13 - Trauma Overview / Head and Spine Injuries Flashcards
What is kinetic energy?
The energy of a moving object
Newton’s first law of motion states that objects at rest tend to stay at rest and objects in motion tend to stay in motion unless acted on by some force
(902)
Describe the peripheral nervous system’s anatomical components and their functions.
The PNS is made up of the following:
Somatic NS: Controls voluntary functions
Autonomic NS: Controls involuntary functions
Sympathetic: Fight or Flight
Parasympathetic: Digestion
(1043-4)
List the three protective coverings of the brain and spinal cord, from top to bottom.
Dura mater
Arachnoid
Pia mater
(1042)
A patient involved inn a vehicle accident hits his knee on the dashboard. Which collision is this injury describing?
Secondary collision
What pertinent information can be obtained by assessing a vehicle that was involved in a crash?
Location of impact: Front, lateral, rear (used to assess potential trauma to the body
Broken windshield: Potential head trauma through impact
Deployed airbags: Impact on the chest from the steering wheel if non deployed
What two conditions can cause vaginal bleeding in a woman who does not appear to be pregnant and may not realize that they are pregnant?
Ectopic pregnancy
Spontaneous abortion
While assessing a patient who was stuck in the head with a pipe, the patient appears to have a runny nose and is complaining of a salty taste inn his throat. Explain what these findings mean.
The force of the impact caused damage and leakage of the cerebral spinal fluid
(1042)
As you continue to assess the patient in the above scenario you notice ecchymosis around the eyes and over the right mastoid process. What are these signs called and what type of head injury are they associated with?
Injury: Basilar skull fracture
Signs: Racoon eyes and Battle signs
(1047)
Rear-end crashes are known to cause what type of injury:
Whiplash
A non-displaced skull fracture may also be described as:
Linear fracture
(1047)
What is Cushing’s Triad? List the S/S of Cushing’s Triad.
Cushing’s Triad is a set of signs that indicate increased intracranial pressure in the brain.
S/S: Bradycardia, Widened pulse pressure, and Irregular respirations
The text lists several significant mechanisms of injury in vehicle crashes. List three of these significant MOI’s.
Death of an occupant in the vehicle
Severe deformity of the vehicle or intrusion into the vehicle
Ejection from the vehicle (906)
You are assessing a patient who fell from construction scaffolding. What questions should be asked for this type of injury?
Height of fall
Type of surface struck
The part of the body that hit first, followed by the path of energy displacement (913)
Where is the accumulation of blood located in the epidural hematoma? How is it caused?
Location: Between the inner surface of the skull and the dura mater
Cause: A skull fracture that tears an underlying artery
(1049)
You are assessing a patient who fell and hit her head while sking down a steep hill. Bystanders state the patient lost consciousness after she fell. She regained consciousness for a brief period but is currently unconscious. Your assessment reveals unequal pupils, a HR of 48, a BP of 168/94 and an irregular RR of 40. Briefly explain what is causing the findings in your assessment..
Epidural Hematoma, Lucid intervals
Epidural Hematoma is an Arterial bleed into the epidural space that will result in rapidly progressing symptoms.
S/S: Lucid intervals
(1049-50)
If the velocity of a bullet is doubled, the energy that is available to cause damage is:
Quadrupled
(902)
A victim that was standing in close proximity to an explosions would suffer from which of the blast mechanisms?
Primary: Injuries do to the blast wave itself
The most important step in treating patients with a head injury, regardless of the severity, is:
Ensure a stable airway, breathing, and circulation (ABC’s)
You are treating an unconscious, critical trauma patient that was pulled from a vehicle accident. When should the secondary assessment be performed?
In the ambulance
The Glasgow Coma Scale is one method to evaluate:
Nervous System Responsiveness
The energy of a moving object is called:
Kinetic energy
What are the three collisions of a motor vehicle crash?
Collision of a car against another
Person to the interior of the car
Internal organs to the internal structures in the body
(904-5)
Why is it important to understand the relationship between the three collisions and how they aid with patient assessment/treatment?
They help to create an index of suspicion for the severity of the trauma and to give proper treatment
Give an example of the second collision of a motor vehicle crash.
Lower extremity fractures - Knee into dashboard
Rib fractures - Rib cage into steering wheel
Head trauma - Head into the windshield
(905)
The text lists four significant mechanisms of injury. List two of these MOIs.
Fall from height
Motor vehicle and motorcycle crashes
Car versus pedestrian
Gunshot wounds and stabbings
What three factors should be taken into account when evaluating a patient who fell off a ladder?
Height of fall
Type of surface they landed on
What part of the body they landed on first
A victim of an explosion is thrown into a wall from the force of the blast. Which of the blast mechanisms would be the cause of injury?
Tertiary
When should SAMPLE history and the secondary assessment be performed, when caring for a critical trauma patient?
On the ambulance
Trauma centers are classified into how many different levels?
Four levels
If the weight of an object is doubled, the energy that is available to cause damage is:
Doubled
(902)
What is the highest possible GCS Score?
15
GCS score is based on Eye Opeing (4-1), Verbal Response (5-1), Motor Response (6-1)
What is blunt trauma?
An injury such as a fall that results inn force to a patients body without penetrating the skin
Trauma injuries occur as a result of:
Force or energy that impact a persons bod
What are the four types of blast injuries:
Primary: Injuries do to the blast wave itself
Secondary: Injuries to the body results from being struck by flying debris
Tertiary: These injuries occur when the patient is hurled by the force of the explosion against a stationary object
Quaternary: Misc. injuries includes burns from hot gases or fires started by the blast
The blood vessels that nourish the brain and spinal cord are located where?
Subarachnoid Space
(1042)
Explain how the nervous system responds to an irritating stimulus, such as touching a heated surface.
A sensory nerve detects the stimulus and sends a direct message to the motor nerve to pull away from the heat (1043)
Which two bones of the skull are most susceptible to depressed skull fractures?
Temporal
Parietal
(1044-45)
You are assessing a patient who was assaulted in a bar fight. You notice ecchymosis around the eyes and over the right mastoid process. What are these two signs called and what type of head injury are the most associated with?
Injury: Basilar skull fracture
Raccon Eyes
Battle signs
(1047)
List two examples of primary brain injury?
Cerebral edema
Contusion
Concussion
(1049-51)
An epidural hematoma is most accurately defined as bleeding outside the _____ and under the _____.
Dura Mater
Skull
What is a subdural hematoma and how is it caused? (Do not say head trauma)
Accumulation of blood beneath the dura mater but outside the brain
Occurs after falls or injuries involving strong deceleration forces
(1050)
You are assessing a 35 year-old patient who was struck by a car, you note a contusion on the forehead, and they are unable to tell what happened. This type of memory loss is called: What is your working diagnosis?
Retrograde amnesia
Concussion
(1051)
What is the primary difference between a concussion of the brain and a contusion of the brain?
Concussion: Temporary loss or alteration of part or all of the brain’s abilities to function without physical damages
Contusion: Physical injury to the brain tissue; long-lasting and potentially permanent damage
(1051)
List three secondary brain injuries that significantly increase the death and disability of a TBI patient.
Hypoxia
Hypertension
Hypothermia
(1048)
The text states the key to managing patients with spinal injuries and airway and breathing problems is:
Move their head and spine as little as possible
The most important step in treating patients with a head injury, regardless of the severity, is:
Maintaining adequate airway and breathing
