Paramedic Chapter 34 - Head and Spine Trauma - Multiple Choice

Pupils that are slow (sluggish) to react to light: A. are a sign of cerebral hypoxia. B. indicate impending brain herniation. C. suggest significant intracranial pressure. D. indicate compression of an oculomotor nerve.

A. are a sign of cerebral hypoxia.

A hangman's fracture is an example of a ______________ force. A. distraction B. flexion C. hyperextension D. vertical compression

A. distraction

Medications administered in the prehospital setting for a patient with a head injury would MOST likely be used to: A. facilitate intubation or terminate seizures. B. reduce body temperature and promote diuresis. C. reduce cerebral edema and prevent shivering. D. prevent cardiac dysrhythmias or increase heart rate.

A. facilitate intubation or terminate seizures.

You are assessing a young woman who fell and hit her head. She is conscious but can't remember the circumstances that led up to the injury. What is this patient experiencing? A. Anterograde amnesia B. Retrograde amnesia C. Systematized amnesia D. Transient global amnesia

B. Retrograde amnesia

Which of the following indications would you see in a patient with moderate ICP elevation? Select all that apply. A. Cheyne-Stokes respirations B. Widened pulse pressure and bradycardia C. Blown pupils D. Decerebrate posturing

B. Widened pulse pressure and bradycardia D. Decerebrate posturing

You are providing care for a 34-year-old female patient who fell down a flight of stairs, striking her head. On closer inspection, you can see blood mixed with a clear fluid draining from her right ear and there is bruising in the area behind the ear. Based on this information, the patient has most likely sustained a(n): A. linear skull fracture. B. basilar skull fracture. C. depressed skull fracture. D. open skull fracture.

B. basilar skull fracture.

A short backboard or vest-type immobilization device is indicated for which of the following? A. A patient in a sitting position who is clinically stable B. A supine patient who is clinically stable C. An unstable patient in need of rapid extrication D. An unconscious patient in the water

A. A patient in a sitting position who is clinically stable

A rise of 20 mm Hg above the patient's normal resting blood pressure along with a history of SCI and associated signs and symptoms indicate the patient is experiencing what? A. Autonomic dysreflexia B. Cauda equina syndrome C. Hypotensive shock D. Spinal stenosis

A. Autonomic dysreflexia

Which of the following statements regarding a closed head injury is correct? A. In a closed head injury, the dura mater remains intact. B. Diffuse brain injury occurs with all open head injuries. C. Closed head injuries are less common than open head injuries. D. Intracranial pressure is usually minimal in a closed head injury.

A. In a closed head injury, the dura mater remains intact.

When applying a short spine board, what part of the body do you need to secure first? A. Torso B. Shoulders C. Chest D. Head

A. Torso

Injury to the temporal lobe on the left side would MOST likely cause: A. abnormal speech. B. visual disturbances. C. sleep abnormalities. D. lack of coordination.

A. abnormal speech.

You are providing care for a 29-year-old male patient who was assaulted with a baseball bat and appears to have sustained a linear skull fracture to the right parietal area. Bystanders report that the patient had initially lost consciousness but got up quickly. As you begin your assessment of the patient, he becomes unresponsive rapidly with signs of increasing intracranial pressure. Based on this information, the patient has most likely sustained a(n): A. epidural hematoma. B. subdural hematoma. C. cerebral contusion. D. intracranial hemorrhage.

A. epidural hematoma.

You are providing care for a 24-year-old female patient who was driving her car when she lost control and struck a telephone pole. The patient was wearing her seatbelt but the impact did throw her head forward. Based on this information, the patient most likely sustained a: A. flexion injury. B. rotation with flexion injury. C. distraction injury. D. hyperextension injury.

A. flexion injury.

Which of the following is the correct method for rapid extrication of a patient from a motor vehicle? A. Apply an extrication collar and remove the patient from the car using the direct carry method. B. Apply an extrication collar, slide a long spine board under the patient's buttocks, and remove the patient from the car. C. Apply a cervical collar, insert a short backboard between the patient's back and the seat, and slide the patient out of the car onto a long spine board for full immobilization. D. Maintain support of the head, grasp the patient by the clothing, and rapidly remove the patient from the car.

B. Apply an extrication collar, slide a long spine board under the patient's buttocks, and remove the patient from the car.

Following a spinal injury, a patient presents with abdominal breathing and use of the accessory muscles in the neck. This suggests injury at or above: A. C1-C2. B. C3-C4. C. T1-T4. D. T2-T5.

B. C3-C4.

You are responding to an older woman who slipped and struck her forehead on the bathtub. She is complaining of having trouble "making her arms work." Which syndrome is this patient exhibiting? A. Anterior cord syndrome B. Central cord syndrome C. Posterior cord syndrome D. Brown-Séquard syndrome

B. Central cord syndrome

What is the most reliable sign of a head injury? A. Cushing triad B. Decreasing level of consciousness C. Dizziness D. Sluggish/nonreactive pupils

B. Decreasing level of consciousness

You are providing care for a 34-year-old patient with a head injury. Your management should include all of the following except: A. maintaining oxygen saturation above 90%. B. covering the patient with warm blankets. C. elevating the head of the backboard 15' to 30'. D. establishing vascular access while en route.

B. covering the patient with warm blankets.

The brain connects to the spinal cord through a large opening at the base of the skull called the: A. cribriform plate. B. foramen magnum. C. occipital condyle. D. palatine bone.

B. foramen magnum.

All of the following statements are true of disc herniation except: A. typically affects men aged 30 to 50 years. B. most often occurs from S2 to S3 and S3 to S4. C. patients present with pain and limited range of motion. D. generally caused by some degree of trauma in patients with pre-existing disc degeneration.

B. most often occurs from S2 to S3 and S3 to S4.

How should you move an injured patient from the ground to a backboard? A. Clothes drag B. Firefighter's lift C. Four-person log roll D. Hammock carry

C. Four-person log roll

Following a traumatic brain injury, initial swelling of the brain occurs due to: A. severe ischemia. B. acute hypertension. C. cerebral vasodilation. D. an increase in cerebral water.

C. cerebral vasodilation.

All of the following statements are true of concussion except: A. may be caused by a direct or indirect blow to the head or face or an impulsive force that is transmitted to the head. B. typically results in rapid onset of short-lived impairement of neurologic impairment that resolves spontaneously. C. may result in long-term structural damage. D. results in a range of signs and symptoms.

C. may result in long-term structural damage.

The ____________ lobe governs the perception of pain, temperature, and vibration. A. frontal B. occipital C. parietal D. temporal

C. parietal

The speech center is located in the: A. frontal lobe. B. parietal lobe. C. temporal lobe. D. occipital lobe.

C. temporal lobe.

You are managing a 36-year-old male patient who sustained a head injury during a motor vehicle collision. The patient is unresponsive and breathing four to six breaths per minute. His pupils are asymmetric. Based on this presentation, you should: A. ventilate the patient to an end-tidal CO2 of 20 to 25 mm Hg. B. ventilate the patient to an end-tidal CO2 of 25 to 30 mm Hg. C. ventilate the patient to an end-tidal CO2 of 30 to 35 mm Hg. D. ventilate the patient to an end-tidal CO2 of 35 to 40 mm Hg.

C. ventilate the patient to an end-tidal CO2 of 30 to 35 mm Hg.

When immobilizing a child younger than the age of 6 on a long backboard, where do you need to place padding? A. Behind the occiput B. Under the lumbar C. Under the knees D. Between the shoulder blades

D. Between the shoulder blades

Which of the following are indicators for Cushing triad? A. Hypotension, focal neurologic deficits, and disorientation B. Tachycardia, hypertension, and decorticate posturing C. Abnormal behavior, pupillary abnormalities, and period of unresponsiveness D. Hypertension, bradycardia, and irregular respirations

D. Hypertension, bradycardia, and irregular respirations

Which of the following types of skull fracture would be the LEAST likely to present with gross physical signs? A. Open fracture B. Depressed fracture C. Basilar fracture D. Linear fracture

D. Linear fracture

You are treating a 20-year-old patient who was kicked in the head during a soccer game. When you arrive, he is unconscious. His coach reports that after the incident, the patient "seemed a little stunned" but got up to rejoin the game before he suddenly collapsed. A teammate reports that the patient had a prior injury due to a car accident a few weeks ago. What condition does this indicate? A. Cerebral concussion B. Moderate diffuse axonal injury (DAI) C. Postconcussion syndrome D. Second impact syndrome

D. Second impact syndrome

According to the National Spinal Cord Injury Statistical Center, MOST spinal cord injuries are caused by: A. acts of violence. B. athletic activities. C. falls in the elderly. D. motor vehicle crashes.

D. motor vehicle crashes.

A moderate diffuse axonal injury: A. is generally characterized by a brief loss of consciousness, with or without retrograde amnesia. B. causes a prolonged loss of consciousness and affects axons in both cerebral hemispheres. C. is the most common result of blunt head trauma and is associated with temporary neuronal dysfunction. D. produces an immediate loss of consciousness and residual neurologic deficits when the patient wakes up.

D. produces an immediate loss of consciousness and residual neurologic deficits when the patient wakes up.