Chapter 29 - Head & Spine Injuries

Question 1

A man jumped from the roof of his house and landed on his feet. He complains of pain to his heels, knees, and lower back. This mechanism of injury is an example of:

Select one:

A. hyperflexion.
B. axial loading.
C. hyperextension.
D. distraction.

Answer 1

B. axial loading.

Question 2

A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response?

Select one:

A. 2
B. 4
C. 3
D. 5

Answer 2

C. 3

Question 3

A tight-fitting motorcycle helmet should be left in place unless:

Select one:

A. the patient must be placed onto a long backboard.
B. the patient complains of severe neck or back pain.
C. the helmet is equipped with a full face shield or visor.
D. it interferes with your assessment of the airway.

Answer 3

D. it interferes with your assessment of the airway.

Question 4

An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is:

Select one:

A. a rapid deterioration of neurologic signs.
B. an acute increase in the patient’s pulse rate.
C. acute unilateral paralysis following the injury.
D. a progressively lowering blood pressure.

Answer 4

A. a rapid deterioration of neurologic signs.

Question 5

Common signs and symptoms of a serious head injury include all of the following, EXCEPT:

Select one:

A. widening pulse pressure.
B. a rapid, thready pulse.
C. decerebrate posturing.
D. CSF leakage from the ears.

Answer 5

B. a rapid, thready pulse.

Question 6

During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose.

You should:

Select one:

A. assist his ventilations with a BVM.
B. immobilize his spine and transport immediately.
C. pack his nostrils to stop the drainage of blood.
D. suction his oropharynx for up to 15 seconds.

Answer 6

D. suction his oropharynx for up to 15 seconds.

Question 7

Hyperextension injuries of the spine are MOST commonly the result of:

Select one:

A. compression.
B. falls.
C. diving.
D. hangings.

Answer 7

D. hangings.

Question 8

In contrast to a cerebral concussion, a cerebral contusion:

Select one:

A. does not cause pressure within the skull.
B. involves physical injury to the brain tissue.
C. usually does not cause a loss of consciousness.
D. results from a laceration to the brain tissue.

Answer 8

B. involves physical injury to the brain tissue.

Question 9

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

Select one:

A. sensory and motor functions remain intact.
B. the patient adamantly denies neck pain.
C. lateral immobilization has been applied.
D. it causes a problem managing the airway.

Answer 9

D. it causes a problem managing the airway.

Question 10

The central nervous system (CNS) is composed of the:

Select one:

A. cerebrum and meninges.
B. cerebellum and brain.
C. brain and spinal cord.
D. meninges and spinal cord.

Answer 10

C. brain and spinal cord.

Question 11

The five sections of the spinal column, in descending order, are the:

Select one:

A. thoracic, cervical, lumbar, coccygeal, and sacral.
B. cervical, coccygeal, thoracic, sacral, and lumbar.
C. cervical, thoracic, lumbar, sacral, and coccygeal.
D. coccygeal, sacral, lumbar, thoracic, and cervical.

Answer 11

C. cervical, thoracic, lumbar, sacral, and coccygeal.

Question 12

The Glasgow Coma Scale (GCS) is used to assess:

Select one:

A. sensory response, pupil reaction, and heart rate.
B. eye opening, verbal response, and motor response.
C. mental status, eye opening, and respiratory rate.
D. verbal response, eye opening, and mental status.

Answer 12

B. eye opening, verbal response, and motor response.

Question 13

The ideal procedure for moving an injured patient from the ground to a backboard is:

Select one:

A. the use of a scoop stretcher.
B. the clothes drag.
C. the direct patient carry.
D. the four-person log roll.

Answer 13

D. the four-person log roll.

Question 14

What part of the nervous system controls the body’s voluntary activities?

Select one:

A. Central
B. Sensory
C. Somatic
D. Autonomic

Answer 14

C. Somatic

Question 15

When activated, the sympathetic nervous system produces all of the following effects, EXCEPT:

Select one:

A. dilation of the bronchiole smooth muscle.
B. increase in heart rate.
C. pupillary constriction.
D. shunting of blood to vital organs.

Answer 15

C. pupillary constriction.

Question 16

When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear.

This indicates:

Select one:

A. significant pressure and bleeding in between the skull and dura mater.

B. rupture of the tympanic membrane following diffuse impact to the head.

C. a linear skull fracture and a significant increase in intracranial pressure.

D. fractures to the internal structures of the ear following direct trauma.

Answer 16

B. rupture of the tympanic membrane following diffuse impact to the head.

Question 17

When immobilizing a trauma patient’s spine, the EMT manually stabilizing the head should not let go until:

Select one:

A. the patient has been secured to the ambulance stretcher.

B. the patient has been completely secured to the backboard.

C. an appropriately sized cervical collar has been applied.

D. the head has been stabilized with lateral immobilization.

Answer 17

B. the patient has been completely secured to the backboard.

Question 18

Which of the following breathing patterns is MOST indicative of increased intracranial pressure?

Select one:

A. Increased rate with a normal inspiratory time and a prolonged expiratory time

B. Increased rate and depth with the distinct odor of acetone on the patient’s breath

C. Irregular rate, pattern, and volume of breathing with intermittent periods of apnea

D. Slow, shallow, occasional gasps that progress to prolonged periods of apnea

Answer 18

C. Irregular rate, pattern, and volume of breathing with intermittent periods of apnea

Question 19

Which of the following statements regarding secondary brain injury is correct?

Select one:

A. Because cerebral edema develops quickly, it is considered to be a primary brain injury.

B. Hypoxia and hypotension are the two most common causes of secondary brain injury.

C. It results from direct brain trauma following an impact to the head.

D. Signs are often present immediately after an impact to the head.

Answer 19

B. Hypoxia and hypotension are the two most common causes of secondary brain injury.

Question 20

You should be MOST suspicious that a patient has experienced a significant head injury if his or her pulse is:

Select one:

A. rapid.
B. weak.
C. slow.
D. irregular.

Answer 20

C. slow.

Question 21

What are the three layers of the Menegies

Answer 21

Dura Mater
Arachnoid Mater
Pia Mater

Question 22

How many bones are in each of the spinal areas?

Answer 22

Cervical - 7 bones
Thoracic - 12 bones
Lumbar - 5 bones
Sacral - 5 bones
Coccygeal - 4 bones