Ch 32, 33, 34, 35, & 36 Flashcards
The nervous system has 2 major functions, what are they?
Communication and control
Most nerve centers are in the — and —
Brain and spinal cord
What does the central nervous system consist of?
-brain
-spinal cord
What does the peripheral nervous system consist of?
-cranial nerves
-spinal nerves
The ——— influences the activity of skeletal muscles and movement throughout the body
Voluntary nervous system
The ———, is automatic and influences the activities of involuntary muscles and glands, also includes the sympathetic nervous system and the parasympathetic nervous system
Autonomic nervous system
The —— gives the body its framework, supports and protects vital organs, and permits motion
Skeletal system
The bony framework of the body is held together by —
Ligaments
What are the two parts of the skull?
-the cranium
-the face
The ——, or vertebral column, is the principal support system of the body
Spinal column
The spinal column is composed of 33 irregularly shaped bones called —
Vertebrae
The — of the vertebra is the bulky portion that faces anteriorly in the spinal column
Body
The — is the posterior aspect of the vertebra
Spinous process
Between each two vertebrae is a fluid filled pad of tough elastic cartilage called a — that acts as a shock absorber
Disk
What are the first 7 of the vertebrae called?
Cervical
What were the next 12 vertebrae under the cervical region called?
Thoracic
What are the next 5 vertebrae under the thoracic region called?
Lumbar
What are the next 5 vertebrae under the lumbar region called?
Sacral
What are the 4 fused vertebrae under the sacral spine called?
Coccyx (tailbone)
Injury to the —— is the most common cause of spinal cord injury
Cervical spine
The —— is composed of nervous tissue, it exits the brain through an opening at the base under the skull. Is surrounded by a sheath of protective membranes called — and a cushioning layer of cerebrospinal fluid
-spinal cord
-meninges
The —— carry impulses down the spinal cord and out to muscles, these are tested by having a patient move
Motor tracts
The —— carry impulses from pain receptors up the spinal cord and to the brain. These are tested by applying pain to the patient
Pain tracts
To test the right pain tract in the spinal cord, you must apply pain to what side of the body?
Left
To test the left pain tract, you must apply pain to the — side of the body
Right
The ——— carry gentle touch impulses from sensory receptors up the spinal cord to the brain, these are tested by applying gentle touch to the patient
Light touch tracts
The light touch sensation is carried up the —— of the spinal cord as the side where the touch is applied
Same side
A patient can have a spinal cord injury without any spinal column damage, this is known as a spinal cord injury without radiologic abnormality or —
SCIWORA
This kind of spinal injury occurs when the weight of the body is driven against the head, caused by falls or MVA’s:
Compression injury
This kind of spinal injury occurs when there is severe forward movement of the head meets the chin, or when the torso is excessively curved forward:
Flexion injury
This kind of spinal injury occurs when there is severe backward movement of the head in which the neck is stretched, or when the torso is severely arched backwards:
Extension injury
This kind of spinal injury occurs when there is lateral movement of the head or spine beyond its normal rotation:
Rotation injury
This kind of spinal injury occurs when the body or neck is bent severely from the side:
Lateral bending injury
This kind of spinal injury occurs when the vertebrae or spinal cord are stretched and pulled apart, common in hangings:
Distraction injury
This kind of spinal injury occurs when there is injury from gunshots, stabbings, and other impaled traumas that involve the cranium or spinal column:
Penetration injury
A ——— is an injury to one or more vertebrae, that is, the portion of the spine composed of bones and ligaments
Spinal column injury
A ——— involves damage to the nervous tissue that is enclosed inside the hollow center of the bony spinal column: the spinal cord
Spinal cord injury
A ———— results when an area of the spinal cord has been completely transected either physically or physiologically
Complete spinal cord injury
—— is a temporary concussion like insult to the spinal cord that causes effects below the level of injury, can cause flaccid muscles, anesthetic effect, and paralysis
Spinal shock
In spinal shock, a male patient may have an involuntary erection of the penis called?
Priapism
—— from spinal shock, also called spinal vascular shock, results from an injury to the spinal cord that interrupts nerve impulses to the arteries
Neurogenic hypotension
An ———— occurs when the spinal cord is injured but not completely through all the three major tracts
Incomplete spinal cord injury
In ———, the medial, or middle portion of the spinal cord is injured, causing a dysfunction in the inner tracts that control upper extremity motor and sensory function, commonly seen in elderly
Central cord syndrome
——— results from injury of the sensory and motor tracts located in the anterior portion of the cord
Anterior cord syndrome
In anterior cord syndrome, the patient loses the ability to ——
Feel pain
An injury to a hemisection (the right or left half) of the spinal cord disrupts the spinal tracts on only one side of the cord. The patient experiences motor and sensory losses below the injury site, but the distinctive feature of ——— is that the effects differ on two sides of the body
Brown sequard syndrome
In ———, the patient loses motor function and light touch sensation on one side of the body while retaining pain sensation on that same side
Brown sequard syndrome
A complete spinal cord injury can result in:
-total paralysis
-loss of sensation below the level of injury
An injury to the third to fifth cervical vertebrae might injure the phrenic nerve that controls the function of the —
Diaphragm
If the patient is alert and oriented, and can obey your commands, some protocols allow you to instruct the patient to perform ——, which is for the patient himself to keep his head, neck, and spine in alignment and to restrict or prevent his movement
Self restriction
To check motor function in the tipper extremities, ask the patient to do the following:
-flex his arms across his chest
-extend his arms to the side of his body
-spread his fingers on both hands and not to let me squeeze them together
-hold out both arms and don’t let me push your hand down
To check motor functions in the lower extremities, ask the patient to do the following:
-push down against my hands with your feet
-pull up against my hands with your feet
As you perform tests for light touch to the fingers, you would ask:
-can you feel me touching your finger?
-can you tell me what hand and which finger I’m touching
The — in spinal shock is due to massive vasodilation and pooling of blood in the peripheral vessels
Hypotension
— breathing is indicative of cervical spine injury
Diaphragmatic
The — of the eye, or eyeball, is a sphere approx 1 inch in diameter. It is covered with a tough outer coat called the — or the white of the eye
-globe
-sclera
The clear front portion of the eye, the — covers the dark center, the — and the colored portion, the —
-cornea
-pupil
-iris
The — is the window through which light enters the eye, it is susceptible to injury, a scratch or small foreign object can cause extreme pain with tears
Cornea
The pupil is the opening that expands or contracts to allow more or less light into the eye through the —, just behind the pupil, the — focuses light on the retina, the back of the eye
Lens
The inner surface of the — and the exposed portion of the sclera are lined with a paper thin covering called the —
Conjunctiva
The interior of the eye contains the —— (front chamber), which is anterior to the iris and is filled with a watery fluid called the ——
-anterior chamber
-aqueous humor
Behind the lens is the large ——, which is filled with a clear jelly called the ——
-Vitreous body
-vitreous humor
The bony structures of the skull that surround the eyes are called the —, or eye sockets
Orbits
What are some signs and symptoms of orbital fracture?
-diplopia
-decrease in vision
-loss of sensation
-nasal discharge
Injury to the globe of the eye might include a pear or irregular shaped eyeball and blood in the anterior chamber of the eye, this condition is called:
Hyphema
What is photophobia?
Sensitivity to light
A ——— occurs from trauma to the orbit, after facial surgery, or hemorrhage from anticoagulant, the eye usually appears to be bulging from pressure
Retro orbital hematoma
Generally you should remove contact lenses when:
-there has been a chemical burn to the eye
-the patient is unresponsive and is wearing hard contact lenses
-if transport time will be delayed
When the — is fractured, it is generally broken in at least two places and will be unstable. Bruising and swelling might be obvious
Mandible
Fracture of the — is often accompanied by a black eye, the face can appear elongated, and the patients bite will no longer be even
Maxilla
What is the pinna?
The visible, exposed part of the ear
The chest cavity is also known as the ——
Thoracic cavity
The thoracic cavity is bordered inferiorly by the —, which separates it from the abdominal cavity
Diaphragm
The — is a hollow area in the middle of the thoracic cavity between the right and left lungs
Mediastinum
What does the mediastinum house?
-the trachea
-the vena cava
-the aorta
-the esophagus
-the heart
The pleura consists of the —— which is the innermost layer and is in contact with the lung and the —— which is the outermost layer and is in contact with the thoracic wall
-visceral pleura
-parietal pleura
Between the pleural layers is a —— that contains serous fluid to provide lubrication
Pleural space or potential space
If a puncture to the visceral pleura, the parietal pleura, or both pleuras occur,the seal is broken and air is sucked into the pleural space each time the chest walls expands. As the pleural space expands, the injured hemithorax can’t generate enough negative pressure to draw in adequate air, this is known as a —
Pneumothorax
Inhalation occurs when the muscles between the ribs, the ——, pull the ribs upward to increase the size of the rib cage
Intercostal muscles
An open chest wound can pull air into the thoracic cavity, sometimes with a noticeable sucking sound, this is referred to as a ———
Sucking chest wound
How should you dress a sucking chest wound?
Cover with gloved hand then apply a nonporous dressing and tape on three sides
A — pneumothorax is caused by air leaking into the chest cavity from a damaged lung with no opening through the outer chest wall
Tension
A common life threatening closed chest injury occurs when two or more adjacent ribs are broken in two or more places, this creates a segment of the chest that is unattached to the rest of the rib cage and is known as a ——
Flail segment
The flail segment may display ——, which is when the flail segment moves in a direction opposite to the movement of the rest of the chest wall
Paradoxical movements
What is the best thing to do for a patient with a flail segment?
CPAP or PPV with BVM
—— is bleeding and edema within the lung tissue and is often a sequence of a flail segment or other blunt force injury and can lead to death, leads to severe hypoxia
Pulmonary contusion
A — pneumothorax usually occurs without external cause, usually the result of a congenitally weak area on the surface of the lung (bleb) which ruptures and allows air to enter the thoracic cavity
Spontaneous
An — pneumothorax is the result of an open would to the chest by a penetrating object, air can be heard escaping through the chest wound, creating a bubbling or sucking sound
Open
An open pneumothorax is referred to as what type of chest wound?
Sucking chest wound
A — is when the thoracic cavity is filled with blood rather than air
Hemothorax
A — is a collection of blood and air in the thoracic cavity
Hemopneumothorax
A hemothorax causes bleeding in and around the lung which usually produces what symptom?
Pink or red frothy sputum when the patient coughs
—— occurs when severe and sudden compression of the thorax causes a rapid increase in pressure in the chest, this causes the back flow of blood out of the right ventricle and into the veins, head, and upper chest, patient often looks like he’s been strangled
Traumatic asphyxia
What are some signs and symptoms of traumatic asphyxia?
-bluish or purplish discoloration in face, head, neck, shoulders
-bloodshot protruding eyes
-JVD
In a —— the heart is violently compressed between the sternum and the spinal column, an actual bruise could occur to the heart wall
Cardiac contusion
What is the most likely area of the heart to be injured in a cardiac contusion?
Right ventricle
What is the most common presenting rhythm in a cardiac contusion?
Ventricular fibrillation
—— occurs when blunt or penetrating trauma can cause bleeding into the though fibrous sac that surrounds the heart, the pericardial sac. this causes inward pressure of the heart
Pericardial tamponade
A reduction in cardiac output leads to —
Hypotension
How many mL of blood is necessary to cause a pericardial tamponade?
50-100 mL
Pericardial tamponade usually causes what symptoms?
-Jugular and peripheral vein distention
-increased venous pressure
The breath sounds usually remain — in pericardial tamponade
Normal
—— is air trapped under the skin giving it a bubbly, inflated appearance and crackling feel when palpated, is usually present in the upper chest and neck
Subcutaneous emphysema
——— is an indication of possible cardiac injury or a tension pneumothorax
Jugular vein distension
When the trachea moves towards the side of the uninjured lung this is known as ——
Tracheal deviation
When watching the jugular veins during inhalation, if they engorge with inspiration it could be a sign of —— or ——. This engorgement is a result of an increased venous pressure and is called a ——
-tension pneumothorax or pericardial tamponade
-kussmaul sign
Fractured ribs can usually cause — (a grating wound or sensation) accompanied with excruciating pain
Crepitus
A drop is systolic pressure greater than 10 mmHg during inhalation is called?
Pulsus paradoxus
What is hemoptysis?
Coughing up blood or blood stained sputum
Sudden cardiac arrest from blunt force applied precordial area of the anterior chest (center of sternum) is a rare event. Usually occurs in young males around 13 years of age, occurs when a projectile like a baseball strikes the patient on the center of the chest, ventricular fibrillation and cardiac arrest, this condition is known as:
Commotio cordis
The abdominal cavity is lined by a two layer, sheath like membrane called the —. The innermost lining being the —— which adheres to and supports organs and the outermost lining being the —— which adheres to the walls of the abdominal cavity
-peritoneum
-visceral peritoneum
-parietal peritoneum
The potential space between the visceral and parietal peritonea is called the ——
Peritoneal space
Organs like the kidneys, duodenum, pancreas, ureters, vena cava, and aorta lie partially or completely behind the peritoneum, these are said to be — and lie in the — cavity
Retroperitoneal
If a hollow organ is ruptured or lacerated it can leak contents into the abdominal cavity, causing an irritation and inflammation of the peritoneal lining known as —
Peritonitis
When a solid organ is ruptured or lacerated, the blood from the organ might irritate the diaphragm and cause referred pain to the shoulder, this referred pain to the shoulder is called ——
Kehr sign
An —— occurs when an open wound through the abdominal wall allows abdominal contents, usually the small intestine, to protrude and be opposed
Abdominal evisceration
A — fracture occurs when a spinal vertebrae fractures at the junction of the thoracic and lumbar spine, is usually common in children with a lap belt restraint
Chance
Kehrs sign to the left shoulder in a child is a good indicator of a — injury
Spleen
—— in the pediatric patient is most often a result from swallowing air associated with crying after a painful incident and not a collection of blood
Abdominal distention
Almost all trauma effects more than one body system. A patient is considered to have —— when more than one major body system is involved
Multisystem trauma
What are the two hormones released in response to shock and why are they secreted?
-anti diuretic hormone
-oxytocin
-to reduce urine output to conserve blood volume
— is the trade name of the drug oxytocin
Pitocin
—— is the premature separation of the placenta from the uterine wall, can also result from traumatic injury is accompanied with vaginal bleeding and abdominal pain
Abuptio placentae
The pediatric assessment triangle (PAT) is composed of three sides, what are they?
-appearance
-work of breathing
-circulation to skin
