Brain trauma quiz 6-9

What portion of the brain is a relay center that filters important signals from routine signals? A.) Hypothalamus B.) Temporal lobe C.) Prefrontal area D.) Thalamus

D.) Thalamus

Which of the following statements regarding the brainstem is correct? A.) All but 4 of the 12 cranial nerves exit the brainstem. B.) The brainstem is responsible for muscle coordination. C.) The brainstem provides protection to the cerebellum. D.) The brainstem connects the spinal cord to the brain.

D.) The brainstem connects the spinal cord to the brain.

The innermost meningeal layer that rests directly on the brain and spinal cord is the: A.) cortex. B.) arachnoid. C.) pia mater. D.) dura mater.

C.) pia mater.

Which of the following signs of a basilar skull fracture would MOST likely be observed in the prehospital setting? A.) Cerebrospinal fluid drainage from the ear B.) Ecchymosis around the eyes C.) Battle's sign D.) Bruising over the mastoid process

A.) Cerebrospinal fluid drainage from the ear

When an unrestrained passenger's head strikes the windshield of a motor vehicle following rapid deceleration: A.) compression injuries occur to the anterior portion of the brain, and stretching or tearing injuries occur to the posterior portion of the brain. B.) the anterior portion of the brain sustains stretching or tearing injuries, and the posterior portion of the brain sustains compression injuries. C.) the brain initially strikes the rear of the skull, resulting in direct bruising, and then rebounds and strikes the front part of the skull. D.) the head falls back against the headrest or seat and the brain collides with the rear of the skull, resulting in direct injury to the occipital lobe.

A.) compression injuries occur to the anterior portion of the brain, and stretching or tearing injuries occur to the posterior portion of the brain.

Chronic subdural hematomas are MOST commonly seen in patients who: A.) are prone to hypoglycemia. B.) have high cholesterol. C.) have alcoholism. D.) are less than 2 years of age.

C.) have alcoholism.

Autoregulation is defined as: A.) the forcing of cerebrospinal fluid into the spinal cord as ICP increases. B.) an increase in mean arterial pressure to maintain cerebral blood flow. C.) reflex bradycardia that occurs secondary to systemic hypertension. D.) a decrease in cerebral perfusion pressure that reduces intracranial pressure.

B.) an increase in mean arterial pressure to maintain cerebral blood flow.

Secondary brain injuries include all of the following, EXCEPT: A.) cerebral edema. B.) axonal injury. C.) cerebral ischemia. D.) intracranial hemorrhage.

B.) axonal injury.

Beginning with the outermost layer, the three meningeal layers of the central nervous system are the: A.) pia mater, dura mater, and arachnoid. B.) dura mater, arachnoid, and pia mater. C.) dura mater, pia mater, and arachnoid. D.) arachnoid, pia mater, and dura mater.

B.) dura mater, arachnoid, and pia mater.

Decerebrate posturing is characterized by: A.) pulling in of the arms toward the core of the body. B.) extension of the arms and extension of the legs. C.) flexion of the arms and extension of the legs. D.) inward flexion of the wrists and flexed knees.

B.) extension of the arms and extension of the legs.

A 19-year-old woman fell from a second story window and landed on her head. She is unconscious with a blood pressure of 168/104 mm Hg, heart rate of 56 beats/min, and irregular respirations of 8 breaths/min. Further assessment reveals blood draining from her nose and bilaterally dilated pupils that are slow to react. In addition to employing full spinal precautions, the MOST appropriate treatment for this patient involves: A.) applying oxygen via nonrebreathing mask, covering her with blankets, starting an IV of normal saline set to keep the vein open, applying a cardiac monitor, initiating transport, and monitoring her pupils while en route to the hospital. B.) intubating her trachea after preoxygenating her for 2 to 3 minutes with a bag-mask device, transporting immediately, starting at least one large-bore IV en route, applying a cardiac monitor, and performing frequent neurologic assessments. C.) preoxygenatin

B.) intubating her trachea after preoxygenating her for 2 to 3 minutes with a bag-mask device, transporting immediately, starting at least one large-bore IV en route, applying a cardiac monitor, and performing frequent neurologic assessments.

When assessing the severity of a traumatic brain injury, the MOST important assessment parameter is the patient's: A.) blood pressure. B.) level of consciousness. C.) response to verbal stimuli. D.) initial Glasgow Coma Scale score.

B.) level of consciousness.

Prehospital treatment of the patient with a traumatic brain injury must focus primarily on: A.) maintaining a systolic BP of at least 120 mm Hg. B.) maintaining cerebral perfusion pressure. C.) hyperventilating the patient at 20 breaths/min. D.) taking measures to decrease intracranial pressure.

B.) maintaining cerebral perfusion pressure.

What portion of the brainstem is responsible for maintenance of consciousness? A.) Diencephalon B.) Limbic system C.) Reticular activating system D.) Basal ganglia

C.) Reticular activating system

Paralysis of the extremities would MOST likely result from injury to the: A.) diencephalon. B.) hypothalamus. C.) cerebral cortex. D.) cerebellum.

C.) cerebral cortex.

The MOST disastrous consequence of a severe traumatic brain injury is: A.) an increase in intracranial pressure. B.) an increase in mean arterial pressure. C.) severe hypertension and bradycardia. D.) a decrease in cerebral perfusion pressure.

D.) a decrease in cerebral perfusion pressure.

Open fractures of the cranial vault: A.) cause death due to increased intracranial pressure. B.) are uncommonly associated with multisystem trauma. C.) typically cause lethal atrial cardiac dysrhythmias. D.) are associated with a high risk of bacterial meningitis.

D.) are associated with a high risk of bacterial meningitis.

Unlike a cerebral concussion, a cerebral contusion is: A.) a diffuse brain injury that results in severe intracranial hemorrhage and pressure. B.) a type of diffuse axonal injury that often leads to permanent neurologic damage. C.) typically not associated with retrograde amnesia or focal neurologic deficits. D.) associated with physical brain damage and more pronounced neurologic deficits.

D.) associated with physical brain damage and more pronounced neurologic deficits.

The dura mater: A.) is the inner meningeal layer and is comprised of a thin, translucent, highly vascular membrane that adheres firmly directly to the surface of the brain. B.) anatomically separates the cerebellum and the brainstem and contains vasculature that resembles a spider web. C.) is the middle meningeal layer and is comprised of a delicate transparent membrane that is damaged easily by trauma. D.) folds in to form the tentorium, a structure that separates the cerebral hemispheres from the cerebellum and brainstem.

D.) folds in to form the tentorium, a structure that separates the cerebral hemispheres from the cerebellum and brainstem.

Early signs and symptoms of increased intracranial pressure include: A.) arm flexion and leg extension. B.)hypertension and bradycardia. C.) widening of the pulse pressure. D.) headache and vomiting.

D.) headache and vomiting.

A diffuse axonal injury: A.) is a specific, grossly observable brain injury that can easily be diagnosed with a computer tomography scan of the head. B.) is generally associated with better neurologic outcomes than a cerebral concussion because permanent brain damage does not occur. C.) results in severe stretching or tearing of the portion of the nerve cell that receives sensory messages from the rest of the body. D.) involves stretching, shearing, or tearing of the extension of the neuron that conducts electrical impulses away from the cell body.

D.) involves stretching, shearing, or tearing of the extension of the neuron that conducts electrical impulses away from the cell body

An epidural hematoma typically causes rapid deterioration in the patient's condition because: A.) concomitant spinal cord injury is often present. B.) the meningeal veins are often disrupted. C.) numerous axons are severely damaged. D.) it is associated with brisk arterial bleeding.

D.) it is associated with brisk arterial bleeding.

Common clinical findings associated with a subdural hematoma include all of the following, EXCEPT: A.) an underlying skull fracture. B.) unilateral hemiparesis or slurred speech. C.) a fluctuating level of consciousness. D.) rapidly increasing intracranial pressure.

D.) rapidly increasing intracranial pressure.

The Broca region of the left frontal lobe is responsible for the muscular actions that are associated with: A.) sight. B.) reflexes C.) eye movement. D.) speech.

D.) speech.

Nuchal rigidity is MOST commonly seen in patients with a(n): A.) subdural hematoma. B.) epidural hematoma. C.) intracerebral hematoma. D.) subarachnoid hemorrhage.

D.) subarachnoid hemorrhage.