Chapter 35 Flashcards
1
Q
Which of the following statements regarding the brainstem is correct?
- All but 4 of the 12 cranial nerves exit the brainstem.
- The brainstem provides protection to the cerebellum.
- The brainstem is responsible for muscle coordination.
- The brainstem connects the spinal cord to the brain.
A
The brainstem connects the spinal cord to the brain
2
Q
Open fractures of the cranial vault:
- typically cause lethal atrial cardiac dysrhythmias.
- cause death due to increased intracranial pressure.
- are uncommonly associated with multisystem trauma.
- are associated with a high risk of bacterial meningitis.
A
Are associated with a high risk of bacterial meningitis
3
Q
The brain connects to the spinal cord through a large opening at the base of the skull called the:
- palatine bone.
- occipital condyle.
- foramen magnum.
- cribriform plate.
A
Foramen magnum
4
Q
Prior to immobilizing an anxious patient with a suspected spinal injury on a backboard, it is important to:
- administer the appropriate dose of a sedative to facilitate patient compliance.
- apply a cervical collar to free up the medic who is holding the patient’s head.
- make note of any neurologic deficits or gross injuries up to that point.
- ask the patient to pull against your hands with their feet.
A
make note of any neurologic deficits or gross injuries up to that point.
5
Q
Spinal cord injuries that cause neurogenic shock generally produce:
- reflex tachycardia due to sympathetic nervous system stimulation.
- signs and symptoms that are identical to those of hypovolemic shock.
- flaccid paralysis and complete loss of sensation distal to the injury.
- cool, clammy skin distal to the site of the spinal cord injury.
A
flaccid paralysis and complete loss of sensation distal to the injury.
6
Q
A positive Babinski reflex is observed when the:
- patient’s reflexes are hyperactive in response to an external stimulus.
- toes curve or move downward when the sole of the foot is touched.
- toes move upward in response to stimulation of the sole of the foot.
- patient responds to pain by flexing the arms and extending the legs.
A
toes move upward in response to stimulation of the sole of the foot.
7
Q
Injury to the temporal lobe on the left side would most likely cause:
- sleep abnormalities.
- lack of coordination.
- abnormal speech.
- visual disturbances
A
Abnormal speech
8
Q
In which of the following situations would it be most appropriate to apply a vest-type extrication device to a patient who is seated in their crashed motor vehicle?
- Confused with lower back pain and tachycardia
- Conscious with neck pain and stable vital signs
- Unconscious with obvious spinal deformity
- Conscious with bilateral femur fractures
A
Conscious with neck pain and stable vital signs
9
Q
Decerebrate posturing is characterized by:
- pulling in of the arms toward the core of the body.
- flexion of the arms and extension of the legs.
- inward flexion of the wrists and flexed knees.
- extension of the arms and extension of the legs.
A
Extension of the arms and extension of the legs
10
Q
When immobilizing a sitting patient with a vest-type extrication device, you should manually stabilize their head and then:
- apply an appropriately sized cervical collar.
- carefully place the vest device behind the patient.
- assess distal pulse, sensory, and motor functions.
- perform a rapid assessment to detect life threats.
A
Assess distal pulse, sensory, and motor functions
11
Q
Following a spinal injury, a patient presents with abdominal breathing and use of the accessory muscles in the neck. This suggests injury at or above:
- C1–C2.
- T1–T4.
- T2–T5.
- C3–C4.
A
C3- C4
12
Q
Hyperacute pain to touch is called:
- hyperesthesia.
- akathisia.
- paresthesia.
- anesthesia.
A
hyperesthesia
13
Q
A leading cause of death in spinal cord injury patients who are discharged from the hospital includes:
- pneumonia.
- muscular atrophy.
- myocardial infarction.
- ischemic stroke.
A
Pneumonia
14
Q
An injured patient’s head should be secured to the long backboard only after:
- both of the legs are secured to the board properly.
- you have placed padding under the shoulders.
- a vest-style immobilization device has been applied.
- their torso has been secured adequately
A
Their torso has been secured adequately
15
Q
According to the National Spinal Cord Injury Statistical Center, most spinal cord injuries are caused by:
- falls in the elderly.
- motor vehicle crashes.
- athletic activities.
- acts of violence.
A
Motor vehicle crashes
16
Q
General treatment for a man with a significant head injury and signs of Cushing triad includes:
- administering a corticosteroid.
- a 20-mL/kg bolus of normal saline.
- ventilating at a rate of 30 breaths/min.
- elevating the head 15 to 30 degrees
A
Elevating the head 15 to 30 degrees
17
Q
You have just completed spinal immobilization of a hemodynamically stable patient with a possible spinal injury. Prior to moving the patient to the ambulance, it is most important to:
- perform a detailed secondary assessment to detect other injuries.
- start an IV of normal saline in case the patient deteriorates.
- apply a cardiac monitor and obtain a full set of vital signs.
- reassess pulse, motor, and sensory functions in all extremities.
A
reassess pulse, motor, and sensory functions in all extremities.
18
Q
A 19-year-old woman fell from a second story window and landed on her head. She is unconscious with a blood pressure of 168/104 mm Hg, heart rate of 56 beats/min, and irregular respirations of 8 breaths/min. Further assessment reveals blood draining from her nose and bilaterally dilated pupils that are slow to react. In addition to employing full spinal precautions, the most appropriate treatment for this patient involves:
- hyperventilating her with a bag-mask device at a rate of 20 breaths/min, starting two large-bore IV lines, applying a cardiac monitor, administering 5 mg of Valium to prevent seizures, and transporting to a trauma center.
- intubating her trachea after preoxygenating her for 2 to 3 minutes with a bag-mask device, transporting immediately, starting at least one large-bore IV en route, applying a cardiac monitor, and performing frequent neurologic assessments.
- applying oxygen via nonrebreathing mask, covering her with blankets, starting an IV of normal saline set to keep the vein open, applying a cardiac monitor, initiating transport, and monitoring her pupils while en route to the hospital.
- preoxygenating her with a bag-mask device and 100% oxygen for 2 to 3 minutes, performing nasotracheal intubation, transporting at once, starting at least one large-bore IV line en route, and obtaining her Glasgow Coma Scale score.
A
intubating her trachea after preoxygenating her for 2 to 3 minutes with a bag-mask device, transporting immediately, starting at least one large-bore IV en route, applying a cardiac monitor, and performing frequent neurologic assessments.
19
Q
The dura mater:
- folds in to form the tentorium, a structure that separates the cerebral hemispheres from the cerebellum and brainstem.
- anatomically separates the cerebellum and the brainstem and contains vasculature that resembles a spider web.
- is the middle meningeal layer and is composed of a delicate transparent membrane that is damaged easily by trauma.
- is the inner meningeal layer and is composed of a thin, translucent, highly vascular membrane that adheres firmly directly to the surface of the brain.
A
Folks in to form the tentorium, a structure that separates the cerebral hemispheres from the cerebellum and brainstem
20
Q
Which of the following is a type of secondary brain injury?
- Intracerebral hemorrhage
- Skull fracture
- Axonal injury
- Cerebral edema
A
Cerebral edema
21
Q
Medications administered in the prehospital setting for a patient with a head injury would most likely be used to:
- prevent cardiac dysrhythmias or increase heart rate.
- reduce body temperature and promote diuresis.
- reduce cerebral edema and prevent shivering.
- facilitate intubation or terminate seizures.
A
Facilitate intubation or terminate seizures
22
Q
Which of the following factors would likely result in secondary spinal cord injury?
- Hyperkalemia
- Hyperglycemia
- Hypocalcemia
- Hypoglycemia
A
Hypoglycemia
23
Q
If the mechanism of injury indicates that your patient may have sustained a spinal cord injury:
- contact medical control to determine if spinal immobilization is needed.
- fully immobilize the spine only if gross neurologic deficits are present.
- assume that a spine injury exists, regardless of the neurologic findings.
- apply a cervical collar and transport the patient in a position of comfort.
A
assume that a spine injury exists, regardless of the neurologic findings.
24
Q
Upon arriving at the scene of a motor vehicle crash, you find the driver of the car still seated in her two-door vehicle. The passenger side of the vehicle has sustained severe damage and is inaccessible. The driver is conscious and alert and complains only of lower back pain. The backseat passenger, a young child who was unrestrained, is bleeding from the head and appears to be unconscious. You should:
- apply a vest-type extrication device to the driver and quickly remove her from the car.
- ask the driver to step out of the vehicle so you can access the backseat passenger.
- rapidly extricate the driver so you can gain quick access to the child in the backseat.
- carefully assess the driver for occult injuries before removing her from the vehicle.
A
Rapidly extricate the drier so you can gain quick access to the child in the backseat
25
What type of intracranial hemorrhage would most likely be caused by a penetrating head injury?
- Epidural hematoma
- Subarachnoid hemorrhage
- Intracerebral hematoma
- Subdural hematoma
Intracerebral hematoma
26
The only area of the spine that allows for significant rotation is:
- T1–T2.
- C1–C2.
- C2–C4.
- C6–C7.
C1-C2
27
Treatment for a patient with neurogenic shock may include:
- drugs used to slow the heart rate.
- an antidysrhythmic drug.
- prevention of hyperthermia.
- a vasopressor medication
A vasopressor medication
28
Which of the following statements regarding the hangman's fracture is correct?
- Most hangman's fractures occur during a fall from greater than 10 feet.
- Severe hyperflexion of the neck commonly results in a hangman's fracture.
- Hangman's fractures occur when the patient's skull rapidly accelerates.
- It is a fracture of C2 that is secondary to significant distraction of the neck.
It is a fracture of C2 that is secondary to significant distraction of the neck.
29
A patient with a possible spinal injury is acutely agitated. What type of medication, if any, should they receive after hypoxia has been ruled out?
- Neuromuscular blocker
- Short-acting, reversible sedative
- Corticosteroid
- Dissociative anesthetic
Short-acting, reversible sedative
30
A motorcycle or football helmet should be removed if:
- the patient is breathing shallowly and access to the airway is difficult.
- the patient complains of severe neck pain and the helmet fits snugly.
- you are going to transport the patient to a medical treatment facility.
- you are properly trained in the technique, even if you are by yourself.
the patient is breathing shallowly and access to the airway is difficult.
31
Wrist extension is controlled at the level of:
- C5.
- T1.
- C4.
- C6.
C6
32
A subdural hematoma is classified as acute if clinical signs and symptoms develop:
- within 36 hours following the injury.
- immediately following the injury.
- within 24 hours following the injury.
- within 48 hours following the injury.
within 48 hours following the injury
33
A moderate diffuse axonal injury:
- produces an immediate loss of consciousness and residual neurologic deficits when the patient wakes up.
- causes a prolonged loss of consciousness and affects axons in both cerebral hemispheres.
- is the most common result of blunt head trauma and is associated with temporary neuronal dysfunction.
- is generally characterized by a brief loss of consciousness, with or without retrograde amnesia.
Produces an immediate loss of consciousness and residual neurologic deficits when the patient wakes up
34
Displacement of bony fragments into the front portion of the spinal cord results in:
- complete spinal cord injury.
- central cord syndrome.
- anterior cord syndrome.
- Brown-Séquard syndrome.
Anterior cord syndrome
35
Disruption of the lower parasympathetic nerves in the sacrum results in:
- pupillary abnormalities.
- numbness or tingling in the extremities.
- loss of bowel/bladder tone.
- irreversible seizures.
Loss of bowel/bladder tone
36
A 45-year-old unrestrained man was ejected from his small truck when it struck a tree. The patient is found approximately 20 feet from the wreckage. Your primary assessment reveals that he is unresponsive and has sonorous respirations and a rapid pulse. Your initial actions should include:
- applying a cervical collar and assisting his ventilations with a bag-mask device.
- manually stabilizing his head and opening his airway with the jaw-thrust maneuver.
- rolling the patient onto his side as a unit and suctioning his mouth for 15 seconds.
- performing a tongue-jaw lift and looking in his mouth for any obvious obstructions.
manually stabilizing his head and opening his airway with the jaw-thrust maneuver.
37
If a trauma patient cannot be assessed properly in their vehicle, you should:
- apply a rigid cervical collar, perform a rapid assessment only, and then remove the patient with the two-person lift technique.
- grasp the patient behind the shoulders, cradle their head in your arms to protect the spine, and rapidly extricate them from the car.
- maintain manual stabilization of the head, apply a cervical collar, and move the patient from the vehicle onto a long backboard.
- apply a vest-type extrication device and then rapidly remove them from the vehicle using at least three people.
maintain manual stabilization of the head, apply a cervical collar, and move the patient from the vehicle onto a long backboard.
38
A patient with diaphragmatic breathing without intercostal muscle use has most likely experienced a spinal injury above the level of:
- C2.
- C5.
- T2.
- C7.
T2
39
Spinal shock is a condition that:
- is usually temporary and results from swelling of the spinal cord.
- typically manifests within 24 to 36 hours following a spinal injury.
- results in permanent neurologic deficits in the majority of patients.
- generally affects the sensory nerves but spares the motor nerves.
is usually temporary and results from swelling of the spinal cord.
40
A compression or burst fracture of the cervical spine would most likely occur following:
- axial loading after a patient falls and lands feet first.
- a significant fall in which the patient lands head first.
- a direct blow to the occipital region of the skull.
- rapid acceleration following a motor vehicle crash.
A significant fall in which the patient lans head first
41
Which of the following statements regarding central cord syndrome is correct?
- Central cord syndrome typically causes complete paralysis of the lower extremities and decreased proprioception.
- Central cord syndrome is almost always associated with a vertebral fracture and has an overall poor prognosis.
- The patient typically presents with greater loss of function in the upper extremities than in the lower extremities.
- Patients with cervical spondylosis or stenosis are at a lower risk for central cord syndrome following an injury.
The patient typically presents with greater loss of function in the upper extremities than in the lower extremities.
42
You have intubated an unresponsive, apneic patient with a suspected spinal injury. After confirming proper endotracheal (ET) tube placement and securing the tube, you should:
- maintain an end-tidal carbon dioxide reading of greater than 45 mm Hg.
- request medical control authorization to give Solu-Medrol.
- provide mild hyperventilation in case a head injury is present.
- ventilate at 10 to 12 breaths/min and monitor end-tidal carbon dioxide.
ventilate at 10 to 12 breaths/min and monitor end-tidal carbon dioxide.
43
A complete spinal cord injury to the upper cervical spine:
- is not compatible with life and results in immediate death due to cardiopulmonary failure.
- results in neurologic dysfunction that is considered to be permanent if it lasts longer than 24 hours.
- will result in permanent loss of all cord-mediated functions below the level of the injury.
- results in quadriplegia but the patient usually retains their ability to breathe spontaneously.
Will result in permanent loss of all cord-mediated functions below the level of the injury
44
As the body ages, the intervertebral discs:
- lose water content and become thinner.
- are not able to protect the spinal cord.
- calcify and become more rigid.
- enlarge and result in increased height.
Lose water content and become thinner
45
The parietal lobe of the brain:
- controls functions such as long-term memory, taste, and smell.
- is important for voluntary motor action and personality traits.
- controls the body's ability to perceive body limb movement.
- is where the optic nerve originates and processes vision.
Controls the body’s ability to perceive body limb movement
46
When immobilizing a patient to a long backboard, you should first:
- ensure that the patient's head is stabilized manually.
- apply the appropriately sized cervical collar to the patient.
- assess distal pulse, sensory, and motor functions.
- log roll the patient as a unit and assess their back.
Ensure that the patients head is stabilized manually
47
In contrast to secondary spinal cord injury, primary spinal cord injury occurs:
- from progressive swelling.
- at the moment of impact.
- within 24 hours of the injury.
- from penetrating mechanisms.
At the moment of impact
48
Which of the following statements regarding a closed head injury is correct?
- In a closed head injury, the dura mater remains intact.
- Intracranial pressure is usually minimal in a closed head injury.
- Diffuse brain injury occurs with all closed head injuries.
- Closed head injuries are less common than open head injuries.
In a closed head injury, the dura mater remains intact
49
A spinal cord concussion is:
- the result of direct trauma and is associated with spinal cord edema.
- caused by a short-duration shock or pressure wave within the cord.
- a condition that results in a permanent loss of neurologic function.
- characterized by temporary dysfunction that lasts for up to 1 week.
Caused by a short-duration shock or pressure wave within the cord
50
The most significant complication associated with prolonged immobilization of a patient on a long backboard is:
- compression of the vena cava.
- patient discomfort and frustration.
- increased intracranial pressure.
- pressure lesion development.
pressure lesion development
51
Horner syndrome is identified when a patient with a spinal injury:
- has a drooping upper eyelid and small pupil.
- can move their arms, but not the legs.
- cannot close their fingers against resistance.
- is unable to identify the left arm from the right arm.
Has a drooping upper eyelid and small pupil
52
You are assessing a patient who sustained blunt trauma to the center of her back. She is conscious, but is unable to feel or move her lower extremities. Her blood pressure is 80/50 mm Hg, pulse is 40 beats/min and weak, and respirations are 24 breaths/min and shallow. If IV fluids do not adequately improve perfusion, you should:
- administer 1 mg of epinephrine 1:10,000 via rapid IV push.
- administer a corticosteroid to reduce spinal cord inflammation.
- give 0.5 mg of atropine and consider a dopamine infusion.
- administer a sedative and paralytic and then intubate her trachea.
Give 0.5 mg of atropine and consider a dopamine infusion
53
Following a traumatic brain injury, initial swelling of the brain occurs due to:
- acute hypertension.
- cerebral vasodilation.
- severe ischemia.
- a slow heart rate.
Cerebral vasodilation
54
Autoregulation is defined as:
- a decrease in cerebral perfusion pressure that reduces intracranial pressure.
- the forcing of cerebrospinal fluid into the spinal cord as intracranial pressure increases.
- reflex bradycardia that occurs secondary to systemic hypertension.
- an increase in mean arterial pressure to maintain cerebral blood flow.
An increase in mean arterial pressure to maintain cerebral blood flow
55
Which of the following is a sign of a moderate elevation in intracranial pressure?
- Widened pulse pressure
- Biot (ataxic) respirations
- Unilaterally blown pupil
- Irregular pulse rate
Widened pulse pressure
56
What spinal cord injury is characterized by motor loss on the same side as the injury, but below the lesion?
- Brown-Séquard syndrome
- Central cord syndrome
- Posterior cord syndrome
- Anterior cord syndrome
Brown-Séquard syndrome
57
What portion of the brainstem is responsible for maintenance of consciousness?
- Reticular activating system
- Diencephalon
- Basal ganglia
- Limbic system
Reticular activating system
58
Pupils that are slow (sluggish) to react to light:
- are a sign of cerebral hypoxia.
- indicate impending brain herniation.
- suggest minor intracranial pressure.
- indicate compression of an optic nerve.
Are a sign of cerebral hypoxia
59
When assigning a Glasgow Coma Scale (GCS) score to a patient who has limb paralysis due to a spinal cord injury, you should:
- use another method for assessing neurologic function.
- score the patient as having no motor response.
- ask the patient to blink or move a facial muscle.
- exclude the motor response portion of the GCS.
Ask the patient to blink or move a facial muscle
60
Proprioception is defined as:
- the loss of thermoregulatory function distal to an injury.
- the ability to perceive the position and movement of one's body.
- a person's awareness of pain and the ability to localize it.
- a person's ability to sense light touch.
the ability to perceive the position and movement of one's body.
61
What type of skull fracture is most common following high-energy direct trauma to a small surface area of the head with a blunt object?
- Basilar fracture
- Depressed fracture
- Nondisplaced fracture
- Open fracture
Depressed fracture
62
Early signs and symptoms of increased intracranial pressure include:
- headache and vomiting.
- hypertension and bradycardia.
- arm flexion and leg extension.
- widening of the pulse pressure.
Headache and vomiting
63
In which of the following situations would spinal motion restriction precautions likely be necessary?
- Syncopal episode in which the patient was already seated or supine
- Vehicular damage with compartmental intrusion of greater than 4 inches
- Isolated head injury without gross signs or symptoms of a spinal injury
- Unrestrained occupant of low-speed motor vehicle crash
Isolated head injury without gross signs or symptoms of a spinal injury
64
When performing your neurologic assessment of a patient, you should first:
- ask the patient if they can feel or move their legs.
- determine the patient's level of consciousness.
- assess the pupils for size, equality, and reactivity.
- obtain an initial Glasgow Coma Scale score.
Determine the patients level of consciousness
65
A skier wiped out while skiing down a large hill. He is conscious and alert and complains of being very cold; he also complains of neck stiffness and numbness and tingling in all of his extremities. A quick assessment reveals that his airway is patent and his breathing is adequate. You should:
- perform a detailed neurologic exam and carefully palpate his neck.
- administer oxygen and perform a detailed secondary assessment.
- immobilize his spine and quickly move him to a warmer environment.
- apply a cervical collar and start an IV line with warm normal saline.
immobilize his spine and quickly move him to a warmer environment.
66
The crescent-shaped fold that divides the cerebrum into left and right hemispheres is called the:
- mesencephalon
- diencephalon
- falx cerebelli.
- tentorium.
Flax cerebelli
67
What spinal nerve tract carries information regarding pain and temperature?
- Corticospinal
- Reticulospinal
- Spinocerebellar
- Lateral spinothalamic
Lateral spinothalamic
68
The innermost meningeal layer that rests directly on the brain and spinal cord is the:
cortex.
arachnoid.
dura mater.
pia mater.
Pia mater
69
Which of the following is a sign of neurogenic shock?
- Tachycardia
- Diaphoresis
- Hypertension
- Bradycardia
Bradycardia
70
Which of the following conditions that can cause an airway obstruction is unique to patients with an injury to the upper cervical spine?
- Oropharyngeal occlusion by the tongue
- Blood or secretions in the mouth
- Retropharyngeal hematoma
- Improperly inserted oropharyngeal airway
Retropharyngeal hematoma
71
A diffuse axonal injury:
- is generally associated with better neurologic outcomes than a cerebral concussion because permanent brain damage does not occur.
- results in severe stretching or tearing of the portion of the nerve cell that receives sensory messages from the rest of the body.
- is a specific, grossly observable brain injury that can easily be diagnosed with a computer tomography scan of the head.
- involves stretching, shearing, or tearing of the extension of the neuron that conducts electrical impulses away from the cell body.
involves stretching, shearing, or tearing of the extension of the neuron that conducts electrical impulses away from the cell body.
72
Common clinical findings associated with a subdural hematoma include:
- bilateral hemiparesis.
- a slow progression of symptoms.
- bilateral hemiparalysis.
- rapidly rising blood pressure.
A slow progression of symptoms
73
A subluxation is defined as:
- a completely severed spinal cord.
- a partially severed spinal cord.
- a partial or incomplete dislocation.
- severe distraction injury of the neck.
A partial or incomplete dislocation
74
A 39-year-old man crashed his vehicle into a wooded area and was not found for approximately 8 hours. When you arrive at the scene and assess him, you note that he is conscious but anxious. He is unable to feel or move below his mid-thoracic area and complains of a severe headache. His blood pressure is 210/130 mm Hg, heart rate is 44 beats/min, and respirations are 22 breaths/min. This patient's clinical presentation is most consistent with:
- neurogenic shock.
- autonomic dysreflexia.
- intracranial pressure.
- symptomatic bradycardia.
Autonomic dysreflexia
75
The cervical collar is designed to:
- simply remind the patient not to move their head in any direction until lateral stabilization is applied.
- realign potentially unstable vertebral injuries and prevent movement of the head in all directions.
- reduce flexion and extension of the head and place the weight of the head on the shoulders.
- maintain a neutral position and eliminate all flexion, extension, and lateral movement of the head.
reduce flexion and extension of the head and place the weight of the head on the shoulders
76
Spinal cord injury without radiographic abnormalities can occur in children because:
- their vertebrae lie flatter on top of each other.
- they have excessive mobility of C1 and C2.
- unlike adults, their vertebrae are more curved.
- their spinal cord is more compressed than an adult's.
Their vertebrae lie flatter on top of each other
77
Following a traumatic injury, a 19-year-old woman presents with confusion, tachycardia, and hypotension. Her skin is cool, clammy, and pale. Further assessment reveals abdominal rigidity and deformity with severe pain over her thoracic vertebrae. In addition to administering high-flow oxygen and immobilizing her spine, you should:
- conclude that she is in neurogenic shock, start an IV line of normal saline, and initiate a dopamine infusion.
- perform a focused history and physical exam, start an IV of normal saline, and administer a corticosteroid.
- start at least one large-bore IV of normal saline and administer a narcotic analgesic to treat her severe pain.
- start at least one large-bore IV line and give crystalloid boluses as needed to maintain adequate perfusion.
start at least one large-bore IV line and give crystalloid boluses as needed to maintain adequate perfusion
78
Hypotension that is associated with neurogenic shock is the result of:
- loss of alpha receptor stimulation.
- increased peripheral vascular tone.
- concomitant internal hemorrhage.
- profound peripheral vasoconstriction.
Loss of alpha receptor stimulation
79
When moving an injured patient from the ground onto a long backboard, it is preferred that you:
- slide the patient onto the backboard.
- log roll the patient away from you.
- use a scoop stretcher to move the patient.
- use the four-person log roll technique.
Use the four-person log roll technique
80
Regardless of the method of spinal immobilization used, you must:
- always secure the head before the torso.
- secure the patient in the position found.
- keep the head, neck, and trunk in alignment.
- stabilize the head using slight manual traction.
Keep the head, neck, and truck in alignment
81
Which of the following types of skull fracture would be the least likely to present with gross physical signs?
- Depressed fracture
- Linear fracture
- Basilar fracture
- Open fracture
Linear fracture
82
When applying a vest-type extrication device to a seated patient, their head should be secured to the device:
- before you secure their torso.
- after you move them to a long backboard.
- before you apply a cervical collar.
- only after the torso is fastened securely.
Only after the torso is fastened securely
83
Vagal tone remains intact following a spine injury because:
- parasympathetic nerve fibers are largely under the control of the involuntary nervous system.
- the thoracolumbar system provides parasympathetic stimulation to the periphery via alpha and beta receptors.
- the vagus nerve originates outside the medulla and regulates the heart via the carotid arteries.
- the nerve fibers of the parasympathetic nervous system do not originate from the brainstem or spinal cord.
The vagus nerve originates outside the medulla and regulates the heart via the carotid arteries
84
The phrenic nerves arise from which plexus?
- Sacral
- Brachial
- Cervical
- Lumbar
Cervical
85
Modification of your physical examination of a patient with a suspected spinal cord injury following a two-car motor vehicle crash is based on:
• the patient's weight or body mass index.
• the number of occupants in the vehicle.
• the mechanism of injury.
• injuries to patients in the other vehicle.
The mechanism of injury.
