Chapter 28: Head and Spine Injuries, EMT - Chapter 28: Head and Spine Injuries

You are treating a patient who went face-first through a windshield. She has extensive head injuries and is displaying hypertension, bradycardia, and Cheyne-Stokes respirations. Which of the following should you suspect? (a) Cushing triad (b) C6 herniation (c) Concussion (d) Cerebral edema

(a) Cushing triad

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: (a) bacterial meningitis. (b) hypovolemic shock. (c) sudden hypotension. (d) permanent hearing loss.

(a) bacterial meningitis.

When assessing a conscious patient with an MOI that suggests spinal injury, you should: (a) determine if the strength in all extremities is equal. (b) rule out a spinal injury if the patient denies neck pain. (c) defer spinal immobilization if the patient is ambulatory. (d) ask the patient to move his or her head to assess for pain.

(a) determine if the strength in all extremities is equal.

When placing a patient onto a long backboard, the EMT at the patient's _________ is in charge of all patient movements. (a) head (b) chest (c) waist (d) lower extremities

(a) head

A patient who cannot remember the events that preceded his or her head injury is experiencing: (a) retrograde amnesia. (b) anterograde amnesia. (c) prograde amnesia. (d) posttraumatic amnesia.

(a) retrograde amnesia.

Which of the following statements regarding cervical collars is correct? (a) Once a cervical collar is applied, you can cease manual head stabilization. (b) A cervical collar is used in addition to, not instead of, manual immobilization. (c) Cervical collars are contraindicated in patients with numbness to the extremities. (d) The patient's head should be forced into a neutral position to apply a cervical collar.

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

Which of the following acts as a shock absorber for the CNS? (a) Dura mater (b) Cerebrospinal fluid (c) Fascia (d) Pia mater

(b) Cerebrospinal fluid

During your primary assessment of a semiconscious 30-year-old female with closed head trauma, you note that she has slow, irregular breathing and a slow, bounding pulse. As your partner maintains manual in-line stabilization of her head, you should: (a) perform a focused secondary assessment of the patient's head and neck. (b) instruct him to assist her ventilations while you perform a rapid assessment. (c) apply 100% oxygen via a nonrebreathing mask and obtain baseline vital signs. (d) immediately place her on a long backboard and prepare for rapid transport.

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

The five sections of the spinal column, in descending order, are the: A. thoracic, cervical, lumbar, coccygeal, and sacral. B. cervical, thoracic, lumbar, sacral, and coccygeal. C. coccygeal, sacral, lumbar, thoracic, and cervical. D. cervical, coccygeal, thoracic, sacral, and lumbar.

B. cervical, thoracic, lumbar, sacral, and coccygeal.

The frontal and parietal bones of the skull are especially susceptible to: A. basilar skull fractures. B. compressed skull fractures. C. linear skull fractures. D. nondisplaced skull fractures.

B. compressed skull fractures.

Which of the following nerves allow sensory and motor impulses to be sent from one nerve directly to another? A. somatic B. connecting C. peripheral D. autonomic

B. connecting

In a(n) ________, CSF flows freely from the patient's ear; this type of injury can be difficult to diagnose with a radiograph. (a) Basilar skull fracture (b) Intracerebral hematoma (c) Linear skull fracture (d) Subdural hematoma

(a) Basilar skull fracture In a basilar skull fracture, CSF flows freely from the patient's ear; this type of injury can be difficult to diagnose with a radiograph.

When securing a patient to a backboard, what area of the body should you secure last? (a) Head (b) Upper torso (c) Pelvis (d) Upper legs

(a) Head

Which of the following skull fractures would be the LEAST likely to present with palpable deformity or other outward signs? (a) Linear (b) Basilar (c) Open (d) Depressed

(a) Linear

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: (a) remove his helmet and shoulder pads (b) leave his helmet and shoulder pads in place. (c) remove his helmet, but leave his shoulder pads in place. (d) leave his helmet in place, but remove his shoulder pads.

(b) leave his helmet and shoulder pads in place.

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: (a) 12. (b) 13. (c) 14. (d) 15.

(c) 14.

The cervical spine is composed of _____ vertebrae. (a) 5 (b) 6 (c) 7 (d) 8

(c) 7

You are reassessing a patient and you find that her left pupil is dilated and fixed. What does this indicate? (a) Decreased blood pressure (b) Increased blood pressure (c) Increased intracranial pressure (d) Drug abuse

(c) Increased intracranial pressure

Cushing triad in a patient is a sign of which of the following? (a) Spinal cord damage (b) Concussion (c) Intracranial pressure (d) Blood clot in the brain

(c) Intracranial pressure

Accounting for approximately 80% of all skull fractures, which of the following often present with no physical signs? (a) Basilar skull fractures (b) Depressed skull fractures (c) Linear skull fractures (d) Open skull fractures

(c) Linear skull fractures

The time between an initial period of unconsciousness and a subsequent loss of consciousness is referred to as what? (a) Coherent stage (b) Danger zone (c) Lucid interval (d) Recognition period

(c) Lucid interval

You are treating a patient who might have a skull fracture. What should you do if a dressing you have applied to a head wound becomes soaked? (a) Replace the dressing with a fresh one. (b) Remove the dressing and apply an occlusive dressing. (c) Place a clean dressing over the bloody one. (d) Apply direct pressure and add a compression dressing.

(c) Place a clean dressing over the bloody one.

Battle sign is an indication of which of the following? (a) Concussion (b) Contusion (c) Skull fracture (d) Secondary injury

(c) Skull fracture

The body's functions that occur without conscious effort are regulated by the _________ nervous system. (a) sensory (b) somatic (c) autonomic (d) voluntary

(c) autonomic

When controlling bleeding from a scalp laceration with a suspected underlying skull fracture, you should: (a) elevate the patient's head and apply an ice pack. (b) apply manual pressure and avoid applying a bandage. (c) avoid excessive pressure when applying the bandage. (d) apply firm compression for no longer than 5 minutes.

(c) avoid excessive pressure when applying the bandage.

Coordination of balance and body movement is controlled by the: (a) medulla. (b) cerebrum. (c) cerebellum. (d) brain stem.

(c) cerebellum.

The MOST important immediate treatment for patients with a head injury, regardless of severity, is to: (a) immobilize the entire spine. (b) administer high-flow oxygen. (c) establish an adequate airway. (d) transport to a trauma center.

(c) establish an adequate airway.

Lacerations to the scalp: (a) bleed minimally because the scalp has few vessels. (b) uncommonly cause hypovolemic shock in children. (c) may be an indicator of deeper, more serious injuries. (d) are most commonly associated with skull fractures.

(c) may be an indicator of deeper, more serious injuries.

While performing a secondary assessment of a patient who was hit with a tire iron on the side of the head, you find a depressed area above the patient's left ear. This indicates that the patient could have which of the following? (a) An intracerebral hematoma (b) A subdural hematoma (c) A subarachnoid hemorrhage (d) An epidural hematoma

(d) An epidural hematoma

Which of the following statements regarding the cranium is correct? (a) The skull is a subdivision of the cranium. (b) Thirty percent of the cranium is occupied by blood. (c) The cranium protects the structures of the face. (d) Eighty percent of the cranium is occupied by brain tissue.

(d) Eighty percent of the cranium is occupied by brain tissue.

When opening the airway of a patient with a suspected spinal injury, you should use the: (a) tongue-jaw lift maneuver. (b) head tilt-neck lift maneuver. (c) head tilt-chin lift maneuver. (d) jaw-thrust maneuver.

(d) jaw-thrust maneuver.

When caring for a patient with a possible head injury, it is MOST important to monitor the patient's: (a) pupil size. (b) blood pressure. (c) pulse regularity. (d) level of consciousness.

(d) level of consciousness.

The _________ nervous system consists of 31 pairs of spinal nerves and 12 pairs of cranial nerves. (a) central (b) somatic (c) autonomic (d) peripheral

(d) peripheral

When immobilizing a child on a long backboard, you should: (a) secure the head prior to securing the torso and legs. (b) defer cervical collar placement to avoid discomfort. (c) place the child's head in a slightly extended position. (d) place padding under the child's shoulders as needed.

(d) place padding under the child's shoulders as needed.

When assessing a patient with a suspected head or spine injury, which of the following should you do? - Administer high-flow oxygen. - Hyperventilate the patient. - Remove the cervical collar during secondary assessment to facilitate reassessment of vital signs. - Assess the patient in the position found.

- Assess the patient in the position found - Administer high-flow oxygen

Which of the following are signs of Cushing triad? - loss of sensation - hypertension - irregular respirations - bradycardia

- irregular respirations - hypertension - bradycardia

When caring for a patient with a possible head injury, it is MOST important to monitor the patient's: A. pupil size. B. blood pressure. C. pulse regularity. D. level of consciousness.

D. level of consciousness.

A patient who cannot remember the events that preceded his or her head injury is experiencing: A. retrograde amnesia. B. anterograde amnesia. C. perigrade amnesia. D. posttraumatic amnesia.

A. retrograde amnesia.

Which of the following statements regarding motor nerves is correct? A. They carry information from the CNS to the muscles. B. They perform special functions such as sight, smell, and hearing. C. They transmit information from the body to the brain via the spinal cord. D. They are part of the CNS and control reflexes.

A. They carry information from the CNS to the muscles.

An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is: A. a rapid deterioration of neurologic signs. B. a progressively lowering blood pressure. C. an acute increase in the patient's pulse rate. D. acute unilateral paralysis following the injury.

A. a rapid deterioration of neurologic signs.

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: Select one: A. axial loading. B. hyperflexion. C. distraction. D. hyperextension

A. axial loading.

An epidural hematoma is MOST accurately defined as: A. bleeding between the skull and dura mater. B. bleeding between the dura mater and brain. C. venous lacerations that occur within the brain. D. an injury caused by a damaged cerebral artery.

A. bleeding between the skull and dura mater.

Which of the following sets of vital signs depicts Cushing's triad? A. blood pressure, 190/110 mm Hg; pulse, 55 beats/min; respirations, 30 breaths/min B. blood pressure, 90/50 mm Hg; pulse, 120 beats/min; respirations, 10 breaths/min C. blood pressure, 200/100 mm Hg; pulse, 140 beats/min; respirations, 28 breaths/min D. blood pressure, 80/40 mm Hg; pulse, 30 beats/min; respirations, 32 breaths/min

A. 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. A. brain stem B. cerebellum C. spinal cord D. cerebral cortex

A. brain stem

The _________ contain(s) about 75% of the brain's total volume. A. cerebrum B. cerebellum C. brain stem D. meninges

A. cerebrum

Common signs and symptoms of a serious head injury include all of the following, EXCEPT: A. constricted pupils. B. combative behavior. C. CSF leakage from the ears. D. decreased sensory function.

A. constricted pupils.

When assessing a conscious patient with an MOI that suggests spinal injury, you should: A. determine if the strength in all extremities is equal. B. rule out a spinal injury if the patient denies neck pain. C. defer spinal immobilization if the patient is ambulatory. D. ask the patient to move his or her head to assess for pain.

A. determine if the strength in all extremities is equal.

It would be MOST appropriate to perform a focused secondary assessment on a patient who: A. fainted and fell to the ground from a standing position. B. was restrained during a high-speed motor vehicle crash. C. has blood draining from the ears following a head injury. D. struck his or her head and is experiencing nausea or vomiting.

A. fainted and fell to the ground from a standing position.

When placing a patient onto a long backboard, the EMT at the patient's _________ is in charge of all patient movements. A. head B. chest C. waist D. lower extremities

A. head

The effectiveness of positive-pressure ventilations when treating a head-injured patient can ONLY be determined by: A. immediate reassessment following the intervention. B. a neurosurgeon or emergency department physician. C. reassessing the patient's blood pressure after at least 10 minutes. D. noting a decrease in the heart rate during ventilations.

A. immediate reassessment following the intervention.

A tight-fitting motorcycle helmet should be left in place unless: A. it interferes with your assessment of the airway. B. the patient must be placed onto a long backboard. C. the patient complains of severe neck or back pain. D. the helmet is equipped with a full face shield or visor.

A. it interferes with your assessment of the airway.

Which of the following skull fractures would be the LEAST likely to present with palpable deformity or other outward signs? A. linear B. basilar C. open D. compressed

A. linear

When activated, the sympathetic nervous system produces all of the following effects, EXCEPT: A. pupillary constriction. B. increase in heart rate. C. shunting of blood to vital organs. D. dilation of the bronchiole smooth muscle.

A. pupillary constriction.

The _________ nervous system consists of 31 pairs of spinal nerves and 12 pairs of cranial nerves. A. central B. somatic C. autonomic D. peripheral

D. peripheral

You should be MOST suspicious that a patient has experienced a significant head injury if his or her pulse is: A. slow. B. weak. C. rapid. D. irregular.

A. slow.

The spinal cord is encased in and protected by the: A. spinal canal. B. vertebral body. C. vertebral arch. D. intervertebral disc.

A. spinal canal.

If you do not have the appropriate size cervical collar, you should: A. use rolled towels to immobilize the patient's head. B. place sandbags on either side of the patient's head. C. ask the patient to keep his or her head in a neutral position. D. defer cervical immobilization and apply lateral head blocks.

A. use rolled towels to immobilize the patient's head.

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): A. cerebral contusion. B. cerebral concussion. C. intracranial hemorrhage. D. intracerebral hematoma.

B. cerebral concussion.

The MOST common and serious complication of a significant head injury is: A. a skull fracture. B. cerebral edema. C. a hypoxic seizure. D. acute hypotension.

B. cerebral edema.

After your partner assumes manual in-line stabilization of the patient's head, you should: A. apply an appropriately sized rigid cervical collar. B. assess distal neurovascular status in the extremities. C. thoroughly palpate the patient's head for deformities. D. use four people to log roll the patient onto a backboard.

B. assess distal neurovascular status in the extremities.

The central nervous system (CNS) is composed of the: A. cerebellum and brain. B. brain and spinal cord. C. cerebrum and meninges. D. meninges and spinal cord.

B. brain and spinal cord.

A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response? A. 2 B. 3 C. 4 D. 5

B. 3

Which of the following statements regarding cervical collars is correct? A. Once a cervical collar is applied, you can cease manual head stabilization. B. A cervical collar is used in addition to, not instead of, manual immobilization. C. Cervical collars are contraindicated in patients with numbness to the extremities. D. The patient's head should be forced into a neutral position to apply a cervical collar.

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

The MOST reliable sign of a head injury is: A. a pulse that is rapid and thready. B. a decreased level of consciousness. C. an abnormally low blood pressure. D. decreased sensation in the extremities.

B. a decreased level of consciousness.

Common signs and symptoms of a serious head injury include all of the following, EXCEPT: Select one: A. CSF leakage from the ears. B. a rapid, thready pulse. C. widening pulse pressure. D. decerebrate posturing.

B. a rapid, thready pulse.

The meninges, along with the cerebrospinal fluid (CSF) that circulates in between each meningeal layer, function by: A. regenerating brain cells after they have been damaged. B. acting as a shock absorber for the brain and spinal cord. C. delivering oxygen directly to the CNS. D. producing leukocytes that protect the brain from infection.

B. acting as a shock absorber for the brain and spinal cord.

Any unresponsive trauma patient should be assumed to have: A. a history of diabetes mellitus. B. an accompanying spinal injury. C. a severe intracranial hemorrhage. D. internal bleeding in the abdomen.

B. an accompanying spinal injury.

A short backboard or vest-style immobilization device is indicated for patients who: A. are found supine and have stable vital signs. B. are in a sitting position and are clinically stable. C. require prompt extrication from an automobile. D. are sitting in their car and are clinically unstable.

B. are in a sitting position and are clinically stable.

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: A. obtain a Glasgow Coma Score value and give him oxygen. B. immobilize his spine and perform a focused secondary exam. C. allow him to refuse transport if his vital signs remain stable. D. perform a rapid head-to-toe exam and immobilize his spine.

B. 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: A. perform a focused secondary assessment of the patient's head and neck. B. instruct him to assist her ventilations while you perform a rapid assessment. C. apply 100% oxygen via a nonrebreathing mask and obtain baseline vital signs. D. immediately place her on a long backboard and prepare for rapid transport.

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

Bleeding within the brain tissue itself is called a(n): A. epidural hematoma. B. intracerebral hematoma. C. subdural hematoma. D. intracranial hematoma.

B. intracerebral hematoma.

Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless: Select one: A. lateral immobilization has been applied. B. it causes a problem managing the airway. C. sensory and motor functions remain intact. D. the patient adamantly denies neck pain.

B. it causes a problem managing the airway.

When a patient experiences a severe spinal injury, he or she: A. will likely be paralyzed from the neck down. B. may lose sensation below the level of the injury. C. most commonly has a palpable spinal deformity. D. often loses motor function on one side of the body.

B. may lose sensation below the level of the injury.

Moderate elevation in intracranial pressure with middle brain stem involvement is characterized by: A. increased blood pressure, bradycardia, reactive pupils, and rapid respirations. B. sluggishly reactive pupils, widened pulse pressure, bradycardia, and posturing. C. ataxic respirations, unequal pupils, no response to pain, and an irregular pulse. D. fixed and dilated pupils, decreased blood pressure, and irregular respirations.

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

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: A. assist his ventilations with a bag-mask device. B. suction his oropharynx for up to 15 seconds. C. immobilize his spine and transport immediately. D. pack his nostrils to stop the drainage of blood.

B. suction his oropharynx for up to 15 seconds.

The ideal procedure for moving an injured patient from the ground to a backboard is: A. the clothes drag. B. the four-person log roll. C. to use a scoop stretcher. D. the direct patient carry.

B. the four-person log roll.

When the parasympathetic nervous system is activated: A. blood is shunted away from the digestive organs. B. the heart rate decreases and the blood vessels dilate. C. hormones are released that prepare the body for stress. D. heart rate and blood pressure increase.

B. the heart rate decreases and the blood vessels dilate.

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: A. 12. B. 13. C. 14. D. 15.

C. 14.

The cervical spine is composed of _____ vertebrae. A. 5 B. 6 C. 7 D. 8

C. 7

Which of the following statements regarding secondary brain injury is correct? A. It results from direct brain trauma following an impact to the head. B. Because cerebral edema develops quickly, it is considered to be a primary brain injury. C. Hypoxia and hypotension are the two most common causes of secondary brain injury. D. Signs are often present immediately after an impact to the head.

C. 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? Select one: A. Increased rate and depth with the distinct odor of acetone on the patient's breath B. Increased rate with a normal inspiratory time and a prolonged expiratory time C. Irregular rate, pattern, and volume of breathing with intermittent periods of apnea D. Slow, shallow, occasional gasps that progress to prolonged periods of apnea

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

Which of the following statements regarding a basilar skull fracture is correct? A. Bloody CSF commonly leaks from the nose. B. In most cases, mastoid bruising occurs. C. The absence of raccoon eyes or Battle's sign does not rule it out. D. They are typically the result of local, low-energy trauma to the head.

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

When immobilizing a seated patient with a short backboard or vest-style immobilization device, you should apply a cervical collar: A. after the torso has been adequately secured. B. after moving the patient to a long backboard. C. after assessing distal neurovascular functions. D. before manually stabilizing the patient's head.

C. after assessing distal neurovascular functions.

The body's functions that occur without conscious effort are regulated by the _________ nervous system. A. sensory B. somatic C. autonomic D. voluntary

C. autonomic

When controlling bleeding from a scalp laceration with a suspected underlying skull fracture, you should: A. elevate the patient's head and apply an ice pack. B. apply manual pressure and avoid applying a bandage. C. avoid excessive pressure when applying the bandage. D. apply firm compression for no longer than 5 minutes.

C. avoid excessive pressure when applying the bandage.

Coordination of balance and body movement is controlled by the: A. medulla. B. cerebrum. C. cerebellum. D. brain stem.

C. cerebellum.

The hormone responsible for the actions of the sympathetic nervous system is: A. insulin. B. thyroxine. C. epinephrine. D. aldosterone.

C. epinephrine.

The MOST important treatment for patients with a head injury, regardless of severity, is to: A. immobilize the spine. B. administer 100% oxygen. C. establish an adequate airway. D. transport to a trauma center.

C. establish an adequate airway.

Distraction injuries of the spine are MOST commonly the result of: A. falls. B. diving. C. hangings. D. compression.

C. hangings.

In contrast to a cerebral concussion, a cerebral contusion: A. does not cause pressure within the skull. B. results from a laceration to the brain tissue. C. involves physical injury to the brain tissue. D. usually does not cause a loss of consciousness.

C. 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: A. the patient adamantly denies neck pain. B. lateral immobilization has been applied. C. it causes a problem managing the ABCs. D. sensory and motor functions remain intact.

C. it causes a problem managing the ABCs.

Lacerations to the scalp: A. bleed minimally because the scalp has few vessels. B. uncommonly cause hypovolemic shock in children. C. may be an indicator of deeper, more serious injuries. D. are most commonly associated with skull fractures.

C. may be an indicator of deeper, more serious injuries.

What part of the nervous system controls the body's voluntary activities? A. central B. sensory C. somatic D. autonomic

C. somatic

When immobilizing a child on a long backboard, you should: A. secure the head prior to securing the torso and legs. B. defer cervical collar placement to avoid discomfort. C. place the child's head in a slightly extended position. D. place padding under the child's shoulders as needed.

D. place padding under the child's shoulders as needed.

The Glasgow Coma Scale (GCS) is used to assess: A. mental status, eye opening, and respiratory rate. B. sensory response, pupil reaction, and heart rate. C. verbal response, eye opening, and mental status. D. eye opening, verbal response, and motor response.

D. eye opening, verbal response, and motor response.

Hyperextension injuries of the spine are MOST commonly the result of: Select one: A. diving. B. falls. C. compression. D. hangings.

D. hangings.

When opening the airway of a patient with a suspected spinal injury, you should use the: A. tongue-jaw lift maneuver. B. head tilt-neck lift maneuver. C. head tilt-chin lift maneuver. D. jaw-thrust maneuver.

D. jaw-thrust maneuver.

Which of the following statements regarding the cranium is correct? A. The skull is a subdivision of the cranium. B. Thirty percent of the cranium is occupied by blood. C. The cranium protects the structures of the face. D. Eighty percent of the cranium is occupied by brain tissue.

D. Eighty percent of the cranium is occupied by brain tissue.

A reflex arc occurs when: A. the motor nerves function automatically without receiving a message from the CNS. B. a sensory nerve sends a message to the brain but the motor nerve fails to send the appropriate response to the body. C. the brain interprets sensory information that it receives from peripheral and cranial nerves and sends a signal to the muscles. D. a sensory nerve detects an irritating stimulus and bypasses the brain by sending a direct message to the motor nerve.

D. a sensory nerve detects an irritating stimulus and bypasses the brain by sending a direct message to the motor nerve.

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: A. hyperventilating her at 30 breaths/min. B. administering oxygen via a nonrebreathing mask. C. ventilation assistance to maintain an oxygen saturation of 90%. D. assisting ventilations at an age-appropriate rate.

D. assisting ventilations at an age-appropriate rate.

Rapid deceleration of the head, such as when it impacts the windshield, causes: A. compression injuries and contusions to the anterior, posterior, and lateral aspects of the brain. B. primary impact to the posterior aspect of the brain, resulting in compression injuries, bruising, or torn blood vessels. C. stretching or tearing of the anterior aspect of the brain and compression injuries or bruising to the posterior aspect of the brain. D. compression injuries or bruising to the anterior portion of the brain and stretching or tearing to the posterior portion of the brain.

D. compression injuries or bruising to the anterior portion of the brain and stretching or tearing to the posterior portion of the brain.

The tough, fibrous outer meningeal layer is called the: A. pia mater. B. arachnoid. C. gray mater. D. dura mater.

D. dura mater.

When immobilizing a patient on a long backboard, you should: A. have the patient exhale before fastening the torso straps. B. secure the torso and then center the patient on the board. C. follow the commands of the person at the patient's torso. D. ensure that you secure the torso before securing the head.

D. 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? A. cerebral contusion B. subdural hematoma C. cerebral concussion D. epidural hematoma

D. epidural hematoma

When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear. This indicates: A. fractures to the internal structures of the ear following direct trauma. B. a linear skull fracture and a significant increase in intracranial pressure. C. significant pressure and bleeding in between the skull and dura mater. D. rupture of the tympanic membrane following diffuse impact to the head.

D. 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? A. motor B. central C. somatic D. sensory

D. sensory

Common signs of a skull fracture include all of the following, EXCEPT: A. mastoid process bruising. B. ecchymosis around the eyes. C. noted deformity to the skull. D. superficial scalp lacerations.

D. superficial scalp lacerations.

When immobilizing a trauma patient's spine, the EMT manually stabilizing the head should not let go until: A. an appropriately sized cervical collar has been applied. B. the patient has been secured to the ambulance stretcher. C. the head has been stabilized with lateral immobilization. D. the patient has been completely secured to the backboard.

D. the patient has been completely secured to the backboard.

True or false: Central nervous system structures are very strong even though they are not well protected.

False. Central nervous system structures, whose bony enclosures protect them quite well, are also very fragile.

True or false: The structure of the skull and the presence of the meninges in effect reduce the likelihood of problems in closed head injuries.

False. The closed bony structure of the skull (which is similar to a vault) and the meninges may lead to serious problems in closed head injuries. Severe injury may cause bleeding within the skull. Such bleeding causes increased pressure inside the skull and compresses softer brain tissue. In many cases, only prompt surgery can prevent permanent brain damage.

True or false: The most prominent and most easily palpable spinous process is at the seventh cervical vertebra at the base of the neck.

True.