3 TERM FINAL (27-40)
Which of the following is NOT a sight of potential injury when the aorta is subjected to shearing forces during rapid deceleration?
Coronary sinus
The ______________ consists of eight bones that encase and protect the brain.
Cranial Vault
Any normotensive patient with a sternal fracture should receive
ECG monitoring
Which of the following statements regarding a pericardial tamponade is correct?
In a pericardial tamponade, blood collects between the visceral and parietal pericardium
What type of intracranial hemorrhage would MOST likely be caused by a penetrating head injury?
Intracerebral hematoma
Which of the following statements regarding the hangman's fracture is correct?
It is a fracture of C2 that is secondary to significant distraction of the neck.
Which of the following clinical signs may not be present in a patient with a tension pneumothorax and associated internal bleeding?
Jugular vein distention
Which of the following is NOT a mediastinal structure?
Lung
Which of the following thoracic injuries would you LEAST likely discover in the primary assessment?
Myocardial contusion
Which of the following cranial nerves innervates the muscles that cause motion of the eyeballs and upper eyelids?
OculomotorThis answer is correct.
Which of the following thoracic injuries generally does NOT require immediate treatment?
Open pneumothorax
Which of the following is the MOST significant complication associated with a fractured nasal bone?
Posterior Epistaxis
Which of the following conditions that can cause an airway obstruction is unique to patients with an injury to the upper cervical spine?
Retropharyngeal hematoma
A patient with diaphragmatic breathing without intercostal muscle use has MOST likely experienced a spinal injury above the level of:
T2
What type of chest injury is characterized by air accumulation in the pleural space when a perforation in the lung parenchyma acts as a one-way valve?
Tension pneumothorax
Which of the following statements regarding the brainstem is correct?
The brainstem connects the spinal cord to the brain.
Cerebrospinal fluid drainage from the ears is MOST indicative of
a skull fracture.
Bony structures of the thorax include all of the following, EXCEPT the:
acromion.
The visceral pericardial layer:
adheres to the heart and forms the epicardium.
Pneumothorax is MOST accurately defined as:
air or gas within the pleural cavity.
The primary risk associated with oral and dental injuries is:
airway compromise
A pulmonary contusion following blunt chest trauma results in
alveolar and capillary damage with intraparenchymal lung hemorrhage.
The crescent-shaped fold that divides the cerebrum into left and right hemispheres is called the:
falx cerebelli.
Spinal cord injuries that cause neurogenic shock generally produce:
flaccid paralysis and complete loss of sensation distal to the injury.
Signs and symptoms of retinal detachment include:
flashing lights, specks, or floaters in the field of vision.
The dura mater:
folds in to form the tentorium, a structure that separates the cerebral hemispheres from the cerebellum and brainstem.
A spinal cord concussion is:
caused by a short-duration shock or pressure wave within the cord.
Patients with evidence of trauma above the _________ should be considered at risk for an associated spine injury
clavicles
Unlike a tension pneumothorax, a massive hemothorax would MOST likely present with:
collapsed jugular veins
A patient with a small simple pneumothorax would MOST likely present with diminished breath sounds:
in the apices of the affected lung if he or she is sitting upright.
Regardless of the method of spinal immobilization used, you must: Selected:
keep the head, neck, and trunk in alignment.
You would MOST likely have to place several blankets or pillows under a patient's upper back prior to immobilization if he or she has:
kyphosis.
When an unrestrained passenger's head strikes the windshield of a motor vehicle following rapid deceleration:
compression injuries occur to the anterior portion of the brain, and stretching or tearing injuries occur to the posterior portion of the brain.
When assessing the severity of a traumatic brain injury, the MOST important assessment parameter is the patient's:
level of consciousness.
Decerebrate posturing is characterized by:
extension of the arms and extension of the legs.
Treatment for a patient with neurogenic shock may include all of the following, EXCEPT:
prevention of hyperthermia.
When assessing a patient with maxillofacial trauma, it is most important to:
protect the cervical spine and monitor the patient's neurologic status
The MOST effective method for decreasing morbidity and mortality associated with spinal cord injury is:
public education and prevention strategies
Common clinical findings associated with a subdural hematoma include all of the following, EXCEPT:
rapidly increasing intracranial pressure.
The anterior-most portion of the heart is the:
right ventricle
Open soft-tissue facial trauma following a significant mechanism of injury:
suggests that the patient may have a closed head injury or spinal injury.
The preferred site for performing a needle thoracentesis is:
superior to the third rib into the intercostal space at the midclavicular line
If the pleural space becomes filled with air or blood:
surface tension is lost and the lung collapses.
Isolated rib fractures may result in inadequate ventilation because:
the patient often purposely limits chest wall movement
Vagal tone remains intact following a spine injury because:
the vagus nerve originates outside the medulla and regulates the heart via the carotid arteries.
Spinal cord injury without radiographic abnormalities can occur in children because:
their vertebrae lie flatter on top of each other.
Ribs 4 through 9 are the most commonly fractured because
they are less protected by other bony and muscular structures.
Death following a head injury is MOST often the result of:
trauma to the brain.
Commotio cordis is a phenomenon in which:
ventricular fibrillation is induced following blunt trauma to the chest during the heart's repolarization period.
A complete spinal cord injury to the upper cervical spine:
will result in permanent loss of all cord-mediated functions below the level of the injury.
Increased intravenous pressure commonly manifests as:
jugular venous distention.
With the exception of the aorta, great vessel injury is MOST likely to occur following:
penetrating trauma.
Pneumothoraces create a ventilation-perfusion mismatch when:
perfusion of the involved lung continues while the pneumothorax prevents adequate ventilation.
Which of the following clinical findings is MOST suggestive of inadequate oxygenation?
Altered mental status
Which of the following statements regarding diaphragmatic injury is correct?
Because the diaphragm is protected by the liver on the right side, most diaphragmatic injuries caused by blunt force trauma occur on the left side.
A compression or burst fracture of the cervical spine would MOST likely occur following:
a significant fall in which the patient lands head first.
Following blunt trauma to the anterior chest, a 44-year-old man presents with restlessness, respiratory distress, perioral cyanosis, and tachycardia. Further assessment reveals a midline trachea, engorged jugular veins, and absent breath sounds on the right side of his chest. You should:
The diaphragm inserts into the anterior thoracic cage below the fifth rib.
Most hemothoraces occur when:
a fractured rib injures the lung parenchyma
A flail chest is characterized by
a free-floating segment of fractured ribs.
Most of the heart is protected
anteriorly by the sternum.
Open fractures of the cranial vault:
are associated with a high risk of bacterial meningitis
The eleventh and twelfth ribs are known as the floating ribs because they:
are not attached anteriorly to the sternum.
As soon as the aorta exits the left ventricle, it:
ascends toward the right shoulder.
Tracheobronchial injuries have a high mortality due to:
associated airway obstruction.
Unlike a cerebral concussion, a cerebral contusion is:
associated with physical brain damage and more pronounced neurologic deficits.
If the mechanism of injury indicates that your patient may have sustained a spinal cord injury
assume that a spine injury exists, regardless of the neurologic findings.
If the mechanism of injury indicates that your patient may have sustained a spinal cord injury:
assume that a spine injury exists, regardless of the neurologic findings.
When performing a needle decompression of the chest, you should insert the needle:
at a 90-degree angle and listen for the release of air.
In contrast to secondary spinal cord injury, primary spinal cord injury occurs:
at the moment of impact.
Any patient with a presumptive diagnosis of a pneumothorax should:
be considered unstable and reassessed every 5 minutes
Hyphema is defined as:
blood in the anterior chamber of the eye.
The parietal lobe of the brain:
controls the body's ability to perceive body limb movement.
Immediate treatment for an open pneumothorax involves:
converting the pneumothorax to a closed injury.
The eighth, ninth, and tenth ribs are indirectly attached to the sternum by the
costal cartilage.
General care for an eye injury involves:
covering both eyes to minimize further injury.
Dysrhythmias following a myocardial contusion are usually secondary to:
damage to myocardial tissue at the cellular level.
As air accumulates in the pleural space, the FIRST thing to occur is
decreased pulmonary function.
General treatment for a 40-year-old patient with a significant head injury and signs of Cushing triad includes:
elevating the head 15 to 30 degrees.
The diaphragm:
forms a barrier between the thoracic and abdominal cavities.
In general, patients suspected of having a partial tracheal tear should be managed with:
he least invasive airway techniques possible.
Due to intrapulmonary hemorrhage, patients with a pulmonary contusion may present with
hemoptysis.
Hyperacute pain to touch is called:
hyperesthesia
You would NOT expect a patient with a flail chest to present with:
hyperpnea
Common clinical findings associated with a traumatic asphyxia include all of the following, EXCEPT:
hyphema
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:
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.
A diffuse axonal injury:
involves stretching, shearing, or tearing of the extension of the neuron that conducts electrical impulses away from the cell body.
Jugular venous distention during a tension pneumothorax:
is caused by blood accumulation in the vena cava.
A ruptured tympanic membrane: Selected:
is extremely painful but typically heals spontaneously
Spinal shock is a condition that:
is usually temporary and results from swelling of the spinal cord.
A young man was assaulted and has extensive maxillofacial injuries. Your primary assessment reveals that he is semiconscious, has shallow breathing, and has blood draining from the corner of his mouth. Initial management for this patient involves:
manually stabilizing his head in a neutral position, suctioning his oropharynx, and assisting ventilations with a bag-mask device and 100% oxygen.
The self-splinting effect observed in patients with chest wall trauma:
may cause atelectasis, hypoxemia, or pneumonia
By definition, a massive hemothorax is characterized by:
more than 1,500 mL of blood within the pleural space.
An open pneumothorax causes ventilatory inadequacy when:
negative pressure created by inspiration draws air into the pleural space.
You should be MOST suspicious that your patient has a pericardial tamponade if he or she presents with hypotension, jugular vein distention, and:
normal lung sounds.
The pressure within the right ventricle is:
one fourth of the pressure within the left ventricle.
A conscious but combative patient with severe facial trauma is fully immobilized on a backboard. During your assessment, the patient begins coughing up large amounts of blood. You suction her oropharynx, but her mouth quickly refills with blood. You should:
roll the backboard on its side, suction her oropharynx, and prepare to perform pharmacologically assisted intubation.
Proper treatment for an open wound to the neck includes:
sealing the wound with an occlusive dressing.
The space between the second and third ribs is called the
second intercostal space.
Traumatic injuries to the aorta are MOST commonly the result of:
shearing forces.
A blood pressure of 100/70 mm Hg in the presence of clinical signs of a tension pneumothorax:
suggests adequate cardiac compensation for the diminished venous return.
