Chapter 29 Trauma to the Head, neck and spine Flashcards
What part of the nervous system controls involuntary functions?
Autonomic nervous system
Nervous system
Provides overall control of thought, sensation, and the body’s voluntary and involuntary motor functions.
What are the components of the nervous system?
Brain
Spinal cord
Nerves that innervate the body
What are the two major subsystems of the nervous system?
Central and Peripheral Nervous System
Neurons
specialized nerve cells that transmit nervous system impulses throughout the body
What are some examples of bodily function that are under control of the autonomic nervous system?
Heartbeat
Breathing
Diameter of vessels
Control of sphincter muscles enclosing the bladder and digestion
What are the bones of the cranium?
Frontal Parietal Occipital Temporal Sphenoid
How many bones make up the face?
14 irregularly shaped bones
What are the major divisions of the skull?
Cranium and facial bones
Which of the facial bones is not fused?
Mandible
What are the immovable joints of the skull called?
sutures
What are the cheek bones?
Malar (May-lar) aka Zygomatic bones/arches
What is the opening at the base of the skull through which the spinal cord passes from the brain?
Foramen Magnum
What is the lower end of the spinal cord called that fans out like a horses tail?
Cauda Equina
What is the protective covering over the brain?
Meninges
What are the irregularly shaped bones that protect the spinal cord?
Vertebrae (33 total)
What is the palpable bony prominence attached to each vertebrae?
Spinous process
What are the five areas that the vertebrae are divided into?
Cervical - 7 Thoracic - 12 Lumbar - 5 Sacral - 4 coccygeal - 4
How do we treat scalp injuries?
Direct pressure unless bone fragments or depression of bone - use loose gauze instead
What is an indirect brain injury?
shock of impact on the skull is transferred to the brain (concussions and contusions)
What is the first and most significant sign of head injury?
Altered mental status, never assume a patient with an altered mental status is intoxicated or on drugs
Traumatic Brain Injury?
An injury that disrupts the normal functioning of the brain
Concussion
Mild closed head injury without detectable damage to the brain. Complete recovery is usually expected but effects can linger for weeks, months even years
TBI accounts for slight more than ______ of injury related deaths
1/3
What are the signs and sxs of concussion according to the CDC?
LOC Amnesia Repetitive Questioning Altered level of consciousness Feeling slugish Difficulty concentrating Feeling off Slurred speech, headache, nausea, blurred vision Sensitivity to light and noises
Coup, contrecoup
Coup - injury to brain on side that sustained the blow
Contrecoup - injury to other side of the brain
What are the TBIs?
Concussion
Contusion
Laceration
Hematoma
How does the body’s blood pressure usually respond in the person with increased ICP?
Blood pressure increases
Cushing’s Reflex
Increased blood pressure and bradycardia indicating increased ICP
Cheyne-Stokes Breathing
Distinct pattern of breathing characterized by quickening and deepening respiration followed by a period of apnea
Central neurogenic hyperventilation
A pattern of rapid and deep breathing caused by injury to the brain
Ataxic respiration
A pattern of irregular and unpredictable breathing commonly caused by brain injury
How do you treat an impaled object in the skull?
Stabilize in place with bulky dressing. If too large, pad around, stabilize object on both sides of where it is to be cut, cut using something that will not cause vibration/movement
What are some signs of facial fx?
discoloration of eye deformity Facial bruises loose, missing are improperly aligned teeth Swollen jaw
What is the primary concern for patients with facial fx?
airway
What is used in addition to AVPU for ongoing neurological assessment?
GCS
What are the three sections of the GCS?
Eyes
Verbal
Motor
What is the breakdown of the eye of the GCS?
spontaneous - 4
voice - 3
pain - 2
none - 1
What is the breakdown of the verbal response of the GCS?
oriented - 5 confused - 4 inappropriate words - 3 incomprehensible sounds 2 none - 1
What is the breakdown of the motor response of the GCS?
obeys commands - 6 localizes pain - 5 withdraws - 4 Flexion - 3 Extension - 2 none - 1
In additions to massive hemorrhage, what is a concern when a patient is bleeding from a large neck vein?
air embolism, pressure in vein is lower than atmospheric pressure, sucking air in
How do you treat an open neck wound?
place gloved hand over the wound
Apply occlusive dressing 2” past the sides of the wound, all 4 sides sealed
place dressing over occlusive dressing
apply pressure, careful not to compress both carotid arteries
What are the two broad classifications of spinal injury?
Primary and Secondary
What two things will the EMT use to determine if a patient has a potential spinal injury?
MOI and Physical assessment
MOI must be paired with physical assessment
What are common spine injuries that involve the spine being moved beyond it’s normal ROM?
Flexion and extension injuries like whiplash
What term describes the spine being excessively compressed?
axial loading
What type of spinal injury happens with a hanging?
distraction
What condition causes the vertebrae to fuse together?
ankylosing spondylitis
