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Paramedic Care Volume 5 - Trauma > Chapter 10 - Head, Face, Neck, and Spinal Trauma > Flashcards

Chapter 10 - Head, Face, Neck, and Spinal Trauma Flashcards

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1
Q

The most common cause of trauma-related death is due to injury to the

A

pg 239

head.

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2
Q

What percentage of gunshot wounds to the cranium result in mortality?

A

pg 239

75 - 80 percent

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3
Q

Which of the following is a layer of the scalp?

The skin

Areolar tissue

Connective tissue

Galea aponeurotica

All of the above

A

pg 240

All of the above

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4
Q

Which of the following is NOT a bone of the cranium?

Frontal

Sphenoid

Mandible

Ethmoid

Parietal

A

pg 240

Mandible

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5
Q

The largest opening in the cranium is the

A

pg 241

foramen magnum.

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6
Q

Which of the following is the lower and movable jaw bone?

A

pg 241

Mandible

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7
Q

What is the bone of the cheek?

A

pg 241

Zygoma

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8
Q

The structure(s) responsible for our positional sense is (are) the

A

pg 242

semicircular canals.

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9
Q

Which of the following is the opening through which light travels to contact the light-sensing
tissue in the eye?

A

pg 243

Pupil

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10
Q

Which of the following is the light-sensing tissue in the eye?

A

pg 243

Retina

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11
Q

The white of the eye is the

A

pg 243

sclera

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12
Q

The delicate, clear tissue covering the pupil and iris is the

A

pg 243

cornea.

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13
Q

The vertebral column is made up of how many vertebrae?

A

pg 245

33 vertebrae

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14
Q

The functions of the ligaments supporting the spinal column include

A

pg 246

preventing hyperextension.

protecting the neck.

allowing straightening of the spine.

connecting adjoining vertebrae.

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15
Q

The component of the vertebrae that protrudes posteriorly and can be felt in several regions of
the spine is which of the following?

A

pg 246

Spinous process

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16
Q

The region of the vertebral column that permits the greatest movement is the

A

pg 246

cervical.

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17
Q

The major weight-bearing component of the vertebral column is the

A

pg 246

vertebral body.

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18
Q

The region of the vertebral column that has 12 vertebrae is the

A

pg 248

thoracic.

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19
Q

The region of the vertebral column that has five separate vertebrae is the

A

pg 249

lumbar.

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20
Q

Head trauma accounts for just over what percentage of motor vehicle—related deaths?

A

pg 250

50%

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21
Q

Which of the following motions is likely to result from the rear-end auto impact?

A

pg 252

Hyperextension

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22
Q

Which of the following motions is likely to result from hanging?

A

pg 253

Distraction

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23
Q

T/F - Spinal cord injury can occur without injury to the vertebral column or its associated ligaments.

A

pg 253

True

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24
Q

T/F - Serious scalp injury is unlikely to produce hypovolemia and shock because the arteries there
frequently constrict and effectively limit blood loss.

A

pg 253

False

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25
Q

Which of the following statements is NOT true of scalp wounds?

A. They pose a risk of meningeal infection.
B. Wounds there tend to heal very well.
C. Wounds there tend to bleed heavily.
D. Contusions there swell outward noticeably.
E. Avulsion of the scalp is not a likely injury.

A

pg 254

E. Avulsion of the scalp is not a likely injury.

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26
Q

The most common type of skull fracture is

A

pg 254

linear fracture

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27
Q

The type of skull fracture most often associated with high-velocity bullet entry is

A

pg 254

comminuted.

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28
Q

T/F - It is common for the paramedic to observe either Battle’s sign or bilateral periorbital
ecchymosis in the patient who has just sustained a basilar skull fracture.

A

pg 255

False

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29
Q

The discoloration found around both eyes due to basilar skull fracture is

A

pg 255

bilateral periorbital ecchymosis.

30
Q

Blood and CSF draining from the ear may display a

A

pg 255

concentric light-yellow circle.

31
Q

T/F - A cranial fracture, by itself, is a skeletal injury that will heal with time; it is the injury
underneath that is of most concern.

A

pg 255

True

32
Q

T/F - With facial trauma, lower airway obstruction is more likely due to blood than other fluids or
physical obstruction.

A

pg 256

True

33
Q

According to the Le Fort criteria, a fracture involving just the maxilla and limited instability is
classified as

A

pg 256

Le Fort I

34
Q

Which type of Le Fort fracture is likely to result in cerebrospinal fluid leakage?

A

pg 257

Le Fort II and III

35
Q

Which of the following statements is TRUE regarding injuries to the pinna of the ear?

A. They hemorrhage severely.
B. Hemorrhage is difficult to control.
C. Hemorrhage is limited.
D. Wounds there do not heal very well.
E. Both C and D.

A

pg 257

E. Both C Hemorrhage is difficult to control.

and

D. Wounds there do not heal very well.

36
Q

What mechanisms are likely to injure the tympanum?

A

pg 257

Basilar skull fracture

An object forced into the ear

An explosion

Diving injury

37
Q

The collection of blood in front of a patient’s pupil and iris due to blunt trauma is called a(n)

A

pg 258

hyphema.

38
Q

A sudden and painless loss of sight is most likely a(n)

A

pg 258

acute retinal artery occlusion.

39
Q

Blood vessel injury in the neck region carries with it the hazards of all of the following,
EXCEPT

A. severe venous hemorrhage.
B. severe arterial hemorrhage.
C. development of subcutaneous emphysema.
D. air aspiration.
E. pulmonary emboli.

A

pg 259

C. development of subcutaneous emphysema.

40
Q

The region that accounts for more than half of spinal cord injuries is the

A

pg 259

cervical spine.

41
Q

Helmets reduce the incidence of both head and spine injury.

A

pg 259

False.

42
Q

T/F - Manual immobilization should continue from the moment you arrive at the suspected spine injured
patient’s side until a cervical collar is applied.

A

pg 260

False

43
Q

Which of the following is a criteria for discontinuing spinal precautions?

A. The patient’s only symptom is dyspnea.
B. The patient is alert and partially oriented.
C. The patient is free of significant distracting injuries.
D. The patient is showing signs of sympathetic response.
E. The patient is a very young child.

A

pg 261

C. The patient is free of significant distracting injuries.

44
Q

Which of the following is NOT a mechanism of injury likely to cause spinal injury?

A. Fall from over three times the patient’s height
B. High-speed motor vehicle crash
C. Serious blunt trauma above the shoulders
D. Penetrating trauma directed to the lateral thorax
E. Penetrating trauma directed to the spine

A

pg 262

D. Penetrating trauma directed to the lateral thorax

45
Q

T/F - Oral intubation is generally more difficult in the patient who requires spinal precautions
because the landmarks are more difficult to visualize.

A

pg 263

True

46
Q

During the initial assessment, you should be aware that exaggerated abdominal movement and
limited chest excursions often suggest

A

pg 264

diaphragmatic breathing.

47
Q

Any significant open wound to the anterior or lateral neck should be covered with a(n)

A

pg 264

occlusive dressing.

48
Q

The major reason for allowing fluid to drain from the nose or ear is that

A

pg 265

its flow will prevent pathogens from entering the meninges.

49
Q

Conditions that may make it difficult to spinally immobilize a patient include all of the
following, EXCEPT

ankylosing spondylitis

herniated disk.

kyphosis

bamboo spine.

scoliosis.

A

pg 265

herniated disk.

50
Q

Which of the following could be considered a component of Cushing’s triad?

A. Cheyne-Stokes respirations

B. Decreasing pulse rate

C. Increasing blood pressure

D. Ataxic respirations

E. All of the above

A

pg 266

E. All of the above

51
Q

T/F - The head injury patient may vomit without warning, and the vomiting may be projectile in nature.

A

pg 268

True

52
Q

Which of the following airway techniques is NOT recommended for the patient with suspected
basilar skull fracture?

A. Nasopharyngeal airway insertion
B. Directed intubation
C. Digital intubation
D. Orotracheal intubation
E. Rapid-sequence intubation

A

pg 268

A. Nasopharyngeal airway insertion

53
Q

T/F - Prolonged attempts at intubation can induce hypoxia and hypercarbia.

A

pg 269

True

54
Q

What are acceptable methods for confirming endotracheal tube placement in
the head injury patient?

A

pg 270

Use of an end-tidal CO 2 monitor

Good and bilaterally equal breath sounds

Use of a pulse oximeter

Observing bilaterally equal chest rise

55
Q

T/F - For adequate ventilation through a needle cricothyrotomy, you must use a demand valve
ventilator.

A

pg 270

False

56
Q

T/F - When locating the cricoid cartilage, either for Sellick’s maneuver or the cricothyrotomy, it is
the first hard rigid ring you feel as you move your fingers up the trachea from the suprasternal
notch.

A

pg 270

True

57
Q

T/F - Proper immobilization of the patient with spinal injury should include placing a blanket roll
under the knees.

A

pg 272

False

58
Q

What are Contraindications to continuing to move the head and spine toward
the neutral, in-line position?

A

pg 272

You meet with significant resistance.

Your patient complains of a significant increase in pain.

You notice gross deformity along the spine.

You notice an increase in the signs of neurologic injury.

59
Q

T/F - Some gentle axial traction on the head will make cervical immobilization more effective.

A

pg 273

False

60
Q

The ideal position for the small adult’s or child’s head during spinal immobilization is

A

pg 273

level with the spine board.

61
Q

The standing takedown for the patient with spinal injuries requires a minimum of how many
care providers?

A

pg 273

Three providers

62
Q

Under what circumstances should a helmet be removed from a patient?

A

pg 274

The head is not immobilized within the helmet.

The helmet prevents airway maintenance.

You cannot secure the helmet firmly to the long spine board.

You anticipate breathing problems.

63
Q

T/F - A four-count cadence is preferable for moves because it better signals care providers when the
move starts.

A

pg 274

True

64
Q

A log-roll is properly performed by

A

pg 275

placing a bulky blanket between the legs.

65
Q

T/F - Newer orthopedic stretchers are rigid enough to be used for spinal immobilization by
themselves.

A

Pg 275

True

66
Q

T/F - The vest-type immobilization device is meant to permit rescuers to move the patient from a
seated to a supine position in an auto crash by rotating the buttocks on the seat, then tilting the
patient to the supine position.

A

pg 275

True

67
Q

Which of the following circumstances would NOT automatically merit employment of rapid
extrication techniques?

A. Toxic fumes

B. An auto collision

C. An immediate threat of fire

D. Rising water

E. None of the above

A

pg 276

B. An auto collision

68
Q

T/F - Once you immobilize the body to the long spine board, you can then secure the head to it.

A

pg 277

True

69
Q

The most ideal position for the adult head during spinal immobilization is

A

pg 277

1 to 3 inches above the spine board.

70
Q

The best technique for immobilizing a patient onto a long spine board who is in the water after
sustaining a diving injury is

A. log-rolling.
B. straddle slide.
C. rope-sling slide.
D. applying a vest-type device.
E. none of the above.

A

pg 278

E. none of the above.

71
Q

When treating an avulsed eye you should

A

pg 279

cover both eyes.

72
Q

Dislodged teeth from a patient should be

A

pg 279

wrapped in gauze soaked in sterile saline.

Paramedic Care Volume 5 - Trauma (11 decks)

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