Quiz Chapter 29: Trauma to the head, neck and spine

hematoma

In a head injury, a collection of blood within the skull or brain

contusion

In brain injuries, a bruised brain caused when the force of a blow to the head is great enough to rupture blood vessels

laceration

In brain injuries, a cut to the brain

concussion

Mild closed head injury without detectable damage to the brain; complete recovery is usually expected

What is the significance of an increase in carbon dioxide in the injured brain? a. it increases the blood pressure. b. It causes brain tissue swelling c. It raises the heart rate. d. It causes brain tissue shrinkage.

b. It causes brain tissue swelling

neurogenic shock

A state of shock caused by nerve paralysis that is sometimes caused by spinal injuries

dermatome

An area of the skin that is innervated by a single spinal nerve

temporal bones

Bone that forms part of the sides of the skull and floor of the cranial cavity

autonomic nervous system

Controls involuntary functions

nervous system

Provides overall control of thought, sensation, and the voluntary and involuntary motor functions of the body; the major components of the nervous system are the brain and the spinal cord

herniation

Pushing of a portion of the brain through the foramen magnum as a result of increased intracranial pressure

Vertebrae

The bones of the spinal column

nasal bones

The bones that form the upper third, or bridge, of the nose

spinous process

The bony bump on a vertebra

cranium

The bony structure making up the forehead and the top, back, and upper sides of the skull

malar

The cheek bone; also called the zygomatic bone

Temporalmandibular joint

The movable joint formed between the mandible and the temporal bones; also called the TMJ

peripheral nervous system

The nerves that enter and exit the spinal cord between the vertebrae, 12 pairs of cranial nerves that travel between the brain and organs without passing through the spinal cord, and all of the body's other motor and sensory nerves

foramen magnum

The opening at the base of the skull through which the spinal cord passes from the brain

Maxillae

The two fused bones forming the upper jaw

You are treating a 35-year-old female who failed to wear a helmet and struck her head when she fell off her bike. In most EMS systems, she would be taken to a trauma center if her Glasgow Coma Scale (GCS) score was less than: a. 14 b. 10 c. 12 d. 15

a. 14

Your patient has a suspected air bubble that may have been sucked into a large vein in his neck. This is called a(n): a. air embolus b. blood clot c. occlusion d. case of the "bends"

a. air embolus

You are treating a 52-year-old man who was involved in a serious high-speed collision. If the patient is up and walking around at the scene, you should: a. assess for potential spinal injury b. check with medical direction for orders. c. check with bystanders about the patient's mental status. d. assume that the patient is uninjured.

a. assess for potential spinal injury

If a responsive patient has the mechanism of injury for a spinal injury, the EMT should do all of the following except: a. assess for spinal pain by asking the patient to move b. keep the patient still while asking him or her questions. c. assess for equality of strength in the extremities. d. assess for tingling in the extremities.

a. assess for spinal pain by asking the patient to move

You suspect your patient may have a traumatic brain injury. His signs and symptoms may include: a. blood or fluid flowing from the ears and/or nose. b. yellow discoloration in the eyes. c. bruising around the base of the nose. d. pain at the base of the neck.

a. blood or fluid flowing from the ears and/or nose.

After performing the primary assessment and rapid trauma exam on a spine-injured patient, your next step is to: a. determine the patient's priority b. administer high-concentration oxygen. c. immobilize the patient on a long spine board d. determine the mechanism of injury.

a. determine the patient's priority

When immobilizing a 6-year-old or younger child on a long backboard: a. provide padding beneath the shoulder blades b. it is unnecessary to apply a cervical collar. c. place a chin cup or chin strap on the patient. d. secure the head first and then secure the torso.

a. provide padding beneath the shoulder blades

When assessing a suspected spine-injured patient, you note a reversal of the normal breathing pattern. This is likely a result of damage to the nerves that control the: a. rib cage b. diaphragm. c. abdomen. d. lungs.

a. rib cage

You are treating a 45-year-old male who was involved in a high-speed car crash. You have decided to use the rapid extrication technique, which is typically used in all of the following situations except when: a. moving a patient rapidly from an unsafe scene. b. a stable, low-priority patient must be immobilized c. more seriously injured patients must be accessed. d. moving a high-priority patient.

b. a stable, low-priority patient must be immobilized

Skull or traumatic brain injury may result in: a. airway swelling and dizziness. b. altered mental status and unequal pupils. c. difficulty moving below the waist. d. nausea and hypoperfusion.

b. altered mental status and unequal pupils.

Your patient is a 19-year-old male who was involved in a motorcycle crash. You should consider keeping the helmet on the patient: a. if it interferes with breathing management. b. if it has a snug fit that allows no head movement c. by using a two-rescuer procedure. d. if it hinders immobilization.

b. if it has a snug fit that allows no head movement

The patient does not complain of any spinal pain. It is important to remember that a lack of spinal pain does not rule out the possibility of spinal-cord injury because: a. spinal injuries seldom cause pain. b. other painful injuries may mask it c. spinal injuries are not painful until shock sets in. d. a patient may feel the pain but cannot verbalize it.

b. other painful injuries may mask it

You are assessing a 22-year-old male who was involved in a bar fight earlier this evening. It is now 4 a.m. and the family called the ambulance because he has been vomiting. Further examination reveals that he also has discoloration of the soft tissues under both eyes. This finding is called: a. Cushing's syndrome. b. raccoon eyes c. Battle's sign. d. posturing syndrome.

b. raccoon eyes

You are assessing a 27-year-old male who you suspect has a spine injury. If he complains of pain when you attempt to place his head in a neutral in-line position, you should: a. pad the neck before immobilizing b. steady the head in the position found c. continue with the stabilization procedure. d. contact medical direction immediately.

b. steady the head in the position found

You are assessing a 22-year-old male who was involved in a bar fight earlier this evening. It is now 4 a.m. and the family called the ambulance because he has been vomiting. You notice he has a bruise behind the ear. This is called: a. Cushing's syndrome. b. raccoon eyes. c. Battle's sign d. posturing syndrome.

c. Battle's sign

You are treating a 22-year-old male who was assaulted with a knife. The attacker slashed the patient's throat. Initially there was considerable blood, but you were able to control it and bandage the wound. The patient went into sudden cardiac arrest. what is the most likely cause? a. a stroke b. a heart attack c. an air embolism d. infection from the wound

c. an air embolism

Your patient fell down the stairs and may have injured his spine. Examples of findings that may lead you to consider a spine injury include all of the following except: a. the presence of priapism. b. the loss of bladder control c. an increased pulse rate d. nerve impairment to the extremities.

c. an increased pulse rate

When a patient has a scalp injury: a. expect minimal bleeding. b. determine the wound depth. c. expect profuse bleeding d. palpate the site with the fingertips.

c. expect profuse bleeding

If a stable 22-year-old male patient is found in a sitting position on the ground and is complaining of back pain, the EMT Should: a. apply a cervical collar and rapidly transport the patient. b. ask the patient to lie down, then immobilize. c. immobilize with a short spine board or extrication vest d. perform a rapid take-down procedure with a long spine board.

c. immobilize with a short spine board or extrication vest

central nervous system

consists of the brain and spinal cord

Which of the following would NOT create a high index of suspicion of a spine injury? a. Motor vehicle or motorcycle collisions b. Falls that cause open fractures to the ankles c. Trauma patients who are found unconscious d. A fall from 1.5 times the patient's height.

d. A fall from 1.5 times the patient's height.

The practice of supine spinal immobilization has recently been on the decline in many services due to possible harmful side effects. These include which of the following? a. hypothermia b. pressure sores c. worsening lung injuries d. all of the above are possible side effects

d. all of the above are possible side effects

You are treating a patient who fell backward and struck his head. You suspect that he is developing increased ICP. The time it takes to develop the symptoms from a increased ICP depend on: a. the rate of bleeding into the head. b. the location of the bleed. c. the age of the patient. d. all of these are important factors.

d. all of these are important factors.

If a patient is found on her back with arms extended above the head, this may indicate a _________ spine injury. a. thoracic b. lumbar c. sacral d. cervical

d. cervical

You are treating a 35-year-old female who has an injury to one of her spinal vertebrae. Based on the frequency of injury, it is most likely one of the: a. lumbar and sacral. b. thoracic and cervical. c. coccygeal and thoracic. d. cervical and lumbar.

d. cervical and lumbar.

ou are treating a patient who has a steel rod penetrating the skull. You should: a. shorten lengthy objects, using any available tools. b. elevate the patient's legs immediately. c. remove the object and quickly control the bleeding. d. stabilize the object with bulky dressings, provided it is a length that can be transported with the patient.

d. stabilize the object with bulky dressings, provided it is a length that can be transported with the patient.

EMS providers can use an assessment tool that physicians use to decide if full spinal immobilization on a long spine board is needed for a possible spinal injury. The key parts of it are: a. conscious and truthful patient to answer questions b. pain along the spinal midline c. pain upon palpation anywhere on the spine d. intact sensory and motor functions in extremities e. all of the above are key parts of the assessment for spinal integrity

e. all of the above are key parts of the assessment for spinal integrity

mandible

lower jaw bone

intercranial pressure

pressure inside the skull

orbits

the bony structures around the eyes; the eye sockets

cerebral spinal fluid

the fluid that surrounds the brain and spinal cord