EXAM 6 EMT CH26

The brain, a part of the central nervous system (CNS), is divided into the: A) cerebrum, cerebellum, and brain stem. B) cerebrum, brain stem, and spinal cord. C) cerebellum, cerebrum, and spinal cord. D) spinal cord, cerebrum, and cerebral cortex.

A) cerebrum, cerebellum, and brain stem. Rationale: The brain and spinal cord comprise the central nervous system (CNS). The brain is divided into three major regions: the cerebrum (the largest portion), the cerebellum, and the brain stem. Each region of the brain carries out specific functions.

A rapid and prolonged loss of consciousness is MOST common in patients with a(n): A) epidural hematoma. B) subdural hematoma. C) concussion. D) contusion.

A) epidural hematoma. Rationale: Epidural hematomas are caused by injury to an artery—usually the middle meningeal artery—that lies in between the skull and brain. Because arteries bleed faster than veins, patients with an epidural hematoma typically experience an immediate and prolonged loss of consciousness as intracranial pressure increases. Subdural hematomas are the result of injury to a vein; therefore, they tend to bleed slowly and usually cause a progressive decline in level of consciousness. Concussions and contusions may cause a loss of consciousness, but it is typically brief.

As you are assessing a 24-year-old man with a large laceration to the top of his head, you should recall that: A) the scalp, unlike other parts of the body, has relatively fewer blood vessels. B) blood loss from a scalp laceration may contribute to hypovolemic shock in adults. C) any avulsed portions of the scalp should be carefully cut away to facilitate bandaging. D) most scalp injuries are superficial and are rarely associated with more serious injuries.

B) blood loss from a scalp laceration may contribute to hypovolemic shock in adults.

A 44-year-old man was struck in the back of the head and was reportedly unconscious for approximately 30 seconds. He complains of a severe headache and "seeing stars," and states that he regained his memory shortly before your arrival. His presentation is MOST consistent with a(n): A) contusion. B) concussion. C) subdural hematoma. D) intracerebral hemorrhage.

B) concussion.

During immobilization of a patient with a possible spinal injury, manual stabilization of the head must be maintained until: A) an appropriate-size extrication collar has been placed. B) the patient is fully immobilized on a long backboard. C) a range of motion test of the neck has been completed. D) pulse, motor, and sensory functions are found to be intact.

B) the patient is fully immobilized on a long backboard.

Your patient is a 21-year-old male who has massive face and head trauma after being assaulted. He is lying supine, is semiconscious, and has blood in his mouth. You should: A) insert a nasal airway, assess his respirations, and give 100% oxygen. B) suction his airway and apply high-flow oxygen via a nonrebreathing mask. C) manually stabilize his head, log roll him onto his side, and suction his mouth. D) apply a cervical collar, suction his airway, and begin assisting his ventilations.

C) manually stabilize his head, log roll him onto his side, and suction his mouth. Rationale: Blood or other secretions in the mouth place the airway in immediate jeopardy and must be removed before they are aspirated. At the same time, you must protect the patient's spine due the mechanism of injury. Therefore, you should manually stabilize the patient's head, log roll him onto his side (allows drainage of blood from his mouth), and suction his mouth for up to 15 seconds. After ensuring that his airway is clear, assess his breathing and give high-flow oxygen or assist his ventilations. Nasal airways should not be used in patients with severe facial or head trauma.

A young male was involved in a motor vehicle accident and experienced a closed head injury. He has no memory of the events leading up to the accident, but remembers that he was going to a birthday party. What is the correct term to use when documenting his memory loss? A) concussion B) cerebral contusion C) retrograde amnesia D) anterograde amnesia

C) retrograde amnesia

A distraction injury to the cervical spine would MOST likely occur following: A) a diving accident. B) blunt neck trauma. C) hyperextension of the neck. D) hanging-type mechanisms.

D) hanging-type mechanisms. Rationale: Excessive traction on the neck, such as what occurs during hanging-type mechanisms, can cause a distraction injury of the cervical spine. Distraction injuries can cause separation of the vertebrae and stretching or tearing of the spinal cord.

A man is found slumped over the steering wheel, unconscious and making snoring sounds, after an automobile accident. His head is turned to the side and his neck is flexed. You should: A) gently rotate his head to correct the deformity. B) carefully hyperextend his neck to open his airway. C) apply an extrication collar with his head in the position found. D) manually stabilize his head and move it to a neutral, in-line position.

D) manually stabilize his head and move it to a neutral, in-line position. Rationale: The patient's snoring sounds indicate an airway problem, which must be corrected or he may die. Manually stabilize his head; carefully move it to a neutral, in-line position; and reassess his breathing. Do not rotate or hyperextend the neck of a patient with a possible spinal injury; the results could be disastrous.

You should NOT remove an injured football player's helmet if: A) a cervical spine injury is suspected, even if the helmet fits loosely. B) the patient has a patent airway, even if he has breathing difficulty. C) he has broken teeth, but only if the helmet does not fit snugly in place. D) the face guard can easily be removed and there is no airway compromise.

D) the face guard can easily be removed and there is no airway compromise.

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: a) 14. b) 12. c) 13. d) 15.

a) 14.

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: a) suction his oropharynx for up to 15 seconds. b) assist his ventilations with a bag-mask device. c) pack his nostrils to stop the drainage of blood. d) immobilize his spine and transport immediately.

a) suction his oropharynx for up to 15 seconds.

After your partner assumes manual in-line stabilization of the patient's head, you should: a) apply an appropriately sized rigid cervical collar. b) assess distal neurovascular status in the extremities. c) thoroughly palpate the patient's head for deformities. d) use four people to log roll the patient onto a backboard.

b) assess distal neurovascular status in the extremities.

The five sections of the spinal column, in descending order, are the: a) coccygeal, sacral, lumbar, thoracic, and cervical. b) cervical, thoracic, lumbar, sacral, and coccygeal. c) cervical, coccygeal, thoracic, sacral, and lumbar. d) thoracic, cervical, lumbar, coccygeal, and sacral.

b) cervical, thoracic, lumbar, sacral, and coccygeal.

Which of the following nerves carry information from the body to the brain via the spinal cord? a) central b) somatic c) sensory d) motor

c) sensory

The body's functions that occur without conscious effort are regulated by the _________ nervous system. a) voluntary b) sensory c) somatic d) autonomic

d) autonomic

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: a) obtain a Glasgow Coma Score value and give him oxygen. b) allow him to refuse transport if his vital signs remain stable. c) perform a rapid head-to-toe exam and immobilize his spine. d) immobilize his spine and perform a focused secondary exam.

d) immobilize his spine and perform a focused secondary

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) apply 100% oxygen via a nonrebreathing mask and obtain baseline vital signs. c) immediately place her on a long backboard and prepare for rapid transport. d) instruct him to assist her ventilations while you perform a rapid assessment.

d) instruct him to assist her ventilations while you perform a rapid assessment.

When immobilizing a child on a long backboard, you should: a) secure the head prior to securing the torso and legs. b) defer cervical collar placement to avoid discomfort. c) place the child's head in a slightly extended position. d) place padding under the child's shoulders as needed.

d) place padding under the child's shoulders as needed.

When immobilizing a trauma patient's spine, the EMT manually stabilizing the head should not let go until: a) the patient has been secured to the ambulance stretcher. b) the head has been stabilized with lateral immobilization. c) an appropriately sized cervical collar has been applied. d) the patient has been completely secured to the backboard.

d) the patient has been completely secured to the backboard.