CHAPTER 33 QUIZ

The globe of the eye, or eyeball, is a sphere approximately 1 inch in diameter. The parts of the eyeball include the:

Inner surface of the eyelids called the conjunctiva

A worker in a factory complex has a sliver of metal lodged in the colored portion of his eye. The EMT would recognize the foreign body as lying in the:

Iris

The eyes, face, and neck may be subject to wide variety of injuries. Which of the following is true regarding these injuries?

Patients with an eye, face, or neck injury may be more emotionally distraught than patients with other types of trauma.

Treatment for a patient with a chemical burn to the eye includes:

Transporting the patient on the side and continuing irrigation throughout transport

A 21 year old female has been struck in the left eye by a softball. Which of the following assessment findings is most concerning for an eye injury?

Unusual sensitiity to light

A 21-year-old-female has been struck in the left eye by a softball. Which finding is most concerning for an eye injury?

Unusual sensitiity to light

A patient with a maxillary fracture would have sustained injury to her:

Upper jaw

A patient with hyphema would exhibit:

blood in the eye chamber

A 39-year-old male has a single stab wound to the anterior chest. When notifying the emergency department, you inform them that the patient is suffering from a/an:

open chest injury.

What is hyphema?

Blood in the anterior chamber the eye

You have arrived on the scene of an industrial plant where a female worker had a chemical splashed into her eye. She is complaining of severe pain in the eye and is flushing it with tap water over a sink. Which of the following questions is it most important that the EMT ask first?

"Are you wearing contact lenses?"

Which statement made by an EMT demonstrates an understanding of chest trauma?

"Closed chest injuries are caused by blunt trauma, and can be just as serious as open chest injuries."

You suspect that a patient has a fracture of the left orbit. What statement made by the patient would reinforce this suspicion?

"I am seeing two of everything."

A construction worker complains of pain to both eyes after an extended period spent welding on a gas well. The light is bothering him and he rates the pain as a 10/10. He states that this occurred once before and was caused by the light of his welding tool. The primary assessment reveals no deficits and his vital signs are: pulse 80, respirations 14, blood pressure 132/68, and SpO2 98%. Although very painful, his vision is not compromised. Which of the following instructions indicate proper care of this patient?

"I do not think that we will need to provide supplemental oxygen."

A 21-year-old male has a stab wound to the left side of his neck. Emergency Medical Responders are holding manual in-line spinal stabilization. As you approach the patient, you note blood on his shirt and pale-looking skin color. As team leader, what direction would you give first?

"I need someone to place a gloved hand over the stab wound."

On scene at a college football game, a wide receiver is unresponsive after colliding with another player and forcefully taking a helmet to the chest. The athletic trainer reports that the patient is pulselesss and apneic. Given the mechanism of injury and patient's presentation, which instruction would be appropriate?

"Let's apply the AED and follow all prompts."

While running in a parking lot, a young boy tripped and fell. He hit his face and mouth on a curb, knocking one of his top front teeth from its socket. Bleeding has been controlled and the tooth found. What instructions would you give your partner when caring for the tooth?

"Rinse the tooth first then put it in a cup of saline for transport."

Which of the following statements made by an EMT indicates an understanding of facial anatomy and injuries?

"The only movable bone making up the face is the mandible."

What instructions would you provide to the Emergency Medical Responders when treating a patient who was punched in the eye and has blood visible in the anterior chamber?

"We will need to cover both eyes with patches before we transport him."

A 19-year-old female was assaulted by her intoxicated boyfriend. After punching her in the chest, he slashed her face with a knife. Assessment reveals her to be stable with a large laceration from beneath her right eye to her right ear. She is very upset and crying and repeatedly asks you if this injury will leave a permanent scar on her face. Your best response would be:

"When we get to the hospital, we can discuss this with the doctor."

You have applied a nonporous dressing to a stab wound on a patient's chest. The Emergency Medical Responder assisting you asks you why the dressing was taped on three sides and not all four. Your best response is that taping the dressing on three sides:

Allows trapped air to escape on exhalation.

A patient was stabbed in the right anterior chest and is in obvious respiratory distress. As you perform the secondary assessment, which of the following signs and/or symptoms would concern you that she is suffering from a tension pneumothorax?

Absent breath sounds on the right, distended neck veins, tracheal deviation to the left

A patient has been splashed in the face with battery acid. He is complaining of being unable to see anything and severe burning to his face. On closer examination, you note him to be holding both eyes tightly shut and significant burns to his cheeks and eyelids. In this situation, the EMT would assess the eyes:

After assessing the patient's radial pulse

A 15-year-old female was struck in the mouth with a baseball bat. She has lost her front teeth and is spitting blood. The EMT's priority concern when caring for this patient would be:

Airway compromise

The body systems represented in the neck include:

All of the above

The front chamber of the eye containing the aqueous humor is the _____________. aqueous humor the watery fluid that fills the anterior chamber of the eye. vitreous body the large chamber of the eye, containing the vitreous humor.

Anterior chamber

While working to build a house, a construction worker was hit in the head by a 2" × 4" plank that slid from the roof and fell to the ground below. The patient has a sizable laceration to the left side of his face and is spitting blood. He also lost several teeth, two of which he is holding. Your initial action when caring for this patient would be to:

Apply Occlusive dressing to the laceration

A 22-year-old male attempted to hang himself in a garage using chains suspended from the roof trusses. He was quickly found by family members and taken down to the ground. Currently he is complaining of neck pain as well as mild difficulty breathing. Assessment shows his airway to be patent, breathing adequate, and skin warm and dry. His neck is red, but free of any subcutaneous air or swelling. Which of the following will you do first when caring for this patient?

Apply a cerical collar

On follow-up, the ED physician informs you that a patient you transported earlier was found to have a hemothorax. You would understand this is a condition in which:

Blood collected in the chest

When treating a patient with damage to the facial bones, you should also have a high index of suspicion for:

Injury to the brain

Your physical exam of a patient with an eye injury should include:

Checking for crepitation in facial injuries

A baseball player was struck in the side of the face by a baseball. Assessment findings include swelling and numbness to the left side of the face and left eyelid, as well as crepitus in the same area. Assessment of the eye reveals no obvious injury. The patient denies any problem with his eyesight, but is having difficulty visually tracking your finger upward. Which of the following would be appropriate care for this injury?

Cold packs to the face and eyelid

During an altercation, an intoxicated male was cut with a sharp knife. Assessment reveals a laceration, oozing dark red blood, across the right eyelid down to the right cheek. It also appears that the patient's eye was cut with the knife, reinforced by the complaint of eye pain and collection of blood in the sclera. The EMT would:

Cover the eye with a sterile dressing soaked in saline

A patient complains of pain and discomfort to the left eye after being hit in the face with a cloud of dust while working at a manufacturing complex. As you specifically assess the eye, you note some redness to the globe but do not see any obvious foreign object. The most appropriate care you can provide to this patient would be:

Covering both eye with a bandage

A man grinding metal took his safety goggles off and was struck in the face with a shower of tiny metal fragments. He is complaining of pain and visual disturbance in his right eye. When assessing the eye, you note that the globe is red with several pieces of metal embedded in the tissue. Proper care of this patient would include:

Covering both eyes with a bandage

A patient who was hit in the face with a cloud of dust while working in an industrial setting is complaining of pain and discomfort to his left eye. While performing your secondary assessment on the eye, you note some redness to the globe but do not see any obvious foreign object. The most appropriate care you can provide to this patient would be:

Covering both eyes with a bandage

A young boy riding an ATV did not see a chain stretched between two poles and hit it with his neck while traveling forward. Subsequently, he was thrown backward from the bike with significant force. He was not wearing a helmet. Emergency Medical Responders are with the patient and are holding manual in-line spinal immobilization as well as administering oxygen. When you are assessing this patient, which of the following signs would indicate the injury that must be addressed and managed first?

Difficulty speaking

When assessing a patient, which sign or symptom is most indicative of a pneumothorax?

Decreased breath sounds to the right lung

A patient has sustained an injury to his mediastinum. Based on the anatomy of his chest, which one of the following structures has been injured?

Esophagus

While working to build a house, a construction worker was hit in the head by a 2" × 4" plank that slid from the roof and fell to the ground below. The patient has a sizable laceration to the left side of his face and is spitting blood. He also lost several teeth, two of which he is holding. Your initial action when caring for this patient would be to:

Establish manual in-line spinal stabilization

During your initial assessment, distory, and physicla exam of a patient with an eye, face, or neck injury, remember to:

Establish manual in-line stabilization of the head and neck on the first contact with the patient.

For injuries to the face, emergency care includes all of the following EXCEPT:

Establishing an maintaining the patient's airway by the use of airway adjucts

A(n) _______________ eyeball is one that has been forced from the socket.

Extruded

A young girl complains of eye pain after having sand thrown in her face by another girl at the park. When assessing her eyes, you note large particles of sand in the right eye. The sand appears to be on the conjunctiva, which also seems to be scratched and irritated. Your initial action would be:

Flush the eye with clean water from a nearby sink

If you need to remove a foreign particle from the eye, the technique includes:

Flushing the eye with clean water while holding the eyelids apart

The function of the ocular lens is to:

Focus light onto the retina

Assessment and care guidelines for a patient with an eye injury should include:

Giving the patient nothing by mouth

A young male golfer has been struck in the right eye with a golf club. The upper and lower lids are swollen shut and ecchymotic. There are also some blood clots noted between the two eyelids. Which one of the following indicates that the EMT is providing proper care to this patient?

He wipes blood from the face, but not the eye

A 36-year-old male patient was involved in an altercation with a knife and has suffered a 2-inch laceration to the right side of the neck. Bleeding was controlled prior to your arrival by Emergency Medical Responders. Your paramedic partner has asked you to apply an occlusive dressing to the wound. You recognize that the primary benefit of the action is to:

Hypoxia

You suspect that a patient has a fracture of the left orbit. Which of the following complaints made by the patient would reinforce this suspicion?

I am seeing two of everything

An important thing to remember about eyelid injuries is that:

If an eyeball injury is not suspected, cover the injured lid with a cold compress to reduce swelling

A conscious and alert 32-year-old was assaulted and struck in the jaw with a baseball bat. He complains of tremendous jaw pain and exhibits an unstable mandible. His airway is patent, breathing adequate, and radial pulse normal. In caring for this patient and his injury, you would:

Immobilize to a long spine board

You should always use the _______ maneuver to open the airway of a patient with a suspected neck injury.

Jaw-thrust

You have been called for an elderly female found by family members on the floor of her bathroom. She is unresponsive and has a bruise to the right side of her face. Her respirations are snoring and shallow. Her skin is cool and dry, and she is incontinent of urine. Her daughter tells you that the patient has a past medical history of stroke, COPD, and seizures. Which of the following would be most appropriate when managing this patient's airway?

Jaw-thrust maneuver

A patient had an unknown chemcial splashed into her left eye. You have been irrigating the eye on scene and are now getting ready to transfer her to the stretcher. Knowing that you will need to continue irrigation throughout transport, how will you position this patient on the stretcher?

Left lateral recumbent

You suspect that a patient with an open pneumothorax may be developing a tension pneumothorax. What action is critical given this situation?

Lift one side of the dressing during expiration

You are transporting a 19-year-old male with a gunshot wound to the chest. On scene you covered the wound with an appropriate dressing. Now, as you reassess the patient, you note that the patient is tachypneic and complaining of difficulty breathing. Breath sounds on the side of the injury are diminished. Your immediate action would be to:

Lift the dressing from the wound for several seconds

A patient has been shot in the chest with a rifle. Assessment reveals a deteriorating level of consciousness and inadequate breathing. Positive pressure ventilation is being administered, and the entrance wound, located midclavicular at the second intercostal space on the left side of the chest, has been covered. Your next action would be to:

Look for an exit wound.

The five vertebrae that form the midback are called the:

Lumbar spine

A black eye is frequently an indication of a fractured:

Maxilla

An alert and oriented young male fell 5 feet from a stage, impacting a metal railing with the right side of his chest, just under his armpit. The primary assessment is negative for life threats, although he does complain of very painful breathing and has remarkable tenderness and crepitus over the 5th rib laterally in this area. Throughout care, what action is essential to perform?

Monitor breath sounds.

Any injury to the _____ should automatically be assumed to have caused spinal injury.

Neck

Impaled objects that penetrate all the way through the cheek need to be removed. Steps for removal include:

Suctioning the mouth and throat frequently throughout transport

A 3-year-old has stuck a crayon in his nose. Assessment reveals the crayon to be deeply embedded in the right nostril with some irritation and swelling noted. His vital signs are: pulse 124, respiration 20, and SpO2 100%. Which of the following would be most appropriate when caring for this child?

Non-emergent transport to the hopsital

Care for an open chest wound and an abdominal evisceration are similar in that:

Occlusive dressings are placed over both wounds

Doube vision, a marked decrease in vision, or a loss of sensation above the eyebrow, over the cheek, or in the upper lip may be caused by a(n):

Orbital fracture

You are treating a patient who has suffered several facial lacerations during an automobile accident. As you are assessing the eyes with your penlight, you observe a circular shadow over the patient's left iris. This indicates that the:

Patient is wearing a hard contact lens

What mechanism of injury produces the conditions for traumatic asphyxia?

Person pinned between a truck and wall of a building

Treatment for an impaled object in the eye, or an extruded eyeball, includes:

Placing the patient supine and immobilizing the head

A 36 year old male patient was involved in an altercation with a knife and has suffered a two inch laceration to the right side of the neck. Bleeding was controlled prior to your arrival by Emergency Medical Responders. Your paramedic partner has asked you to apply an occlusive dressing to the wound. You recognize that the primary benefit of the action is to:

Prevent air entry into the circulatory system

A 36-year-old male patient was involved in an altercation with a knife and has suffered a 2-inch laceration to the right side of the neck. Bleeding was controlled prior to your arrival by Emergency Medical Responders. Your paramedic partner has asked you to apply an occlusive dressing to the wound. You recognize that the primary benefit of the action is to:

Prevent air entry into the circulatory system

A 36-year-old male patient was involved in an altercation with a knife and has suffered a 2-inch laceration to the right side of the neck. Bleeding was controlled prior to your arrival by Emergency Medical Responders. Your paramedic partner has asked you to apply an occlusive dressing to the wound. You recognize that the primary benefit of the action is to:

Prevent airway into the circulatory system

A patient with blunt chest wall trauma has a flail section to her chest. She is conscious and confused and breathing rapidly and shallowly. After manually stabilizing the flail section of the chest wall, the EMT best treats this condition by:

Providing positive pressure ventilation

Assessment findings of a patient ejected from a motorcycle indicate that he has a flail chest wall segment to his right anterior chest. He exhibits labored breathing and an SpO2 at 94%. Breath sounds are clear and equal bilaterally. The segment has been stabilized, and you are prepared to start positive pressure ventilation. Given these assessment findings, what type of injury underlying the flail segment is your primary concern?

Pulmonary contusion

A young male patient is self-extricated after hitting a telephone pole and rolling his car several times at a high rate of speed. He is spitting blood and has a large area of tenderness and instability to the left side of his chest. On scene you did not observe any paradoxical motion of the chest wall. The patient remains alert and oriented with stable vital signs, but continually complains of painful breathing. During transport, what is it essential that you do?

Reassess for paradoxical motion of the chest wall

911 was dialed by a frantic mother for her 3 year old daughter who stuck a small, dried bean into her ear. Assessment shows the bean to be lodged firmly in the ear canal. When treating this patient, the EMT would:

Reassure the mother and transport the patient

For a patient suffering from conjunctivitis, the EMT would expect to observe a/an:

Reddened membrane over the sclera

Which of the following is a general guideline to use when determining whether or not to remove a patient's contact lenses?

Remoe if the eye has been injured by a chemcial burn

An elderly woman is suffering from a closed head injury after falling down five steps. She is responsive to painful stimuli and is breathing shallowly. When evaluating her airway, you note that she has both upper and lower dentures. Her upper dentures are secure, but her lower dentures are loose and cracked. Prior to providing positive pressure ventilation, you would:

Remove the lower dentures

A young male patient has been involved in a motor vehicle accident. As an unrestrained driver, his head went through the driver's side window; in the process a portion of his ear was severed. Blood is now coming from the remaining portion of his left ear. In overseeing the care of this patient, which of the following would require corrective action?

Rolled gauze in the ear canal

When assessing a male patient who was punched in the face by another man, you detect blood in the white part of his eye. As such, you would recognize injury to what optical structure?

Sclera

There are many types of injuries that can occur to the globe of the eye. Which of the following is true regarding injuries to the globe?

Signs and symptoms of injury to the globe may include a pear- or irregular-shaped eyeball

During the secondary assessment, the EMT notes instability and a flail segment to a patient's lower left lateral chest. The EMT would immediately:

Stabilize the segment with his hand

A young boy was running with a pencil and tripped. The pencil impaled the boy's left eye and remains lodged in place. He is in his mother's arms and both are crying hysterically. Appropriate care for the eye would include:

Stabilizing the impaled object and providing immediate transport

stabilize the segment with his hand.

Stopping air entry

A female patient struck her face on the steering wheel in a head-on motor vehicle collision and has deformity and crepitus to the bridge of her nose. Further assessment reveals bleeding deep within the nasal passages. The patient has been fully immobilized to a long board. To best address the hemorrhage in the nasopharynx, the EMT would:

Suction blood from the airway as needed

A construction worker has been shot with a nail gun, resulting in a long nail going through his cheek and firmly embedding into the lower gum and jaw. There is considerable blood in his mouth and he is in excruciating pain. Given this scenario, which of the following would be your first priority?

Suctioning the airway

A 23-year-old male struck his face on the steering wheel after he struck another car from behind. His nose is deformed and actively bleeding. In his care, which of the following would be a priority?

Suctioning the airway to keep it free of blood

A patient complaining of eye pain informs you that he was diagnosed with a corneal abrasion three days ago. He called 911 today because the discomfort has not yet resolved and he desires medical attention. Based on this information, which of the following is true?

The clear structure that covers the pupil has been damaged.

Which one of the following statements by by an EMT indicates an understanding of facial injuries?

The only movable bone makign up the face is the mandible

Special considerations you should heed for injuries to the face, mouth, or jaw include:

The tongue may lose its support structure with a facial injury and may fall back, requiring you to grasp the tongue and pull it forward

Generally, while caring for a patient with an eye injury, you should remove contact lenses if:

There has been a chemcial burn to the eye

An Emergency Medical Responder asks you to explain a pneumothorax. You would explain that a pneumothorax occurs when:

air accumulates around the lung, causing a portion of it to collapse.

You have been called to a high school science lab where a male student was splashed in the eye with an alkaline solution. He is complaining of burning to the eye as well as pain. After performing the primary assessment and finding no life-threatening conditions, you would:

hold the patient's eye open and begin flushing with large amounts of tap water and continue throughout transport.