Biloxi EMT CH 29 Head and Spine Injuries Flashcards

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1
Q

Which of the following is NOT part of the central nervous system?

a. The brain
b. The spinal cord
c. Cerebrospinal fluid
d. Cranial nerves

A

d. Cranial nerves

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2
Q

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

a. autonomic nervous system
b. peripheral nervous system
c. sympathetic nervous system
d. somatic nervous system

A

b. peripheral nervous system

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3
Q

The brain is divided into the cerebrum, the cerebellum, and the:

a. foramen magnum
b. meninges
c. brainstem
d. spinal column

A

c. brainstem

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4
Q

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

a. thoracic spine
b. lumbar spine
c. cervical spine
d. sacral spine

A

c. cervical spine

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5
Q

The ___________ is composed of three layers of tissue that suspend the brain and spinal cord within the skull and spinal canal.

a. meninges
b. dura mater
c. pia mater
d. arachnoid space

A

a. meninges

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6
Q

The skull is divided into the cranium and the:

a. occipital
b. face
c. parietal
d. foramen magnum

A

b. face

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7
Q

Peripheral nerves include all of the following EXCEPT:

a. connecting nerves
b. sensory nerves
c. motor nerves
d. the spinal cord

A

d. the spinal cord

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8
Q

Which of the following is NOT a function of cerebrospinal fluid?

a. Acts as a shock absorber
b. Bathes the brain and spinal cord
c. Buffers the brain and spinal cord from injury
d. Provides continuous oxygen to the brain

A

d. Provides continuous oxygen to the brain

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9
Q

The autonomic nervous system is composed of the sympathetic nervous system and the:

a. peripheral nervous system
b. central nervous system
c. parasympathetic nervous system
d. somatic nervous system

A

c. parasympathetic nervous system

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10
Q

The most prominent and the most easily palpable spinous process is at the ________ cervical vertebra at the base of the neck.

a. 7th
b. 6th
c. 5th
d. 4th

A

a. 7th

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11
Q

You respond to a 14-year-old boy who fell out of a tree at a local park. He is unresponsive. His airway is open, and respirations are 16 breaths/min and regular. His pulse is strong and regular. Distal pulses are present. You manage the cervical spine. Whom should you NOT ask for help in determining how the injury happened?

a. First responders
b. Family members
c. Bystanders
d. Curious passerby who did not witness the accident

A

d. Curious passerby who did not witness the accident

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12
Q

Emergency medical care of a patient with a possible spinal injury begins with:

a. opening the airway
b. assessing level of consciousness
c. summoning law enforcement
d. standard precautions

A

d. standard precautions

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13
Q

The ___________ is a tunnel running the length of the spine, which encloses and protects the spinal cord.

a. foramen magnum
b. spinal cord
c. foramen foramina
d. meninges

A

b. spinal cord

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14
Q

Once the head and neck are manually stabilized, you should assess for:

a. pulse
b. motor function
c. sensation
d. all of the above

A

d. all of the above

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15
Q

You are called to a motor vehicle collision where a 27-year-old woman has a bump on her head. You immediately begin manual stabilization of the head. Her airway is open, and respirations are within normal limits. Her pulse is a little fast but strong and regular. Distal pulses are present. You can release manual stabilization when:

a. the patient’s head and torso are in line
b. the patient is secured to a backboard with the head immobilized
c. the rigid cervical collar is in place
d. the patient arrives at the hospital

A

b. the patient is secured to a backboard with the head immobilized

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16
Q

One procedure for moving a patient from the ground to the backboard is the:

a. four-person log roll
b. lateral slide
c. four-person lift
d. push-and-pull maneuver

A

a. four-person log roll

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17
Q

You respond to a motor vehicle collision with a 29-year-old woman who struck the rearview mirror and has serious bleeding from the scalp. Her airway is open, and respirations are normal. The pulse is a little rapid but strong and regular. Distal pulses are present, and there is no deformity to the skull. Most bleeding from the scalp can be controlled by:

a. direct pressure
b. elevation
c. pressure point
d. tourniquet

A

a. direct pressure

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18
Q

Exceptions to using a short spinal extrication device include all of the following EXCEPT:

a. you or the patient is in danger
b. the patient is conscious and complaining of lumbar pain
c. you need to gain immediate access to other patients
d. the patient’s injuries justify immediate removal

A

b. the patient is conscious and complaining of lumbar pain

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19
Q

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

a. Epidural hematoma
b. Subdural hematoma
c. Intracerebral hematoma
d. Subarachnoid hemorrhage

A

d. Subarachnoid hemorrhage

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20
Q

A _________ is a temporary loss or alteration of a part or all of the brain’s ability to function without actual physical damage to the brain.

a. contusion
b. concussion
c. hematoma
d. subdural hematoma

A

b. concussion

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21
Q

Which of the following is NOT a symptom of a concussion?

a. Dizziness
b. Weakness
c. Muscle tremors
d. Visual changes

A

c. Muscle tremors

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22
Q

Intracranial bleeding outside of the dura mater and under the skull is known as a(n):

a. concussion
b. intracerebral hemorrhage
c. subdural hematoma
d. epidural hematoma

A

d. epidural hematoma

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23
Q

The first step in securing a patient to a short backboard is to:

a. assess pulse, motor function, and sensation
b. assess the cervical area
c. provide manual stabilization of the cervical spine
d. apply an appropriately sized cervical collar

A

c. provide manual stabilization of the cervical spine

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24
Q

________ is the most reliable sign of a head injury.

a. Vomiting
b. Decreased level of consciousness
c. Seizures
d. Numbness and tingling in extremities

A

b. Decreased level of consciousness

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25
Q

Hyperventilation should be used with caution in head injury patients and only be attempted when ________ is/are available.

a. pulse oximetry
b. capnography
c. air medical services
d. noninvasive blood pressure monitoring

A

b. capnography

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26
Q

Common causes of head injuries include all of the following EXCEPT:

a. falls
b. motor vehicle collisions
c. seizure activity
d. sports injuries

A

c. seizure activity

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27
Q

Assessment of mental status is accomplished through the use of the mnemonic:

a. SAMPLE
b. OPQRST
c. AVPU
d. AEIOU-TIPS

A

c. AVPU

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28
Q

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:

a. brain injury
b. hypoxia
c. seizure activity
d. chronic hypertension

A

a. brain injury

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29
Q

Which of the following is NOT part of Cushing’s triad?

a. increased blood pressure
b. decreased pulse rate
c. decreased pulse oximetry
d. irregular respirations

A

c. decreased pulse oximetry

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30
Q

A cervical collar should be applied to a patient with a possible spinal injury based on:

a. the mechanism of injury
b. the history
c. signs and symptoms
d. All of the above

A

d. All of the above

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31
Q

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

a. cardiac arrest
b. when the helmet allows for excessive movement
c. when there are no impending airway or breathing problems
d. when a shield cannot be removed for access to the airway

A

c. when there are no impending airway or breathing problems

32
Q

A vacuum mattress molds to the specific contours of the patient’s body and:

a. reduces pressure-point tenderness
b. provides better comfort
c. provides thermal insulation
d. All of the above

A

d. All of the above

33
Q

True/False

An intracerebral hematoma involves bleeding outside the brain tissue.

A

False

34
Q

True/False

If a sensory nerve in the reflex arc detects an irritating stimulus, it will bypass the brain and send a message directly to the motor nerve.

A

True

35
Q

True/False

Voluntary activities are those actions we perform unconsciously.

A

False

36
Q

True/False

The autonomic nervous system is composed of the sympathetic nervous system and the parasympathetic nervous system.

A

True

37
Q

True/False

The parasympathetic nervous system reacts to stress with the fight-or-flight response whenever it is confronted with a threatening situation.

A

False

38
Q

True/False

All patients with suspected head and/or spine injuries should have their heads realigned to an in-line, neutral position when you begin assessing them.

A

False

39
Q

True/False

When assessing a patient for possible spinal injury, you should begin with a full-body scan.

A

False

40
Q

True/False

One procedure for moving a patient from the ground to a backboard is the four-person log roll.

A

True

41
Q

True/False

You should not try to put a patient on a backboard if the patient is in danger.

A

True

42
Q

True/False

To properly measure a cervical collar, use the manufacturer’s specifications.

A

True

43
Q

Fill in the blank

The __________ nerves carry information to the muscles.

A

motor

44
Q

Fill in the blank

The dura mater, arachnoid, and pia mater are layers of _________ within the skull and spinal canal.

A

meninges

45
Q

Fill in the blank

The brain and spinal cord are part of the _________ nervous system.

A

central

46
Q

Fill in the blank

The peripheral nervous system has _________ pairs of spinal nerves.

A

31

47
Q

Fill in the blank

The __________ nerves are the 12 pairs of nerves that emerge from the brainstem and transmit information directly to or from the brain.

A

cranial

48
Q

Fill in the blank

Vertebrae are separated by cushions called ________ _________.

A

Intervertebral disks

49
Q

Fill in the blank

The skull is composed of two groups of bones, the ________ and the _________ bones.

A

Cranium, facial

50
Q

Fill in the blank

The ________ and _________ _________ are the inner two layers of the meninges and are much thinner than the dura mater.

A

Arachnoid, pia mater

51
Q

Fill in the blank

The _________ nervous system reacts to stress.

A

sympathetic

52
Q

Fill in the blank

The ________ nervous system causes the body to relax.

A

parasympathetic

53
Q

Fill in the blank

A(n) ________ ________ involves bleeding within the brain tissue itself.

A

Intracerebral hematoma

54
Q

Fill in the blank

A(n) ________ is far more serious than a concussion because it involves physical injury to the brain tissue.

A

contusion

55
Q

Fill in the blank

When immobilizing a small child, __________ may need to be added to maintain an in-line, neutral position.

A

padding

56
Q

Fill in the blank

On completion of spinal immobilization, reassessment of __________, __________, and _________ function in each extremity is necessary.

A

Pulse, motor, sensory

57
Q

Fill in the blank

In a patient with a suspected head injury, you should use the _________ method for opening the airway.

A

Jaw-thrust

58
Q

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.

A

b. brain and spinal cord.

59
Q

Coordination of balance and body movement is controlled by the:

a. medulla.
b. cerebrum.
c. cerebellum.
d. brain stem.

A

c. cerebellum.

60
Q

The tough, fibrous outer meningeal layer is called the:

a. pia mater.
b. arachnoid mater.
c. gray mater.
d. dura mater.

A

d. dura mater.

61
Q

The ____________ nervous system consists of 31 pairs of spinal nerves and 12 pairs of cranial nerves.

a. central
b. somatic
c. autonomic
d. peripheral

A

d. peripheral

62
Q

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

a. Central
b. Sensory
c. Somatic
d. Autonomic

A

c. Somatic

63
Q

The hormone responsible for the actions of the sympathetic nervous system is:

a. insulin.
b. thyroxine.
c. epinephrine.
d. aldosterone.

A

c. epinephrine.

64
Q

The spinal cord is encased in and protected by the:

a. spinal canal.
b. vertebral body.
c. vertebral arch.
d. intervertebral disc.

A

a. spinal canal.

65
Q

The frontal and parietal bones of the skull are especially susceptible to:

a. basilar skull fractures.
b. depressed skull fractures.
c. linear skull fractures.
d. nondisplaced skull fractures.

A

b. depressed skull fractures.

66
Q

Signs and symptoms that might be found in a patient who has experienced a concussion include:

a. anxiety and restlessness.
b. nausea and ringing in the ears.
c. tachycardia and diaphoresis.
d. hypotension and nosebleed.

A

b. nausea and ringing in the ears.

67
Q

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.

A

c. involves physical injury to the brain tissue.

68
Q

When opening the airway of a patient with a suspected spinal injury, you should use the:

a. tongue-jaw lift maneuver.
b. head tilt-lift maneuver.
c. head tilt-chin lift maneuver.
d. jaw-thrust maneuver.

A

d. jaw-thrust maneuver.

69
Q

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

a. slow.

70
Q

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.

A

b. a decreased level of consciousness.

71
Q

When a patient experiences a severe spinal injury, he or she:

a. will likely be paralyzed from the neck down.
b. might 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.

A

b. might lose sensation below the level of the injury.

72
Q

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. the use of a scoop stretcher.
d. the direct patient carry.

A

b. the four-person log roll.

73
Q

A short backboard or vest-style immobilization device is indicated for patient 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.

A

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

74
Q

Which of the following interventions may be used to help reduce intracranial pressure?

a. Supine with the legs elevated
b. Maintaining the SpO2 at 90%
c. 30-degree elevation of the head
d. Increasing the patient’s body temperature

A

c. 30-degree elevation of the head

75
Q

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

a. head

76
Q

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 airway.
d. sensory and motor functions remain intact.

A

c. it causes a problem managing the airway.

77
Q

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

a. bleeding between the skull and dura mater.