Chapter 28: Head and Spine Injuries

Which of the following statements regarding motor nerves is correct?

They carry information from the CNS to the muscles.

The MOST reliable sign of a head injury is:

a decreased level of consciousness.

When immobilizing a child on a long backboard, you should:

place padding under the child's shoulders as needed.

Lacerations to the scalp

may be an indicator of deeper, more serious injuries.

The _________ nervous system consists of 31 pairs of spinal nerves and 12 pairs of cranial nerves.

peripheral

Which of the following statements regarding secondary brain injury is correct?

Hypoxia and hypotension are the two most common causes of secondary brain injury.

pupillary constriction

When activated, the sympathetic nervous system produces all of the following effects, EXCEPT:

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:

14

A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response?

3

leave his helmet and shoulder pads in place

A high school football player was injured during a tackle and complains of neck and upper back pain. He is conscious and alert and is breathing without difficulty. The EMT should

it interferes with your assessment of the airway

A tight-fitting motorcycle helmet should be left in place unless

Which of the following statements regarding the cranium is correct?

Eighty percent of the cranium is occupied by brain tissue.

Which of the following breathing patterns is MOST indicative of increased intracranial pressure?

Irregular rate, pattern, and volume of breathing with intermittent periods of apnea

Which of the following statements regarding a basilar skull fracture is correct?

The absence of raccoon eyes or Battle's sign does not rule it out.

7

The cervical spine is composed of _____ vertebrae.

four-person log roll

The ideal procedure for moving an injured patient from the ground to a backboard is:

head

When placing a patient onto a long backboard, the EMT at the patient's _________ is in charge of all patient movements.

A cervical collar is used in addition to, not instead of, manual immobilization.

Which of the following statements regarding cervical collars is correct?

bacterial meningitis

You are assessing a man who has a head injury and note that cerebrospinal fluid is leaking from his ear. You should recognize that this patient is at risk for:

An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is:

a rapid deterioration of neurologic signs.

Common signs and symptoms of a serious head injury include all of the following, EXCEPT:

a rapid, thready pulse

The meninges, along with the cerebrospinal fluid (CSF) that circulates in between each meningeal layer, function by:

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:

after assessing distal neurovascular functions.

A short backboard or vest-style immobilization device is indicated for patients who:

are in a sitting position and are clinically stable

After your partner assumes manual in-line stabilization of the patient's head, you should:

assess distal neurovascular status in the extremities.

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:

assisting ventilations at an age-appropriate rate.

The body's functions that occur without conscious effort are regulated by the _________ nervous system.

autonomic

When controlling bleeding from a scalp laceration with a suspected underlying skull fracture, you should:

avoid excessive pressure when applying the bandage.

A man jumped from the roof of his house and landed on his feet. He complains of pain to his heels, knees, and lower back. This mechanism of injury is an example of:

axial loading

An epidural hematoma is MOST accurately defined as:

bleeding between the skull and dura mater.

Which of the following sets of vital signs depicts Cushing's triad?

blood pressure, 190/110 mm Hg; pulse, 55 beats/min; respirations, 30 breaths/min

The _________ is the best-protected part of the CNS and controls the functions of the cardiac and respiratory systems.

brain stem

A temporary loss or alteration of part or all of the brain's abilities to function without physical damage to the brain MOST accurately describes a(n):

cerebral concussion.

The MOST common and serious complication of a significant head injury is:

cerebral edema.

The _________ contain(s) about 75% of the brain's total volume.

cerebrum

The frontal and parietal bones of the skull are especially susceptible to:

compressed skull fractures.

Rapid deceleration of the head, such as when it impacts the windshield, causes:

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?

connecting

When assessing a conscious patient with an MOI that suggests spinal injury, you should:

determine if the strength in all extremities is equal.

The tough, fibrous outer meningeal layer is called the:

dura mater

When immobilizing a patient on a long backboard, you should:

ensure that you secure the torso before securing the head.

Which of the following head injuries would cause the patient's condition to deteriorate MOST rapidly?

epidural hematoma

The hormone responsible for the actions of the sympathetic nervous system is:

epinephrine.

The MOST important treatment for patients with a head injury, regardless of severity, is

establish an adequate airway.

It would be MOST appropriate to perform a focused secondary assessment on a patient who:

fainted and fell to the ground from a standing position.

Distraction injuries of the spine are MOST commonly the result of:

hangings.

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:

immobilize his spine and perform a focused secondary exam.

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:

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

Bleeding within the brain tissue itself is called a(n)

intracerebral hematoma.

In contrast to a cerebral concussion, a cerebral contusion:

involves physical injury to the brain tissue.

Traumatic brain injury

is a severe head injury that can be life threat or leave the patient with life altering injuries

head injury

is a traumatic injury to the head that may result in injury to soft tissue, bony structures, or the brain

Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless:

it causes a problem managing the airway

When opening the airway of a patient with a suspected spinal injury, you should use the:

jaw-thrust maneuver.

When caring for a patient with a possible head injury, it is MOST important to monitor the patient's:

level of consciousness.

Which of the following skull fractures would be the LEAST likely to present with palpable deformity or other outward signs?

linear

When a patient experiences a severe spinal injury, he or she:

may lose sensation below level of injury

A patient who cannot remember the events that preceded his or her head injury is experiencing

retrograde amnesia

When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear. This indicates:

rupture of the tympanic membrane following diffuse impact to the head

Which of the following nerves carry information from the body to the brain via the spinal cord?

sensory

You should be MOST suspicious that a patient has experienced a significant head injury if his or her pulse is:

slow.

Moderate elevation in intracranial pressure with middle brain stem involvement is characterized by:

sluggishly reactive pupils, widened pulse pressure, bradycardia, and posturing.

What part of the nervous system controls the body's voluntary activities?

somatic

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:

suction his oropharynx for up to 15 seconds.

When the parasympathetic nervous system is activated:

the heart rate decreases and the blood vessels dilate.

When immobilizing a trauma patient's spine, the EMT manually stabilizing the head should not let go until:

the patient has been completely secured to the backboard

establish and adequate airway, control bleeding, and reassess the patient's baseline level of consciousness

treatment for a patient with a head injury include

maintain the airway while keeping the spine properly aligned, assess respirations and give supplemental oxygen

treatment for a patient with a spinal injury include

If you do not have the appropriate size cervical collar, you should:

use rolled towels to immobilize the patient's head.