization has been applied. b) the patient adamantly denies neck pain. c) sensory and motor functions remain intact. d) it causes a problem managing the ABCs.
it causes a problem managing the ABCs.
A tight-fitting motorcycle helmet should be left in place unless: a) the patient complains of severe neck or back pain. b) it interferes with your assessment of the airway. c) the helmet is equipped with a full face shield or visor. d) the patient must be placed onto a long backboard.
it interferes with your assessment of the airway.
Lacerations to the scalp: a) are most commonly associated with skull fractures. b) bleed minimally because the scalp has few vessels. c) uncommonly cause hypovolemic shock in children. d) may be an indicator of deeper, more serious injuries.
may be an indicator of deeper, more serious injuries.
When a patient experiences a severe spinal injury, he or she: a) often loses motor function on one side of the body. b) most commonly has a palpable spinal deformity. c) may lose sensation below the level of the injury. d) will likely be paralyzed from the neck down.
may lose sensation below the level of the injury.
The _________ nervous system consists of 31 pairs of spinal nerves and 12 pairs of cranial nerves. a) autonomic b) central c) peripheral d) somatic
peripheral
When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear. This indicates: a) fractures to the internal structures of the ear following direct trauma. b) rupture of the tympanic membrane following diffuse impact to the head. c) a linear skull fracture and a significant increase in intracranial pressure. d) significant pressure and bleeding in between the skull and dura mater.
rupture of the tympanic membrane following diffuse impact to the head.
When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear. This indicates: a) significant pressure and bleeding in between the skull and dura mater. b) rupture of the tympanic membrane following diffuse impact to the head. c) fractures to the internal structures of the ear following direct trauma. d) a linear skull fracture and a significant increase in intracranial pressure.
rupture of the tympanic membrane following diffuse impact to the head.
Moderate elevation in intracranial pressure with middle brain stem involvement is characterized by: a) ataxic respirations, unequal pupils, no response to pain, and an irregular pulse. b) increased blood pressure, bradycardia, reactive pupils, and rapid respirations. c) fixed and dilated pupils, decreased blood pressure, and irregular respirations. d) sluggishly reactive pupils, widened pulse pressure, bradycardia, and posturing.
sluggishly reactive pupils, widened pulse pressure, bradycardia, and posturing.
Moderate elevation in intracranial pressure with middle brain stem involvement is characterized by: a) sluggishly reactive pupils, widened pulse pressure, bradycardia, and posturing. b) increased blood pressure, bradycardia, reactive pupils, and rapid respirations. c) fixed and dilated pupils, decreased blood pressure, and irregular respirations. d) ataxic respirations, unequal pupils, no response to pain, and an irregular pulse.
sluggishly reactive pupils, widened pulse pressure, bradycardia, and posturing.
The spinal cord is encased in and protected by the: a) vertebral arch. b) intervertebral disc. c) spinal canal. d) vertebral body.
spinal canal.
Common signs of a skull fracture include all of the following, EXCEPT: a) noted deformity to the skull. b) mastoid process bruising. c) superficial scalp lacerations. d) ecchymosis around the eyes.
superficial scalp lacerations.
The ideal procedure for moving an injured patient from the ground to a backboard is: a) to use a scoop stretcher. b) the four-person log roll. c) the direct patient carry. d) the clothes drag.
the four-person log roll.
When the parasympathetic nervous system is activated: a) hormones are released that prepare the body for stress. b) heart rate and blood pressure increase. c) the heart rate decreases and the blood vessels dilate d) blood is shunted away from the digestive organs.
the heart rate decreases and the blood vessels dilate
If you do not have the appropriate size cervical collar, you should: a) use rolled towels to immobilize the patient's head. b) ask the patient to keep his or her head in a neutral position. c) place sandbags on either side of the patient's head. d) defer cervical immobilization and apply lateral head blocks.
use rolled towels to immobilize the patient's head.
