Biloxi EMT CH 28 Face and Neck Injuries Flashcards

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1
Q

As an EMT, your objective when treating patients with face and neck injuries is to do all of the following EXCEPT:

a. prevent further injury
b. manage any acute airway problems
c. control bleeding
d. disregard the cervical spine

A

d. disregard the cervical spine

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2
Q

The head is divided into two parts: the cranium and the:

a. brain
b. face
c. skull
d. medulla oblongata

A

b. face

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3
Q

The brain connects to the spinal cord through a large opening at the base of the skull known as the:

a. eustachian tube
b. spinous process
c. foramen magnum
d. vertebral foramina

A

c. foramen magnum

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4
Q

Approximately ____________ of the nose is composed of bone. The remainder is composed of cartilage.

a. nine-tenths
b. two-thirds
c. three-quarters
d. one-third

A

d. one-third

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5
Q

Motion of the mandible occurs at the:

a. temporomandibular joint
b. mastoid process
c. chin
d. mandibular angle

A

a. temporomandibular joint

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6
Q

You respond to a 71-year-old woman who is unresponsive. You try to get her to respond but have no success. Her airway is open, and she is breathing at a rate of 14 breaths/min. You know that you can check a pulse on either side of the neck. You know that the jugular veins and several nerves run through the neck to the trachea. What structure are you trying to locate to take a pulse?

a. Hypothalamus
b. Subclavian arteries
c. Cricoid cartilage
d. Carotid arteries

A

d. Carotid arteries

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7
Q

The __________ connects the cricoid cartilage and thyroid cartilage.

a. larynx
b. cricoid membrane
c. cricothyroid membrane
d. thyroid membrane

A

c. cricothyroid membrane

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8
Q

You respond to a 68-year-old man who was involved in a motor vehicle collision. He is unresponsive and as you approach, you notice that he is not breathing. He was unrestrained and has massive facial injuries. When you check his airway, it is obstructed. Which of the is NOT likely to cause an upper airway obstruction in a patient with facial trauma?

a. Heavy bleeding
b. Loosened teeth or dentures
c. Soft-tissue swelling
d. Inflamed tonsils

A

d. Inflamed tonsils

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9
Q

You are dispatched to a residential neighborhood for a 6-year-old girl who was bitten by the family pet. The mother meets you at the door with the girl, who is crying uncontrollably and has blood covering the right side of her head. You look at the child and notice that her lower right ear has been completely avulsed. You control the bleeding with direct pressure and bandage the injury. You follow the blood trail back to where the incident occurred and find the avulsed part. How do you manage the avulsed tissue?

a. Wrap the skin in a sterile dressing, place it in a plastic bag, and keep it cool.
b. Place the skin in a plastic “biohazard” bag and dispose of it properly.
c. Place the skin in a plastic bag filled with ice and transport it to the emergency department.
d. Leave it at the scene to be disposed of later.

A

a. Wrap the skin in a sterile dressing, place it in a plastic bag, and keep it cool.

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10
Q
The nasal cavity is divided into two chambers by the:
]
a.  frontal sinus
b.  middle turbinate
c.  zygoma
d.  nasal septum
A

d. nasal septum

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11
Q

You are called to the home of a 48-year-old woman who has a history of high blood pressure and now has a major nosebleed. She is alert and oriented and converses freely with you. Her respirations and pulse are within normal limits. Her blood pressure is 194/108 mm Hg. You have been able to rule out trauma. How would you manage the nosebleed?

a. Apply a sterile dressing.
b. Pinch the nostrils together.
c. Place the patient in a supine position.
d. Have the patient hold ice in her mouth.

A

b. Pinch the nostrils together.

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12
Q

The middle ear is connected to the nasal cavity by the:

a. frontal sinus
b. zygomatic process
c. eustachian tube
d. superior trachea

A

c. eustachian tube

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13
Q

Which of the following is NOT a sign or symptom of a laryngeal injury?

a. Hoarseness
b. Difficulty breathing
c. Subcutaneous emphysema
d. Wheezing

A

d. Wheezing

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14
Q

Which of the following is NOT a sign of a possible facial fracture?

a. Bleeding in the mouth
b. Absent or loose teeth
c. Bleeding from the forehead
d. Loose and/or moveable bone fragments

A

c. Bleeding from the forehead

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15
Q

The presence of air in the soft tissues of the neck that produces a crackling sensation is called:

a. the “Rice Krispies” effect
b. a pneumothorax
c. rales
d. subcutaneous emphysema

A

d. subcutaneous emphysema

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16
Q

Which of the following statements is NOT true regarding the treatment of bleeding from a neck injury?

a. Apply a circumferential bandage around the neck.
b. Apply pressure to the bleeding site using a gloved fingertip.
c. Apply a sterile occlusive dressing.
d. Use gauze to secure the dressing in place.

A

a. Apply a circumferential bandage around the neck.

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17
Q

What is the main purpose of eye blinking?

a. Clean the eye
b. Prevent eye muscle atrophy
c. Natural reflex to bright light
d. Refocus the eye

A

a. Clean the eye

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18
Q

When flushing an eye with saline to remove a foreign object, it is important to remember to:

a. flush from the outside of the eye in toward the nose
b. flush from the top of the eye toward the bottom
c. flush from the nose side of the eye toward the outside
d. flush only along the bottom of the eye

A

c. flush from the nose side of the eye toward the outside

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19
Q

When stabilizing a large foreign object in the eye, you should first cover the eye with a moist dressing, then:

a. irrigate the eye with saline
b. surround the object with a doughnut-shaped collar made from gauze
c. apply tape around the object and then secure the tape to the forehead
d. place an ice pack over the eye to reduce swelling

A

b. surround the object with a doughnut-shaped collar made from gauze

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20
Q

When a patient has a chemical burn to the eye, you should irrigate the eye for at least 5 minutes; however, if the burn was caused by an alkali or strong acid, you should irrigate for:

a. 10 minutes
b. 15 minutes
c. 20 minutes
d. 25 minutes

A

c. 20 minutes

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21
Q

True/False

Injuries to the face often lead to airway problems.

A

True

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22
Q

True/False

Care for facial injuries begins with standard precautions and the ABCs.

A

True

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23
Q

True/False

Exposed eye or brain injuries are covered with a dry dressing.

A

False

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24
Q

True/False

Clear fluid in the outer ear is normal.

A

False

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25
Q

True/False

Any crushing injury of the upper part of the neck likely involves the larynx or the trachea.

A

True

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26
Q

True/False

Soft-tissue injuries to the face are common.

A

True

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27
Q

True/False

The opening through which the spinal cord leaves the head is called the occiput.

A

False

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28
Q

True/False

The muscle that allows movement of the head is the temporomandibular.

A

False

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29
Q

True/False

Standard precautions for assessing face and throat injuries should include eye protection and a face mask.

A

True

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30
Q

True/False

Stabilization and maintenance of an airway can be difficult in patients with facial injuries.

A

True

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31
Q

True/False

Unequal pupil size could possibly indicate a brain injury.

A

True

32
Q

True/False

Gentle irritation will usually wash out foreign material stuck in the cornea.

A

False

33
Q

True/False

Retinal injuries caused by exposure to extremely bright light are generally painless and may restore permanent damage.

A

True

34
Q

True/False

You should never exert pressure on or manipulate an injured eye in any way.

A

True

35
Q

True/False

Bleeding into the anterior chamber of the eye is commonly called conjunctivitis.

A

False

36
Q

True/False

When dealing with an injured eye, you should always remove contact lenses before treatment.

A

False

37
Q

True/False

Open injuries to the larynx can occur as the result of a stabbing.

A

True

38
Q

True/False

Broken teeth and lacerations to the tongue cause minimal bleeding and are not concerning.

A

False

39
Q

True/False

Oxygen and airway management are important for all patients with face and neck injuries.

A

True

40
Q

Fill in the blank.

Pulsations in the neck are felt in the _____________ vessels.

A

carotid

41
Q

Fill in the blank.

The __________ vertebrae are in the neck.

A

cervical

42
Q

Fill in the blank.

The _________ regions of the cranium are located on the lateral portion of the head.

A

temporal

43
Q

Fill in the blank.

The _________ connects the oropharynx and the larynx with the main air passages of the lungs.

A

trachea

44
Q

Fill in the blank.

The rings of the trachea are made of _________.

A

cartilage

45
Q

Fill in the blank.

The Adam’s apple is more prominent in ________ than in ________.

A

men, women

46
Q

Fill in the blank.

The ________ ________ is a large opening at the base of the skull.

A

foramen magnum

47
Q

Fill in the blank.

Blunt trauma that causes fractures to the orbit is commonly called a(n) __________ __________.

A

blowout fracture

48
Q

Fill in the blank.

Trauma to the face and skull that results in the posterior wall of the nasal cavity becoming unstable is caused by ________ _________ _________.

A

basilar skull fracture

49
Q

Fill in the blank.

When dealing with an avulsed tooth, handle it by its __________ and not by the __________.

A

crown, root

50
Q

Fill in the blank.

A(n) _______ _______ results when an open vein sucks air into it and the air travels to the heart.

A

air embolism

51
Q

Assessment Review

You have responded to a motor vehicle collision and find a 21-year-old man who has massive facial trauma. He is bleeding heavily and is unconscious. The first thing that you do in your treatment of this patient is to:

a. take cervical spine precautions
b. open the airway
c. assess his breathing
d. take standard precautions

A

d. take standard precautions

52
Q

Assessment Review

You have responded to a motor vehicle collision and find a 21-year-old man who has massive facial trauma. He is bleeding heavily and is unconscious. How often would you reassess his vitals during your ongoing assessment?

a. Every 3 minutes
b. Every 5 minutes
c. Every 10 minutes
d. Every 15 minutes

A

b. Every 5 minutes

53
Q

Assessment Review

You have a patient who has had a tooth knocked out. You find the tooth. How would you transport it to the hospital?

a. In saline
b. In dextrose
c. In ice
d. In a dry sterile dressing

A

a. In saline

53
Q

Assessment Review

You have a patient who has severe epistaxis. You have been able to rule out trauma. How would you position this patient to help control the bleeding?

a. Supine
b. Prone
c. Sitting leaning back
d. Sitting leaning forward

A

d. Sitting leaning forward

54
Q

Assessment Review

You respond to a child who has placed a pebble in his ear. He is complaining that his ear hurts. You should:

a. remove the pebble with a cotton-tipped applicator
b. have the child try to shake the pebble out
c. leave the pebble in the ear and transport
d. not load the patient because this is not an emergency

A

c. leave the pebble in the ear and transport

55
Q

The upper jawbones are called the:

a. mandible.
b. mastoid.
c. zygoma.
d. maxillae.

A

d. maxillae.

56
Q

The lower jawbone is called the:

a. zygoma.
b. maxillae.
c. mandible.
d. mastoid.

A

c. mandible.

57
Q

The small, rounded, fleshy bulge immediately anterior to the ear canal is called the:

a. incus.
b. pinna.
c. tragus.
d. stapes.

A

c. tragus.

58
Q

The superficial temporal artery can be palpated:

a. slightly above the ear.
b. at the angle of the jaw.
c. over the mastoid process.
d. just anterior to the tragus.

A

d. just anterior to the tragus.

59
Q

The mastoid process is located approximately:

a. 1 inch posterior to the external opening of the ear.
b. ½ inch anterior to the external opening of the ear.
c. 1 inch inferior to the external opening of the ear.
d. 1 inch posterior to the angle of the mandible.

A

a. 1 inch posterior to the external opening of the ear.

60
Q

The cricoid cartilage:

a. lies superior to the thyroid cartilage in the neck.
b. is the only complete circular cartilage of the trachea.
c. is easier to see and palpate than the thyroid cartilage.
d. lies superior to the cricothyroid membrane in the neck.

A

b. is the only complete circular cartilage of the trachea.

61
Q

The eyeball itself is referred to as the:

a. orbit.
b. globe.
c. sclera.
d. cornea.

A

b. globe.

62
Q

The white portion of the eye is called the:

a. iris.
b. retina.
c. sclera.
d. cornea.

A

c. sclera.

63
Q

When a light is shone into the pupil:

a. the opposite pupil should dilate.
b. it should become smaller in size.
c. it should become larger in size.
d. both pupils should dilate together.

A

b. it should become smaller in size.

64
Q

The skin and underlying tissues of the face:

a. have a rich blood supply and bleed profusely.
b. swell minimally when exposed to blunt trauma.
c. are well protected by the maxillae and mandible.
d. contain a relatively small number of nerve fibers.

A

a. have a rich blood supply and bleed profusely.

65
Q

Frequent reassessments of the patient with face or neck injuries are most important because:

a. they land credibility to your documentation.
b. such injuries can affect the respiratory system.
c. hospital staff require frequent patient updates.
d. rapid facial swelling might mask hidden injuries.

A

b. such injuries can affect the respiratory system.

66
Q

Bleeding from soft-tissue injuries to the face is MOST effectively controlled with:

a. pressure dressings and chemical ice packs.
b. digital pressure to an adjacent pulse point.
c. direct pressure using dry, sterile dressings.
d. ice packs and elevation of the patient’s head.

A

c. direct pressure using dry, sterile dressings.

67
Q

The term “hyphema” is defined as:

a. blood in the anterior chamber of the eye.
b. an acute rupture of the globe of the eye.
c. inflammation of the iris, cornea, and lens.
d. compression of one or both optic nerves.

A

a. blood in the anterior chamber of the eye.

68
Q

The inner surface of the eyelids and the exposed surface of the eye itself are covered by a delicate membrane called the:

a. sclera.
b. cornea.
c. retina.
d. conjunctiva.

A

d. conjunctiva.

69
Q

The conjunctiva are kept moist by fluid produced by the:

a. corneal duct.
b. posterior orbit.
c. optic chiasma.
d. lacrimal gland.

A

d. lacrimal gland.

70
Q

Facial injuries should be identified and treated as soon as possible because:

a. of the risk for airway problems.
b. bleeding must be controlled early.
c. the spine might be injured as well.
d. swelling might mask hidden injuries.

A

a. of the risk for airway problems.

71
Q

When transporting a patient with a facial injury, it is MOST important to be as descriptive as possible with the hospital regarding the patient’s injuries because:

a. they must make arrangements for an ICU bed.
b. they might need to call a specialist to see the patient.
c. it saves time on repeat assessments at the hospital.
d. most patients with facial trauma will need surgery.

A

b. they might need to call a specialist to see the patient.

72
Q

Which of the following findings would be LEAST suggestive of a head injury?

a. One pupil larger in size than the other pupil
b. Failure of the eyes to move in the same direction
c. Briskly constricting pupils when exposed to light
d. Failure of the eyes to follow movement of an object

A

c. Briskly constricting pupils when exposed to light

73
Q

The “Adam’s apple” is:

a. the upper part of the larynx that is formed by the thyroid cartilage.
b. the lower part of the larynx that is formed by the cricoid cartilage.
c. the small indentation in between the thyroid and cricoid cartilages.
d. below the thyroid cartilage and forms the upper part of the trachea.

A

a. the upper part of the larynx that is formed by the thyroid cartilage.

74
Q

What is the function of the sternocleidomastoid muscle?

a. Allows flexion of the neck
b. Provides respiration
c. Connects the scapulae together
d. Allows movement of the head

A

d. Allows movement of the head