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EMT > Chapter 28 > Flashcards

Chapter 28 Flashcards

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1
Q 
nervous system is a complex network of nerve cells that enables all parts of the body to function 
includes: 
... 
... 
several billion ...
A

brain
spinal cord
nerve fibers

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2
Q

the nervous system is well protected:
the brain is protected by the …
the spinal cord is protected by the …
despite this protection, serious injuries can damage the nervous system

A

skull; spinal canal

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3
Q

the nervous system is divided into two anatomic parts:
… system
… system

A

central nervous

peripheral nervous

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4
Q

(CNS) includes the … and …
the brain controls the body and is the center of …
brain is divided into three major areas: …, …, …

A

brain; spinal cord; consciousness; cerebrum; cerebellum; brainstem

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5
Q

(CNS) …: controls a wide variety of activities, including most voluntary motor function and conscious though
…: coordinates balance and body movements
..: controls most functions necessary for life

A

cerebrum
cerebellum
brainstem

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6
Q

(CNS) spinal cord: made up of fibers that extend from the brain’s …
carries messages between the brain and the body via the … and … of the spinal cord

A

nerve cells; grey and white matter

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7
Q

(CNS) protective coverings:
brain and spinal cord are covered with thick, bony structures
the CNS is further protected by the …:
… (dura mater) is a tough, fibrous layer that forms a sac to contain the CNS
inner two layers (… and ..) contain the blood vessels

A

meninges; outer layer; arachnoid mater; pia mater

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8
Q

(CNS) CSF: produced in a chamber inside the brain called the …
primarily acts as a …

A

third ventricle; shock absorber

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9
Q

(peripheral NS) … pairs of spinal nerves–> conduct impulses from the skin and other organs to the …, conduct motor impulses from the spinal cord to the …
… pairs of cranial nerves–> transmit info directly to/from the brain

A

31; spinal cord; muscles; 12

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10
Q

(peripheral NS) two types of peripheral nerves:
… nerves: carry only one type of info from the body to the brain via the spinal cord
… nerves: carry info from the CNS to the muscles

A

sensory; motor

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11
Q

(peripheral NS) connecting nerves: found only in the … and …
connect the sensory and motor nerves with …
allow the exchange of …

A

brain; spinal cord; short fibers; simple messages

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12
Q

nervous system controls virtually all the body’s activities, including:
… activities
… activities (consciously performed)
… activities (not under conscious control)

A

reflex
voluntary
involuntary

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13
Q

connecting nerves in the spinal cord form a …–> if a sensory nerve detects an irritating stimulus, it bypasses the brain and sends the message directly to a …

A

reflex arc; motor nerve

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14
Q

… nervous system handles voluntary activities
… nervous system handles body functions–> … ns reacts to stress with a fight-or-flight response
… ns has the opposite effect on the body

A

somatic; autonomic; sympathetic; parasympathetic

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15
Q

(skeletal system) skull: the skull is composed of the …, which protects the brain, and the …
brain connects to the spinal cord

A

cranium; facial bones

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16
Q

(skeletal system) skull contd:
four major bones make up the cranium: …, …, … regions, and … region
face is composed of 14 bones: …, …, …, …, and … bones

A

occiput; temples; parietal; frontal; maxilla; zygoma; mandible; nasal; frontal

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17
Q

(skeletal system) spinal column:
body’s central supporting structure
… vertebrae are divided into five sections
vertebrae are connected by … and separated by cushions, called …
spinal column is almost entirely surrounded by …

A

33; ligaments; intervertebral disks; muscles

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18
Q

(head injuries) traumatic insult to the head that may result in injury to soft tissue, bony structures, or the brain:
head injuries account for more than … of all traumatic deaths
fatal injuries invariably involve the …
be alert to the fact that the patient may have sustained additional trauma

A

half; brain

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19
Q

(head injuries) closed injuries: the … has been injured but there is no opening into the brain
open injuries: often caused by .. trauma, may be bleeding and exposed brain tissue

A

brain; penetrating

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20
Q

(head injuries) … are the most common MOI; other common MOIs include …, .., and ..-related injuries

A

motor vehicle crashes; assault; falls; sports

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21
Q

scalp lacerations:
can be minor or serious
small lacerations can lead to significant … especially in children

A

blood loss

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22
Q

(skull fracture) may be open/closed, depending on whether there is an overlying laceration of the scalp
signs of skull fracture include:
patient’s head appears …
visible … in the skull
… (bruising) under the eyes (raccoon eyes) or behind one ear over the mastoid process (battle’s sign)

A

deformed; cracks; ecchymosis

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23
Q

(skull fracture) linear skull fractures: account for about …% of all skull fractures; radiographs are required to diagnose a linear skull fracture because there are often no … signs

A

80; physical

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24
Q

(skull fracture) depressed skull fractures: result from high-energy direct trauma to the head by a blunt trauma. … may be driven into the brain, resulting in injury

A

bony fragments

25
Q

(skull fracture) basilar skull fracture:
associated with high-energy trauma
signs include … drainage from the ears, … and …

A

CSF; raccoon eyes; Battle’s sign

26
Q

traumatic brain injuries:
most serious of all head injuries
two broad categories:
… (direct) brain injury results instantaneously from impact to the head
… (indirect) brain injury increases the severity of the direct injury

A

primary; secondary

27
Q 
traumatic brain injuries: 
secondary injuries may be caused by: 
... 
... 
... 
... 
.. 
... 
...
A 
hypoxia
hypotension
cerebral edema
intracranial hemorrhage
increased intracranial pressure
cerebral ischemia
infection
28
Q

traumatic brain injuries:
can result from blunt/penetrating trauma
… injury: initial impact injures front part of brain, head falling back against headrest injures rear part of brain
… (swelling of the brain) may not develop until several hours following the initial injury

A

coup-countercoup

cerebral edema

29
Q

(intracranial pressure) accumulation of blood within the skull or swelling of the brain can rapidly lead to an increase in ICP: increased ICP squeezes the brain against … within the cranium

A

bony prominences

30
Q 
(intracranial pressure) signs of increased icp: 
abnormal ... patterns
decreased ... rate
... 
... 
... 
decreased ... 
... 
... or ... pupils
... posturing 
increased or widened ... 
... reflex
A 
respiratory;
pulse
headache
nausea
vomiting
alertness
bradycardia
sluggish; nonreactive
decerebrate
blood pressure
cushing
31
Q

(intracranial pressure) intracranial hemorrhage:
bleeding inside the skull also increases the ICP
bleeding can occur:
between the … and …
beneath the … but outside the brain
within the … itself

A

skull; dura mater; dura mater; tissue of the brain

32
Q

(intracranial pressure) epidural hematoma: accumulation of blood between the … and …
nearly always the result of a blow to the head–> produced by a … fracture of the thin … bone

A

skull; dura mater; linear; temporal

33
Q

(intracranial pressure) subdural hematoma: accumulation of blood beneath the dura mater but outside the brain
occurs after … or injuries involving strong … forces

A

falls; deceleration

34
Q

(intracranial pressure) intracerebral hematoma: bleeding within the brain tissue itself
can occur following a … injury to the head or because of rapid .. forces

A

penetrating; deceleration

35
Q

(intracranial pressure) subarachnoid hemorrhage:
bleeding occurs into the subarachnoid space, where the CSF circulates
results in … and signs of …
common causes include trauma or …

A

bloody CSF; meningeal irritation; rupture of an aneurysm

36
Q

a blow to the head or face may cause … of the brain–> considered a mild TBI
temporary loss or alteration of part or all of the brain’s abilities to function without … to the brain
about 90% of patients do not experience a loss of consciousness
a patient may be … or hav e…
usually lasts only a short time. assume that a patient with signs/symptoms of a concussion has a more serious injury until proven otherwise

A

concussion; physical damage; confused; amnesia

37
Q

contusion:
more serious than a concussion
involves … to brain tissue
may sustain long-lasting and even … damage
a patient may exhibit any or all of the signs of brain injury

A

physical injury; permanent

38
Q

brain injuries can also arise from medical conditions, such as … or …

A

blood clots; hemorrhages

39
Q

spine injuries:
… injuries can result from a fall: forces that compress the patient’s vertebral body can cause … of disks
motor vehicle crashes can … the spine
… injuries of the spine result from rapid acceleration forces

A

compression; herniation; overextend; rotation-flexion

40
Q

spine injuries:
when the spine is pulled along its length (…), it can cause …
any one of these unnatural motions can result in fractures or …
when bones of the spine are altered from traumatic forces, they can fracture or move out of place

A

hyperextension; fractures; neurologic deficit

41
Q

always suspect a possible head/spinal injury with:
… collisions
… collisions
…
..
… trauma to the head, neck, black, or torso

A 
motor vehicle
pedestrian-motor vehicle 
falls
blunt trauma
penetrating
42
Q 
always suspect a possible head/spinal injury with CONTD:
.. injuries 
... 
... injuries
... accidents
A

rapid deceleration
hangings
axial loading
diving

43
Q

primary assess:
spinal immobile considerations: assess patient in the …, assess scene to determine risk of injury
backboard often places patient in an … position for a long period of time

A

position found; anatomically incorrect

44
Q

primary assess:
assessing for signs and symptoms of a head/spine injury:
ask about CC
… or … speech, … questioning, or … in responsive patients
in the setting of trauma, assume your patient has a head injury until your assessment proves otherwise

A

confused; slurred; repetitive; amnesia

45
Q

primary assess:
assessing for signs and symptoms of a head/spine injury CONTD:
.. patients should be assumed to have a spinal injury
patients with a decreased level of responsiveness should be considered to have a spinal injury based on their …

A

unresponsive trauma; chief complaint

46
Q

primary assess airway and breathing:
irregular breathing may result from … on the brai n
oxygen is always indicated for patients with … and … injuries

A

increased pressure; head; spinal

47
Q

secondary assess:
perform baseline assessment using the …
record levels of consciousness that .. or …

A

Glasgow coma scale; fluctuate; deteriorate

48
Q 
cushing's triad: 
increased ...
decreased .... rate
irregular ... (Cheyne stokes or Biot)
perform controlled ... of your patient at a rate of ... breaths/min
A 
blood pressure
heart
respirations
hyperventilation 
20
49
Q

cervical collars provide preliminary, … support

A

partial

50
Q

(prep for transport) supine patients;
secure to a long backboard or …
another procedure to move a patient from the ground to backboard is the …
you may also slide the patient onto a backboard or vacuum matt

A

vacuum mattress; four-person log roll

51
Q

vacuum mattress:
an alternative to the long backboard
molds to the specific contours of patient’s body
provides …
excellent for the elderly or a patient with …. of the spine
can be used on a supine, sitting or standing patient

A

thermal insulation

abnormal curvature

52
Q 
sitting patients: 
use a ... to restrict movement of the cervical and thoracic spine 
then secure it to the long board
exceptions include situations in which: 
you or the patient is in danger
you need immediate access to ... 
the patient's injuries justify ...
A

short backboard; other patients; urgent removal

53
Q

Standing patients:
Immobilize the patient to a long backboard before proceeding with assessment.
Establish manual, in-line stabilization and apply a cervical collar.
Position the board … directly behind the patient.
Carefully lower the patient as a unit under the direction of the EMT at the head.

A

upright;

54
Q

Short backboards
Vest-type device and rigid short board
Designed to immobilize and restrict movement of the …, …, and …
Used to immobilize … patients found in a sitting position

A

head; neck; torso; noncritical

55
Q

Long backboards:

Provide full body spinal immobilization and motion restriction to the …, …, …, …, and …Used to immobilize patients found in any position

A

head; neck; torso; ;pelvis; extremities

56
Q

A helmet that fits well prevents the patient’s head from moving and should be left on, provided:
There are no impending …or … problems.
It does not interfere with assessment and treatment of airway or ventilation problems.
You can properly .. the spine.

A

airway; breathing; immobilize

57
Q

Remove a helmet if:
It is a …
It makes assessing or managing airway problems difficult.
It prevents you from properly immobilizing the spine.
It allows excessive …
The patient is in …

A

full-face helmet; head movement.; cardiac arrest

58
Q

helmet removal:
preferred method involves removing a helmet with at least … people
Alternate method:
The advantage is that it allows the helmet to be removed with the application of less … , therefore reducing the likelihood of motion occurring in the neck.
The disadvantage is that it is slightly more …

A

2; force; time consuming.

59
Q 
Alternate method of helmet removal: 
Remove the chin strap.
Remove the face mask.
Pop the jaw pads out of place.
Place your fingers ... the helmet.
Hold the .. with one hand and the ... with the other.
Insert ... behind the occiput.
A

inside; jaw; occiput; padding

EMT (45 decks)

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