Chapter 29 - Head and Spine Injuries

Question 1

Injuries in which load is applied along the vertical or longitudinal axis of the spine, which results in load being transmitted along the entire length of the vertebral column; for example, falling from a height and landing on the feet in an upright position.

Answer 1

axial loading injuries

Question 2

Actions of the body that are not under a person’s conscious control.

Answer 2

involuntary activities

Question 3

Inability to remember events after an injury.

Answer 3

anterograde amnesia

Question 4

The recommended procedure for moving a patient with a suspected spinal injury from the ground to a long backboard or other spinal precaution device.

Answer 4

four-person log roll

Question 5

The inability to remember events leading up to a head injury.

Answer 5

retrograde amnesia

Question 6

Bruising under the eyes that may indicate a skull fracture.

Answer 6

raccoon eyes (periorbital ecchymosis or the raccoon sign)

Question 7

An accumulation of blood beneath the dura mater but outside the brain.

Answer 7

subdural hematoma

Question 8

Bleeding into the subarachnoid space, where the cerebrospinal fluid circulates.

Answer 8

subarachnoid hemorrhage

Question 9

Fractures that usually occur following diffuse impact to the head (eg, falls, motor vehicle crashes); generally result from extension of a linear fracture to the base of the skull and can be difficult to diagnose with a radiograph.

Answer 9

basilar skull fractures

Question 10

Injury to the head often caused by a penetrating object in which there may be bleeding and exposed brain tissue.

Answer 10

open head injury

Question 11

Swelling of the brain.

Answer 11

cerebral edema

Question 12

Bruising behind an ear over the mastoid process that may indicate a skull fracture.

Answer 12

battle sign (also known as mastoid ecchymosis)

Question 13

An abnormal breathing pattern associated with increased intracranial pressure that is characterized by deep, rapid breathing; this pattern is similar to Kussmaul respirations, but without an acetone breath odor.

Answer 13

central neurogenic hyperventilation

Question 14

Three distinct layers of tissue that surround and protect the brain and the spinal cord within the skull and the spinal canal.

Answer 14

meninges

Question 15

Injury in which the brain has been injured but the skin has not been broken and there is no obvious bleeding.

Answer 15

closed head injury

Question 16

An injury to the brain and its associated structures that is a direct result of impact to the head.

Answer 16

primary injury

Question 17

The pressure within the cranial vault.

Answer 17

intracranial pressure

Question 18

Bleeding within the brain tissue (parenchyma) itself; also referred to as an intraparenchymal hematoma.

Answer 18

intracerebral hematoma

Question 19

The aftereffects of the primary injury; includes abnormal processes such as cerebral edema, increased intracranial pressure, cerebral ischemia and hypoxia, and infection; onset is often delayed following the primary brain injury.

Answer 19

secondary injury

Question 20

Fractures that commonly occur in the temporoparietal region of the skull and that are not associated with deformities to the skull; account for 80% of skull fractures; also referred to as nondisplaced skull fractures.

Answer 20

linear skull fracture

Question 21

A head position in which the patient’s eyes are looking straight ahead and the head and torso are in line.

Answer 21

eyes forward position

Question 22

A traumatic insult to the brain capable of producing physical, intellectual, emotional, social, and vocational changes.

Answer 22

traumatic brain injury (TBI)

Question 23

A temporary loss or alteration of part or all of the brain’s abilities to function without actual physical damage to the brain.

Answer 23

concussion

Question 24

An accumulation of blood between the skull and the dura mater.

Answer 24

epidural hematoma

Question 25

Tough, elastic structures between adjoining vertebrae that act as shock absorbers.

Answer 25

intervertebral disks

Question 26

Actions that we consciously perform, in which sensory input or conscious thought determines a specific muscular activity.

Answer 26

voluntary activities

Question 27

A brain injury that occurs when force is applied to the head and energy transmission through brain tissue causes injury on the opposite side of original impact.

Answer 27

coup-contrecoup brain injury

Question 28

Bleeding from soft-tissue injuries to the face is most effectively controlled with:

Answer 28

direct pressure using dry, sterile dressings.

Question 29

Facial injuries should be identified and treated as soon as possible because:

Answer 29

of the risk for airway problems.

Question 30

Frequent reassessments of the patient with face or neck injuries are most important because:

Answer 30

such injuries can affect the respiratory stystem.

Question 31

The skin and underlying tissues of the face:

Answer 31

have a rich blood supply and bleed profusely.

Question 32

When a light is shone into the pupil:

Answer 32

it should become smaller in size.

Question 33

An epidural hematoma is most accurately defined as:

Answer 33

bleeding between the skull and dura mater.

Question 34

Coordination of balance and body movement is controlled by the:

Answer 34

cerebellum.

Question 35

Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless:

Answer 35

it causes a problem managing the airway.

Question 36

Signs and symptoms that might be found in a patient who has experienced a concussion include:

Answer 36

nausea and ringing in the ears.

Question 37

The most reliable sign of a head injury is:

Answer 37

a decreased level of consciousness.