CH 33 Flashcards
Which of the following is a function of the autonomic nervous system?
Constriction of blood vessels
Your patient is a 27-year-old male who has been involved in a motorcycle collision in which he was not wearing a helmet. He does not respond when you speak to him, but he makes incomprehensible sounds when you press your knuckles on his sternum. Which of the following best describes his level of consciousness?
painful
When blood accumulates between the brain and the dura mater, what is the result?
subdural hematoma
Your patient is pregnant at 30 weeks’ gestation and has been thrown from a horse. She is complaining of back pain. Which of the following is the correct procedure for immobilizing her spine?
Place the patient supine on the backboard, then put a pillow under the right side of the backboard.
Your patient is a 30-year-old female involved in a motorcycle crash. She was not wearing a helmet and struck her head on the pavement. She is unresponsive and has a blood pressure of 152/110 mmHg. Her pulse is 60 beats per minute and respirations are 8 breaths per minute and shallow. Which of the following is an appropriate intervention?
Provide cervical spine immobilization.
Which of the following is controlled by the left side of the brain?
sensation of the right leg
A 36-year-old male was accidentally shot with a nail gun into the head. You see the nail, which protrudes about 2 to 3 centimeters from the skull, when you visualize the injury site. Under which of the following circumstances should you remove the nail from the injury site?
none
Which of the following describes the proper position of the patient’s head for spinal immobilization?
Neutral, inline position
Which of the following is used to calculate a patient’s GCS?
Eye movement
Verbal response
motor response
Which of the following may be a hazard of an improperly fitting cervical collar?
Prevents the patient from opening his mouth
B.
Allows hyperextension of the neck
C.
Allows flexion of the neck
Which of the following signs is least likely to indicate a traumatic brain injury?
low blood pressure
In which of the following circumstances should a helmet be removed?
If the helmet interferes with airway management
While assessing a patient with a laceration to the neck, the EMT must be aware that which of the following conditions may develop?
air embolus
Which of the following is a potential complication of hyperventilating a patient with a brain injury?
Decreasing blood flow to the brain
Your patient is a 30-year-old construction worker who fell from scaffolding and has been impaled through the right orbit by a 36-inch piece of concrete reinforcement bar. The patient responds to verbal stimuli and appears to have multiple other injuries. Which of the following is the best course of action?
Firmly stabilize the reinforcement bar in place so that the rescue crew can cut it short.
Your patient is a 10-year-old male whose jacket hood caught on a branch as he jumped out of a tree. He was momentarily suspended about 12 inches off the ground but was immediately lowered to the ground by his brothers. Which of the following injuries should you suspect?
Cervical spine injury
Which of the following is the underlying cause of neurogenic shock?
Failure of the nervous system to control the diameter of blood vessels
A 65-year-old man was doing some work on his roof when he lost his footing and fell to the ground, approximately 15 feet. He is unconscious but his respirations are normal. You note an obviously angulated left leg. You are more concerned about a possible head injury. Which of the following would indicate a possible head injury?
increased blood pressure
The bony bumps you feel along the center of a person’s back are known as which of the following?
Spinous process
Your patient was ejected from his motorcycle when he struck a deer late at night on a deserted highway. He is drowsy and unable to communicate clearly. As you immobilize him on the long spine board, you find that you are unable to obtain neutral alignment of his spine due to the large helmet he has on. You should:
remove the helmet to better manage proper alignment.
In most cases, which of the following is the correct way to provide initial management of a suspected cervical spine injury?
Hold the patient’s head still in a neutral, “eyes forward” position.
You are en route to the trauma center with a patient who was injured when he was thrown from a horse. You suspect multiple trauma injuries including a closed head injury. You will monitor his mental status using the Glasgow Coma Scale (GCS) per your protocols. Which of the following will you check?
Eye opening, motor response, and verbal response
What is another name for the zygomatic bone?
malar
Your patient has had his throat slashed during a robbery attempt. You are concerned because it is apparent that the vessels in his neck have been lacerated. A breach in which of the following vessels would be most likely to lead to an air embolism?
veins
What is the Glasgow Coma Scale (GCS) of your adult male patient who has fallen off a horse, has his eyes open, and can follow your commands to squeeze his hands, but is confused about what happened and his whereabouts?
14
Which of the following is classified as an open head injury?
Laceration with a skull fracture
At which point may manual stabilization of the cervical spine be terminated?
When the patient is secured to a long backboard
Which of the following is not a common field finding in spinal injuries?
deformity
Messages from the body to the brain are carried by which of the following types of nerves?
sensory
A 44-year-old male involved in a collision at 50 mph struck the windshield of his vehicle with his face. Which of the following injuries should you prepare to treat?
Airway obstruction
B.
Brain injury
C.
Cervical spine trauma
Which of the following is the opening at the base of the skull?
Foramen magnum
When should the EMT calculate a GCS with a patient who suffered a fall of 20 feet from his apartment building?
En route to the hospital
Your patient is a 16-year-old male who was ejected from an all-terrain vehicle and struck his head on a large rock. He was not wearing a helmet. He is unresponsive with shallow, irregular respirations; a blood pressure of 170/110 mmHg; and a heart rate of 50 beats per minute. Which of the following interventions would be most appropriate?
Insert an oropharyngeal airway and ventilate via bag-valve mask at 10 to 12 breaths per minute.
Which of the following systems includes the pairs of nerves that enter and exit the spinal cord between each pair of vertebrae?
Peripheral nervous system
Your patient has been injured by a fall down a flight of steps. He is alert and oriented but complains of back and neck pain. You immobilize him on a long spine board with a cervical collar on his neck as a precaution because you know that the:
cervical spine is not supported by other bony structures.
You are called for a man who is not acting right. His wife says he was outside working in the garden but didn’t come in for lunch when he was called. She went to check on him and found him sitting next to a stump, confused. You assessment shows a pulse rate of 58, blood pressure of 186/82, respirations of 16, and one of his pupils is dilated. You are unable to detect any signs of trauma and you don’t see any obvious indication that he has fallen. You should suspect a(n):
nontraumatic brain injury.
The maxillae form which of the following structures?
upper jaw
Which of the following may result from the application of a cervical collar that is too large for the patient?
Hyperextension of the neck
When using a short spine immobilization device, which part of the body is secured last?
head
Which of the following pieces of equipment is acceptable for use in the prehospital stabilization of suspected cervical spine injuries?
Rigid cervical collars
How many cervical vertebrae are there?
7
Your patient is a 38-year-old male driver of a vehicle that left the roadway and struck a bus stop shelter and a tree. He is sitting in the driver’s seat and conscious and alert, he has some abrasions on his forehead, his skin is warm and dry, and he has a strong radial pulse and no difficulty breathing. After applying a cervical collar, which of the following actions represents the most appropriate way for removing the patient from the vehicle?
Place a long spine board under the patient’s buttocks and then carefully lower the patient to the board in a supine position.
Which of the following injuries is considered an indirect brain injury?
Concussion
When log-rolling a patient with a suspected spinal injury, which of the following EMTs directs the move?
EMT at the head of the patient
EMT at the head of the patient
Cervical and lumbar
Which of the following causes worsening of the damage in a brain injury?
Improper management of airway and ventilation
Your patient has sustained a serious laceration to his neck. He appears to have lost a lot of blood, and you are considering how you will control the bleeding. Your primary treatment should be to
place your gloved hand over the wound before placing an occlusive dressing.
You are treating a 35-year-old male patient who has been involved in a motorcycle incident. The patient is unresponsive with a blood pressure of 60/40, a pulse of 66 beats per minute, and respirations of 18 breaths per minute. The patient’s skin is flushed and warm. The patient’s presentation is most likely caused by which of the following?
Neurogenic shock
Which of the following is not used to calculate a patient’s GCS?
Work of breathing
Which of the following causes worsening of the damage in a brain injury?
Improper management of airway and ventilation
You are treating an unresponsive homeless patient found in an alley. During your assessment you notice the Battle sign, which is bruising:
behind the ear.
Your 38-year-old male patient has been injured in an assault. He has several facial lacerations and a large knot on his head. Bystanders say that he was thrown over a large table and landed on his head and shoulder. As part of your scene size-up and primary assessment, you should:
immobilize his cervical spine.
Which of the following statements concerning a concussion is true?
The patient may not have any symptoms of the injury.
Which of the following is defined as an area of the body surface that is innervated by a single spinal nerve?
Dermatome
Which of the following systems includes the pairs of nerves that enter and exit the spinal cord between each pair of vertebrae?
Peripheral nervous system
Your patient is a 35-year-old woman who was driving a minivan that was struck in the driver’s side door by another vehicle. You notice that when you apply pressure to her sternum with your knuckles she extends her legs and flexes her arms and wrists. When giving your radio report, which of the following terms should you use to describe this?
Posturing
As pressure within the cranium increases, which of the following is the result?
Increased blood pressure, decreased pulse
A fracture of which of the following bones would be considered a skull fracture?
Temporal bone
B.
Nasal bones
C.
Maxilla
A 17-year-old girl was injured when her car was struck from behind while she was stopped at a red light. She is complaining of a headache with neck and back pain. You suspect she has sustained a(n):
whiplash injury.
To which of the following sections of the spine are the ribs attached?
thoracic
A young female was injured in an automobile wreck, striking her head on the windshield. She is unconscious and her breathing is irregular. She is bleeding from a scalp wound, but your assessment shows that her cranium is intact. Her vital signs are pulse 68 and blood pressure 148/90, and her pupils are unequal. You should suspect a(n):
closed head injury.
Of the following patients, which injury is the highest priority to receive bag-valve mask ventilations?
15-year-old female who was ejected from a vehicle, struck her head on a tree, and displays decerebrate movements in response to painful stimuli
You are treating a 54-year-old female patient who was involved in a domestic dispute; you notice an abrasion to the side of her head. The patient is unresponsive with a blood pressure of 200/110, a pulse of 60 beats per minute, and slightly irregular breathing. The patient’s presentation is most likely caused by which of the following?
Increased intracranial pressure
When a patient has a serious open wound to the neck, you are concerned about the possibility of an air embolism. The reason an air embolism can occur is because of:
pressure in the large neck veins that is lower than atmospheric pressure.
Which of the following is a sign of possible brain injury?
A.
Projectile vomiting
B.
Deep laceration of the scalp
C.
Irregular breathing patterns
Your patient is a 16-year-old centerfielder on his high school baseball team. He was injured when he and the left fielder collided trying to catch a fly ball. He is disoriented and is unable to tell you what happened. His vital signs are pulse 88, blood pressure 132/86, respiratory rate 16, and pupils equal. As you assess his head, you do not see any cuts or bleeding, but you feel a spongy, depressed area over his left ear. You should suspect a(n):
open head injury.
