Chapter 29 - [additional] Head and Spine Injuries Flashcards
The brain, a part of the central nervous system (CNS), is divided into the:
A. cerebrum, cerebellum, and brainstem.
B. cerebrum, brainstem, and spinal cord.
C. cerebellum, cerebrum, and spinal cord.
D. spinal cord, cerebrum, and cerebral cortex.
A. cerebrum, cerebellum, and brainstem.
As you are assessing a 24-year-old man with a large laceration to the top of his head, you should recall that:
A. the scalp, unlike other parts of the body, has relatively fewer blood vessels.
B. blood loss from a scalp laceration may contribute to hypovolemic shock in adults.
C. any avulsed portions of the scalp should be carefully cut away to facilitate bandaging.
D. most scalp injuries are superficial and are rarely associated with more serious injuries.
B. blood loss from a scalp laceration may contribute to hypovolemic shock in adults.
A patient who experiences an immediate loss of consciousness followed by a lucid interval has a(n):
A. epidural hematoma.
B. subdural hematoma.
C. concussion.
D. contusion.
A. Epidural hematoma
Epidural hematomas are caused by injury to an artery—usually the middle meningeal artery—that lies in between the skull and brain.
Subdural hematomas are the result of injury to a vein; therefore, they tend to bleed slowly and usually cause a progressive decline in level of consciousness. Concussions and contusions may cause a loss of consciousness, but it is typically brief.
A 44-year-old man was struck in the back of the head and was reportedly unconscious for approximately 30 seconds. He complains of a severe headache and “seeing stars,” and states that he regained his memory shortly before your arrival. His presentation is MOST consistent with a(n):
A. contusion.
B. concussion.
C. subdural hematoma.
D. intracerebral hemorrhage.
B. concussion.
A young male was involved in a motor vehicle accident and experienced a closed head injury. He has no memory of the events leading up to the accident but remembers that he was going to a birthday party. What is the correct term to use when documenting his memory loss?
A. Concussion
B. Cerebral contusion
C. Retrograde amnesia
D. Anterograde amnesia
C. Retrograde amnesia
A distraction injury to the cervical spine would MOST likely occur following:
A. a diving accident.
B. blunt neck trauma.
C. hyperextension of the neck.
D. hanging-type mechanisms.
D. hanging-type mechanisms.
Distraction injuries can cause separation of the vertebrae and stretching or tearing of the spinal cord.
During immobilization of a patient with a possible spinal injury, manual stabilization of the head must be maintained until:
A. an appropriate-size extrication collar has been placed.
B. the patient is fully immobilized on a long backboard.
C. a range of motion test of the neck has been completed.
D. pulse, motor, and sensory functions are found to be intact.
B. the patient is fully immobilized on a long backboard.
Your patient is a 21-year-old male who has massive face and head trauma after being assaulted. He is lying supine, is semiconscious, and has blood in his mouth. You should:
A. insert a nasal airway, assess his respirations, and give 100% oxygen.
B. suction his airway and apply high-flow oxygen via a nonrebreathing mask.
C. manually stabilize his head, log roll him on to his side, and suction his mouth.
D. apply a cervical collar, suction his airway, and begin assisting his ventilations.
C. manually stabilize his head, log roll him on to his side, and suction his mouth.
A man is found slumped over the steering wheel, unconscious and making snoring sounds, after an automobile accident. His head is turned to the side and his neck is flexed. You should:
A. gently rotate his head to correct the deformity.
B. carefully hyperextend his neck to open his airway.
C. apply an extrication collar with his head in the position found.
D. manually stabilize his head and move it to a neutral, in-line position.
D. manually stabilize his head and move it to a neutral, in-line position.
You should NOT remove an injured football player’s helmet if:
A. a cervical spine injury is suspected, even if the helmet fits loosely.
B. the patient has a patent airway, even if he has breathing difficulty.
C. he has broken teeth, but only if the helmet does not fit snugly in place.
D. the face guard can easily be removed and there is no airway compromise.
D. the face guard can easily be removed and there is no airway compromise.
After your partner assumes manual in-line stabilization of the patient’s head, you should:
Select one:
A.
assess distal neurovascular status in the extremities.
B.
use four people to log roll the patient onto a backboard.
C.
thoroughly palpate the patient’s head for deformities.
D.
apply an appropriately sized rigid cervical collar.
A.
assess distal neurovascular status in the extremities.
In the setting of a head injury, hypertension, bradycardia, and Biot respirations indicate:
Select one:
A.
internal bleeding in the chest.
B.
herniation of the brain stem.
C.
decreased cerebral blood flow.
D.
an underlying skull fracture.
B.
herniation of the brain stem.
When immobilizing a child on a long backboard, you should:
Select one:
A.
place the child’s head in a slightly extended position.
B.
defer cervical collar placement to avoid discomfort.
C.
place padding under the child’s shoulders as needed.
D.
secure the head prior to securing the torso and legs.
C.
place padding under the child’s shoulders as needed.
It would be most appropriate to perform a focused secondary assessment on a patient who:
Select one:
A.
was restrained during a high-speed motor vehicle crash.
B.
fainted and fell to the ground from a standing position.
C.
struck his or her head and is experiencing nausea or vomiting.
D.
has blood draining from the ears following a head injury.
B.
fainted and fell to the ground from a standing position.
When immobilizing a seated patient with a short backboard or vest-style immobilization device, you should apply a cervical collar:
Select one:
A.
after moving the patient to a long backboard.
B.
before manually stabilizing the patient’s head.
C.
after assessing distal neurovascular functions.
D.
after the torso has been adequately secured.
C.
after assessing distal neurovascular functions.
