Chapter 28: Head and Spine Injuries - Delilah

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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

In supine patients with a head injury, the head should be elevated _____ to help reduce intracranial pressure.

30 degrees

The peripheral nervous system has _____ pairs of spinal nerves.

31 (you type this number)

Inability to remember events after a head injury

Anterograde amnesia

Swelling of the brain

Cerebral edema

Temporary loss of the brain's ability to function without actual physical damage

Concussion

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

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

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 is NOT a symptom of a concussion?

Muscle tremors

Inability to remember events leading up to a head injury.

Retrograde amnesia

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

Somatic

Neck rigidity, bloody cerebrospinal fluid, and headache are associated with what kind of bleeding in the brain?

Subarachnoid hemorrhage

Accumulation of blood beneath the dura mater but outside the brain.

Subdural hematoma

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 _______ and pia mater are the inner two layers of the meninges and are much thinner than the dura mater.

arachnoid (you have to be able to spell this)

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.

The central nervous system (CNS) is composed of the:

brain and spinal cord.

Injury to the head and neck may indicate injury to the:

cervical spine.

The five sections of the spinal column, in descending order, are the:

cervical, thoracic, lumbar, sacral, and coccygeal.

The Glasgow Coma Scale (GCS) is used to assess:

eye opening, verbal response, and motor response.

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

hangings.

You respond to a 38-year-old man who fell while rock climbing. He is unconscious with an open airway. The respiration and pulse rates are within normal limits. His distal pulses are intact. You check his pupils and find that they are unequal. You know this could be a sign of:

increased intracranial pressure.

In contrast to a cerebral concussion, a cerebral contusion:

involves physical injury to the brain tissue.

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.

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

it interferes with your assessment of the airway.

The nervous system is divided into the central nervous system and the:

peripheral nervous system.

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

pupillary constriction

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.

Upon completion of spinal immobilization, reassessment of pulse, motor, and _____ function in each extremity is necessary.

sensory (spelling again)

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

slow.

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.

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

the four-person log roll.

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.

Helmets must be removed in all of the following cases, EXCEPT:

when there are no impending airway or breathing problems.


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