Question 1

``` H-1) The process by which the brain is compressed toward and through the foramen magnum is known​ as: A. herniation. B. subdural hematoma. C. concussion. D. cerebral contusion. ```

Accepted Answer

A. herniation. Pushing a portion of the brain downward toward the foramen magnum is called herniation.

Question 2

``` H-2) The purpose of spinal motion restriction is to prevent movement of​ individual: A. muscles. B. joints. C. vertebrae. D. tendons. ```

Accepted Answer

C. vertebrae

Question 3

``` H-3) he 12 vertebrae in the upper back are known as​ the: A. coccyx. B. sacral spine. C. thoracic spine. D. lumbar spine. ```

Accepted Answer

C. thoracic spine The thoracic spine is the region of vertebrae named as such because of the attachment of the ribcage that provides the external borders of the thoracic cavity.

Question 4

``` H-4) Which of the following structures is the only movable part of the​ face? A. Maxilla B. Mastoid C. Mandible D. Zygoma ```

Accepted Answer

C. Mandible The​ mandible, or​ jaw, is the only movable part of the face. It is hinged at its posterior​ aspect, and the movement allows for functions such as talking and chewing.

Question 5

``` H-5) Skull injuries divide into two general​ categories, which​ are: A. traumatic and nontraumatic. B. subdural and epidural. C. open and closed. D. direct and indirect. ```

Accepted Answer

C. open and closed.

Question 6

H-6) Which of the following statements about an epidural hematoma is​ true? A. Patients with epidural hematomas may present similarly to those with subdural hematomas. B. Unlike subdural​ hematomas, which occur​ rapidly, epidural hematomas take hours or days to develop. C. Epidural hematomas do not carry the threat to life that subdural hematomas do. D. The bleeding site is between the brain and the dura mater.

Accepted Answer

A. Patients with epidural hematomas may present similarly to those with subdural hematomas Patients with epidural hematomas may present similarly to those with subdural​ hematomas, although numerous factors such as​ size, location, and concurrent injuries play a role in how a patient presents. In a subdural​ hematoma, presentation of symptoms may be delayed by as long as a day or more.

Question 7

``` H-7) Which of the following findings is least likely in a patient with nontraumatic brain​ injury? A. Unequal pupils B. Battle sign C. Altered level of consciousness D. Slurred speech ```

Accepted Answer

B. Battle sign Battle sign is an indication of possible basal skull​ fracture, and is unlikely in a patient with nontraumatic brain injury.

Question 8

``` H-8) Which of the following intracranial physiological events is most likely to occur in a patient with traumatic brain injury but not in a patient with nontraumatic brain​ injury? A. Cerebral edema B. Cerebral contusion C. Increased intracranial pressure D. Cerebral hemorrhage ```

Accepted Answer

B. Cerebral contusion

Question 9

``` H-9) Which of the following is a component of Cushing​ reflex? A. Increased cerebral perfusion B. Decreased heart rate C. Decreased intracranial pressure D. Decreased blood pressure ```

Accepted Answer

B. Decreased heart rate Increased blood pressure and decreased heart rate are known as the Cushing​ reflex, and indicate rising intracranial pressure.

Question 10

H-10) In a patient who sustained massive impact trauma to the face during a motor vehicle​ crash, the presence of facial fractures and a fractured mandible should lead you to​ suspect: A. that a compromised airway is not very likely. B. that the patient is not likely to have a brain​ injury, because the facial fractures absorbed all of the energy at impact. C. that the patient was unrestrained. D. that the energy involved might have caused skull or brain injury.

Accepted Answer

D. that the energy involved might have caused skull or brain injury.

Question 11

``` H-11) Your patient responds to painful stimulus with decorticate posturing​ (arms bent to his​ chest, fists​ clenched, and legs straight​ out), his eyes do not open to​ pain, and he makes incomprehensible sounds when you pinch him. What score would you give him on the Glasgow Coma​ Scale? A. 4 B. 6 C. 5 D. 3 ```

Accepted Answer

B. 6 His score would be eye​ = 1​ (no eye​ opening), verbal​ = 2​ (incomprehensible sounds), and motor​ = 3​ (flexion to​ pain).

Question 12

``` H-12) What is your first priority for a patient with massive facial​ trauma? A. Preventing permanent scarring B. Keeping the airway open C. Protecting the​ patient's privacy D. Bandaging all open injuries ```

Accepted Answer

B. Keeping the airway open Top priorities include securing the airway and controlling​ bleeding, with cervical spine precautions if indicated.

Question 13

``` H-13) Which of the following indicates a possible mandible​ injury? A. Unequal pupils B. Memory loss C. Improperly aligned teeth D. Bruising around the eyes ```

Accepted Answer

C. Improperly aligned teeth Improperly aligned teeth and difficulty speaking are indications of possible mandible injury.

Question 14

H-14) If a standard medically approved occlusive dressing is not​ available, what material might be effective in treating an open neck​ wound? A. Elastic wrap​ (e.g., an Ace​ bandage) B. Aluminum foil C. A piece of heavy plastic that is at least 2 inches larger in diameter than the wound site D. A​ water- or​ saline-soaked 4 x 4 gauze pad

Accepted Answer

C. A piece of heavy plastic that is at least 2 inches larger in diameter than the wound site A sheet of heavy plastic of an appropriate size will most effectively occlude the neck from air entry. (secured with medical tape)

Question 15

H-15) You arrive on scene to an assault victim who is grabbing the side of her neck. You notice hemorrhage on the left side of her neck. How should you manage this​ patient's neck wound once you arrive at her​ side? A. Locate an occlusive dressing and place it on the wound in a timely fashion B. Apply​ firm, direct pressure bilaterally to the neck C. Immediately wrap a bandage around the neck D. Immediately cover the wound with a gloved hand

Accepted Answer

D. Immediately cover the wound with a gloved hand

Question 16

``` H-16) Your patient attempted suicide by hanging. What type of spinal injury is most​ likely? A. Extension injury B. Compression injury C. Distraction injury D. Flexion injury ```

Accepted Answer

C. Distraction injury The spine is pulled excessively (hanging is an example of this)

Question 17

``` H-17) A diver struck his head on the bottom of the swimming pool and now complains of neck pain and numbness in his lower extremities. You​ suspect: A. compression injury. B. rotational injury. C. crush injury. D. distraction injury. ```

Accepted Answer

A. compression injury.

Question 18

``` H-18) In neurogenic​ shock, the pulse rate may​ be: A. normal. B. lower than the blood pressure. C. undetectable. D. erratic. ```

Accepted Answer

A. normal In neurogenic​ shock, the heart rate may continue to be​ normal, or even​ slow, because the neural messages for the heart to speed up its pumping action are blocked by spinal injury.

Question 19

``` H-19) Paralysis of the extremities is probably the most reliable sign of spinal cord​ injury: A. if accompanied by paresthesia. B. in patients who are conscious. C. in pediatric patients. D. if verbal response is also impaired. ```

Accepted Answer

B. in patients who are conscious.

Question 20

H-20) You are the second unit on the scene of a​ multiple-vehicle crash. You and your partner are caring for a​ middle-aged woman who is sitting in the passenger seat of a vehicle that seems undamaged. You see no signs of injury in this patient. When you ask her about​ pain, she replies in a foreign language. What should you​ do? A. Take full spinal​ precautions, because you cannot determine the extent of the​ patient's injuries. B. Although communication is​ important, given the fact that there are no MOIs and no signs of​ injury, you can safely choose not to immobilize the patient. C. The​ patient's language has no bearing on how you treat here. She does not require immobilization. D. Examine the patient more​ closely, and look for physical signs of pain when you palpate her back.

Accepted Answer

A. Take full spinal​ precautions, because you cannot determine the extent of the​ patient's injuries. The language barrier creates an inability to communicate. The patient should be immobilized as a​ precaution, because the patient cannot relay information about her injuries.

Question 21

H-21) The police call you for a​ 50-year-old male patient who has a history of intoxication and belligerence. You find him sitting on the curb with a small​ abrasion, minimal bleeding to his​ forehead, and his hands cuffed behind his back. He is exhibiting​ tremors, and his speech is slurred. He denies any​ pain, denies any consumption of​ alcohol, and says that he sustained the abrasion 3 days earlier. You​ should: A. transport him without spinal precautions. B. ask law enforcement for permission to immobilize the patient. C. immobilize​ him, because the history seems unreliable. D. explain the risks to the patient and let him choose whether or not to be immobilized.

Accepted Answer

C. immobilize​ him, because the history seems unreliable. The history is inconsistent with your physical​ findings, and the patient is probably intoxicated. The patient should be immobilized. You should identify the potential for spinal injury while also identifying secondary causes to the​ patient's condition.

Question 22

``` PT-1) The catcher at a baseball game is struck on the front of his head by a thrown bat. He sustains a cerebral bruise on the front of his brain but also has a contusion on the back of his brain. The bruise on the back of his brain is called​ a(n): A. unilateral injury. B. contrecoup injury. C. coup injury. D. anterior cerebral contusion. ```

Accepted Answer

B. contrecoup injury.

Question 23

``` PT-2) You are assessing a patient who is unconscious but who responds to painful stimuli by attempting to push away the painful stimulus​ (for instance, a pinch on the​ leg) with his hand. How would you score his motor response according to the Glasgow Coma​ Scale? A. 4 B. 3 C. 5 D. 6 ```

Accepted Answer

C. 5

Question 24

``` PT-3) You respond to the scene of an explosion to treat a victim with a penetrating injury to the occipital area from shrapnel. For which of the following additional injuries should you have a high level of​ suspicion? A. Spinal injury B. Transection of the trachea C. Penetrating thoracic injury D. Carotid artery involvement ```

Accepted Answer

A. Spinal injury

Question 25

PT-4) Which of the following describes shock following spinal​ injury? A. Dilation of the blood​ vessels, resulting in reduction of perfusion to tissues B. Paralysis of the respiratory muscles occurring with injury to the thoracic spine C. Paralysis to only one side of the body that does not resolve D. Inadequate circulation indicated by a rapid pulse and​ cool, clammy skin

Accepted Answer

A. Dilation of the blood​ vessels, resulting in reduction of perfusion to tissues

Question 26

``` PT-5) The region where the jaw articulates with the remainder of the head is termed​ the: A. temporomandibular joint. B. frontomandibular joint. C. parietomandibular joint. D. angle of the mandible. ```

Accepted Answer

A. temporomandibular joint.

Question 27

``` PT-6) You are assessing a victim of a gunshot wound to the head. Her eyes are​ open, but she does not follow or track any movement. There is no eye​ blink, and her pupils are fixed and dilated. Her motor response score is a​ 1, and her verbal response is a 1 as well. What is her​ eye-opening score? A. 4 B. 1 C. 2 D. 3 ```

Accepted Answer

B. 1

Question 28

PT-7) In treating a patient with suspected head or spine​ injury, manual stabilization of the head and neck can be​ released: A. only after the cervical spine has been cleared by an​ X-ray. B. when you find a good​ pulse, motor​ function, and sensation in the distal extremities. C. after the patient has been secured to a backboard. D. after the cervical collar has been applied.

Accepted Answer

C. after the patient has been secured to a backboard.

Question 29

PT-8) You are treating a​ 22-year-old male who was stabbed in the neck during a bar fight. What is an important part of the treatment of this​ injury? A. Sealing the wound with an occlusive dressing B. Laying the patient down C. Checking for subcutaneous emphysema D. Listening to the lung sounds right away

Accepted Answer

A. Sealing the wound with an occlusive dressing

Question 30

PT-9) You are caring for a​ 19-year-old female patient who was involved in a motor vehicle crash. She sustained​ blunt-force trauma to her face with​ contusions, swelling, and minor bleeding throughout her facial region. Which of the following findings most strongly suggests a fractured​ mandible? A. Tenderness to palpation of her zygomatic bone B. Inability to close her mouth from a​ wide-open position C. Bleeding from the nose D. Lower teeth that are out of alignment in the front

Accepted Answer

D. Lower teeth that are out of alignment in the front

Question 31

PT-10) When you are stabilizing an impaled object in the​ head, always: A. use a​ pressure-type dressing such as elastic wrap to hold the object in place. B. avoid wrapping the dressing around the​ head, as this may increase pressure in the head. C. cover both the​ patient's eyes as well. D. use bulky and rigid support.

Accepted Answer

D. use bulky and rigid support.

Question 32

``` PT-11) How many vertebrae make up the cervical​ spine? A. Nine B. Five C. Seven D. Three ```

Accepted Answer

C. Seven 7 - 12 - 5 - 5 - 4

Question 33

``` PT-12) Your patient is unable to move his lower jaw or speak. You should suspect an injury to​ the: A. temporal region. B. maxilla. C. orbit. D. mandible. ```

Accepted Answer

D. mandible.

Question 34

PT-13) A brain injury is classified as nontraumatic if it​ is: A. not serious. B. not permanent. C. not attributable to an external cause. D. not assessable on the Glasgow Coma Scale.

Accepted Answer

C. not attributable to an external cause

Question 35

PT-14) You are treating a​ 6-year-old car crash​ victim, and have decided to immobilize him. You should refrain from doing which of the​ following? A. Using a coordinated long axis move onto the backboard B. Securing the patient on an adult long spine board C. Securing the patient in his child safety seat D. Padding the​ patient's shoulders

Accepted Answer

C. Securing the patient in his child safety seat

Question 36

``` PT-15) The regions on the surface of the body that individually are innervated by a single spinal nerve are​ called: A. myotomes. B. nerve tracts. C. dermatomes. D. vertebral branches. ```

Accepted Answer

C. dermatomes

Question 37

``` PT-16) If an individual sustains a head​ injury, and blood has accumulated on top of the brain but beneath the​ dura, this type of injury is termed​ a(n): A. subarachnoid hemorrhage. B. epidural hematoma. C. intracerebral laceration. D. subdural hematoma. ```

Accepted Answer

D. subdural hematoma

Question 38

PT-17) You just arrived at the scene of a motor vehicle crash involving two cars. The passenger of one car is sitting in the front​ seat, unconscious, with her chin to her chest. She is having snoring​ respirations, so you carefully position her head in a neutral position to clear her airway. In doing​ so, you notice that her nose is​ bleeding, there is a reddened area on her forehead at the​ hairline, and the windshield is​ starred, with some hair stuck in the fractured glass. What type of cervical injury should you​ suspect? A. Extension or flexion injury B. Flexion or rotational injury C. Axial loading or rotational injury D. Axial loading or hyperextension injury

Accepted Answer

A. Extension or flexion injury

Question 39

PT-18) Manual cervical stabilization should be provided to all patients with a significant mechanism of injury​ until: A. completion of a sensory examination. B. completion of a neuromotor examination. C. establishment of spinal tenderness. D. completion of the assessment.

Accepted Answer

D. completion of the assessment.

Question 40

``` PT-19) Which of the following is a common cause of nontraumatic brain​ injury? A. Syncope B. Tinnitus C. Blood clot D. TIA ```

Accepted Answer

C. Blood clot

Question 41

``` PT-20) You find out that one of your patients from an earlier car wreck suffered bleeding that caused the blood to collect and pool within the​ patient's skull. Based on this​ information, you know that the patient most likely suffered which type of brain​ injury? A. Concussion B. Contusion C. Laceration D. Hematoma ```

Accepted Answer

D. Hematoma

Question 42

PT-21) You have established manual​ in-line cervical spine stabilization of an unconscious trauma patient. You may release manual​ stabilization: A. once a cervical collar has been applied. B. when immobilization has begun. C. when the patient is fully immobilized and secured to the backboard. D. when the patient arrives at the hospital emergency department.

Accepted Answer

C. when the patient is fully immobilized and secured to the backboard.

Question 43

PT-22) A​ 22-year-old male patient was involved in a physical altercation at a bar. He has no evidence of head​ trauma, and reportedly did not fall or lose consciousness at any time. His only complaint is pain upon deep inspiration along the front of his left rib cage. Given the mechanism of injury and his​ presentation, should this patient be​ immobilized? A. Probably​ so, because he was at a bar and was likely drinking B. Probably​ not, because evidence of spinal injury would be obvious C. Probably​ so, because he has pain in his chest D. Probably​ not, because he does not have the mechanism of injury or the symptoms to suggest the need

Accepted Answer

D. Probably​ not, because he does not have the mechanism of injury or the symptoms to suggest the need

Question 44

PT-23) In caring for an open neck​ wound, it is important to avoid compressing both carotid arteries at the same time.​ Why? A. To prevent the release of clots to the brain B. Because the carotid arteries are the only arteries that supply the heart C. To prevent a dangerous reduction of blood flow to the brain D. To allow the blood to freely flow from the brain

Accepted Answer

C. To prevent a dangerous reduction of blood flow to the brain

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CH 33 Trauma to the Head, Neck and Spine Flashcards

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