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EMT > Ch 28 Head And Spine Injuries > Flashcards

Ch 28 Head And Spine Injuries Flashcards

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1
Q

Sections of spine and #

A 
Cervical 1-7
Thoracic 1-12
Lumbar 1-5
Sacrum 1-5
Coccyx 1-5
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2
Q

Signs of a skull fracture

A

Ecchymosis- raccoon eyes and battle signs

CSF out of ear/blood

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3
Q

Linear skull fracture

A

Account for 80% of skull fractures; also referred to as non-displaced skull fractures. Occur commonly in the temporl-parietal region; Usually no scalp signs, needs CT to notice

Uninjured brain + NO scalp lacs = non-life threatening
Linear skull fracture + scalp lacs = high risk of infection and bleeding inside of the brain

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4
Q

Depressed skull fracture

A

High engergy trauma with blunt object
Usually in frontal or parietal bones
Loss of consciousness

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5
Q

Basilar skull fractures

A

Usually occur following diffuse impact to the head and generally result from extension of a linear fracture to the base of the skull and can be hard to diagnose

Crashes or falls
CSF through the ear (bacterial meningitis risk)*
Racoon eyes/battle signs

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6
Q

Open head injuries

A

Injury to the head often caused by penetrating object in which there may be bleeding and exposed brain tissue

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7
Q

Intracranial pressure

A

ICP; Increased ICP squeezed the brain agains boney prominences; Accumulation of blood in cranium

Signs of ICP:
Headache, nausea, bradycardia, Cheyne-Stroke respirations, Ataxic (biot) respirations, etc.

In supine patients, head should be elevated 30 degrees to help reduce ICP

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8
Q

Cheyne-stokes

A

Respirations go from fast to slow

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9
Q

Ataxic (biot) respirations

A

Irregular rate, pattern, and volume respirations

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10
Q

Epidural hematoma

A

Collection of blood betweeen skull and dura mater
Usually back and fourth between consciousness and unconsciousness
Pupil on side of the hematoma becomes fixed and dilated

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11
Q

Subdural hematoma

A

Blood beneath dura matter, on top of brain

Strong deceleration injuries and falls

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12
Q

Intercerebral hematoma

A

Brain tissue bleeding, also referred to as intraparenchymal hematoma
High mortality rate

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13
Q

Subsrachnoid hemorrhage

A

Loon for CSF
Trauma/aneurism
Neck rigidity/ headache

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14
Q

Concussion

A

Temporary loss or alternation of a part or all of the brain’s ability to function without acute physical damage to the brain.

Mild injury where brain swells

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15
Q

Retrograde amnesia

A

No memory of before the injury

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16
Q

Anterograde amnesia

A

No memory of right after the injury

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17
Q

Contusion

A

More severe concussion where brain tissue is damaged more severely and permanently

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18
Q

Cushings reflex

A

Increased BP
Decreased pulse
Irregular respirations

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19
Q

How many emt’s are required to immobilize a standing patient

A

Three

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20
Q

Vaccum mattress uses

A

Reduces pressure point tenderness
Provides comfort
Provides thermal insulation

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21
Q

Axial loading injuries

A

Injuries in which load is applied along the vertical or longitudinal axis of the spine, which results in load being transmitted along the entire length of the vertebral coloms (e.x. falling from a height and landing on the feet in an upright position)

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22
Q

Battle signs

A

Bruising behind an ear over the mastoid process that may indicate a skull fracture

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23
Q

Cerebral edema

A

Swelling of the brain; may not develop until several hours following the initial injury
Aggravated by low oxygen levels - ensure viable airway, ventilations and high-flow O2

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24
Q

Closed head injury

A

Injury in which the brain has been injured but the skin has not been broken so there is no obvious bleeding

25
Q

Coup-Contrecoup injury

A

Dual impacting of the brain into the skull; coup injury occurs at the point of impact, countercoup injury occurs on the opposite site side of the impact as the brain rebounds

26
Q

Eyes forward position

A

A head position in which the patient’s eyes are looking straight ahead and the head and torso are aligned

27
Q

Four person log roll

A

The recommended procedure for moving a patient with a suspected spinal injury from the ground to a long backboard or other spinal immobilization device

28
Q

Intervertebral disk

A

The cushion that lies between two vertebrae

29
Q

Meninges

A

Three distinct layers of tissue that surround and protect the brain and spinal cord within the skill and spinal canal
Dura mater - tough fiberuos, forms a sac to contain the CNS
Arachnoid & Pia mater - contain blood vessels that nourish the brain and spinal cord
When all layers are penetrated, CSF may leak

30
Q

Primary (direct) injury

A

Injury to the brain and its associated structures that is a direct result of impact to the head

31
Q

Racoon eyes

A

Bruising under the eyes that may indicate a skull fracture; typically a late sign

32
Q

Secondary (Indirect) injury

A

The after effects of the primary injury; includes abnormal processes such as cerebral edema, increased intracranial pressure, cerebral ischemia and hypoxia, and infection; onset is often delayed following the primary injury

33
Q

Subarachnoid hemmorage

A

Bleeding into the subarachnoid space where CSF circulates

34
Q

Traumatic Brain Injury

A

TBI; a traumatic insult to the brain capable of producing physical, intellectual, emotional, social and vocational changes

35
Q

Peripheral Nervous System

A

31 pairs of spinal nerves (sensory impulses, motor impulses)
12 pairs of cranial nerves (transmit information directly to/from the brain, 5 senses)

36
Q

Most common MOI for head injuries

A

Motor vehicle crashes, >2/3 of people involved experience head injuries
Followed by assaults, older adult falls, sports-related incidents

37
Q

Seizures and convulsions

A

It is not uncommon for patients with head injuries to have a convulsion or seizure as a result of excessive excitability of the brain caused bu the direct injury of the accumulation of fluid within the brain

38
Q

Hyperventilation

A

Controversial because it can increase the severity of head injuries and therefore should be avoided except in cases where signs of brainstem herniation have been identified

39
Q

Glasgow Coma Scale

A 
Eye Opening
4 - Spontaneous 
3 - In response to speech
2 - In response to pain
1 - none
Best Verbal Response
5 - Oriented conversation
4 - Confused conversation
3 - Inappropriate words 
2 - Incomprehensible sounds
1 - none
Best Motor Response
6 - Obeys commands
5 - Localizes pain
4 - Withdraws to pain
3 - Abnormal flexion
2 - Abnormal extension
1 - none
40
Q

Injuries to C5-6

A

Quadripeligia

41
Q

Injuries to L1

A

Paraplegia

42
Q

Cheyne-Stroke respirations

A

fast and then slow with periods of apnea

43
Q

Ataxic (biot) respirations

A

irregular rate and volume with periods of apnea

44
Q

Cushing Triad

A

Also referred to as herniation syndrome where intracranial pressure is so great that it forces the brainstem and midbrain through the foramen magnum; can be fatal

Increased blood pressure (hypertension), decreased heart rate (bradycardia) and irregular respirations

Signs of a traumatic brain injury

45
Q

When to leave a helmet on?

A

1) there are no impending airway/breathing problems
2) it does not interfere with assessment and treatment of airway/breathing problems
3) you can properly immobilize the spine

46
Q

When to remove a helmet?

A

Removing a helmet should always be a two person job!

1) it is a full-face helmet
2) it makes assessing or managing the airway difficult and removal of a face guard to improve airway access is not possible
3) it prevents you from properly immobilizing the spine
4) it allows excessive head movement

47
Q 
Which of the following is NOT a part of the central nervous system?
The Brain
The spina cord
CSF
Cranial Nerves
A

Cranial Nerves

48
Q

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

A

Peripheral nervous system

49
Q

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

A

Brain stem

50
Q

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

A

C-spine

51
Q

Which of the following is NOT a function of CSF?
Acts as a shock absorber
Bathes the brain and spinal cord
Buffers the brain and spinal cord from injury
Provides continuous oxygen to the brain

A

Provides continuous oxygen to the brain

52
Q

The most prominent and most easily palpable spinous process at the base of the neck

A

C7

53
Q

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

A

Subarachnoid hemorrhage

54
Q

The first step in securing a patient to a backboard is

A

to provide manual stabilization of the C-spine

55
Q

The most reliable sign of a head injury

A

Decreased LOC

56
Q

Hyperventilation should be used with caution in head injury patients and only be attempted when ____ is available

A

Capnography

57
Q

How many EMTs needed to immobilize a standing patient?

A

3

58
Q

A vacuum mattress molds to the specific contours of the patient’s body and ____, ____, _____

A

Reduced pressure point tenderness, provides better comfort and provides thermal insulation

EMT (25 decks)

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