Module 23: Head and spine injuries Flashcards
Name the main cranial bones
1 frontal bone
2 parietal bones
2 temporal bones
1 occipital bone
Name the facial bones
nasal bones
maxillae
mandible
zygomatic (cheek) bones
When do the fontanelles begin to fuse to create sutures?
between one year and eighteen months
When might an EMT observe bulging fontanelles?
brain swelling in children less than eighteen months, who do not have fused fontanelles and are more prone to falling on their head
What is the foramen magnum?
exit point out of the skull for the spinal cord
What are the three layers between the skull and brain, or meninges?
dura, arachnoid, pia
Where are the arteries in the meninges?
epidural space (between dura and skull)
Where are the veins in the meninges?
subdural space (between dura and arachnoid)
autonomic nervous system is ____ while somatic is ___
involuntary
voluntary
The CNS consists of ____ and the PNS consists of ___
brain and spinal cord
everything else
How do we test the communication between CNS and PNS?
wiggling their fingers and toes (motory)
grabbing a finger/toe and asking pt which one you’re touching (sensory). Do this one at a time.
You may assume skull Fx when ….
CSF is coming from ears or nose
Compare retrograde to anterograde amnesia
retrograde: before the accident
anterograde: amnesia is after the accident
What are coup - contrecoup contusions?
rapid deceleration injuries
injury can occur on both sides, even though one side is impacted (think about brain/organs bouncing forward or to one side, coup, then back or to the other side, contre coup)
What are epidural hematomas?
arterial bleeding
unconsciousness may be preceded by lucid interval
low mortality rate if treated in time
What are subdural hematomas?
venous bleeding
slow onset
HIGH mortality rate
What is an intracerebral hemorrhage? What commonly causes it?
Bleeding inside the brain
common result of penetrating trauma
can mimic a CVA (stroke)
will result in rapid increase in ICP (intercranial pressure)
Name some signs and symptoms of head injuries
AMS
unequal pupils
Blood and CSF from ears and nose
racoon eyes
Battle’s signs
seizures
vomiting
abnormal breathing
changes to heart rate and BP
posturing
What is herniation? Name the signs and symptoms
Build up of ICP leads to brain tissue herniating through foramen magnum
cushing’s reflex ,posturing, neurologic hyperventilation
What are the three aspects of cushing’s reflex?
hypertension, bradycardia, irregular ventilation
What is posturing? compare decerebrate to decorticate.
a sign of herniation
decorticate posturing (abnormally flexing hands toward head, toward the cord)
decerebrate posturing (abnormal extension of hands away from head)
Name the sections of the spine in order and with numbers. There are __ vertebra total
cervical, thoracic, lumbar, sacral, cocyx
7, 12, 5, 5, 4
33
Where does the spinal cord start and end on the spine?
starts a foramen magnum, ends at L1
The most anterior portion of the spine is the ___ and the most superior is the ___.
vertebral body
spinal process
C3, C4, C5 keep the patient alive because of the ___nerve, which goes into the diaphragm
phrenic
What are flexation spinal injuries?
chin to chest
What are extension spinal injuries?
chin away from chest, ex whiplash
What are distraction spinal injuries?
pulling apart of vertebra
What are compression spinal injuries?
Vertebra come together
Name three interventions that may be done differently due to suspected spinal injuries?
manually stabilize the spine (both hands on either side of head, two fingers under mandible)
jaw thrust
application of a c-collar
What two devices can be used to transport spine injury pts?
long board and scoop stretchers
When you lay a child flat on their back, what should be done to achieve neutral alignment?
roll towels up under back
For patients who cannot fit a c-collar, what should be used instead?
DIY it: make sure they can’t move head side to side and front to back
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 very large blood clots in his mouth. You should:
apply a c-collar, suction, and use BVM
suction, apply NRB
insert Nasal cannula and give 100% oxygen
manually stabilize his head, log roll onto side, and remove them with gloved fingers.
manually stabilize his head, log roll onto side, and remove them with gloved fingers.
The brain, a part of the central nervous system (CNS), is divided into the:
cerebrum, cerebellum, brain stem
What is a contusion?
Actual physical injury to the brain
What is a contusion?
Actual physical injury to the brain
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):
intracerebral hemorrhage
concussion
contusion
subdural hematoma
concussion
A patient who experiences an immediate loss of consciousness followed by a lucid interval has a(n):
epidural hematoma
Blood loss from a scalp laceration may contribute to ____ in adults
hypovolemic shock
During spinal motion restriction, manual stabilization of the head must be maintained until:
the patient is placed on the stretcher
What is a contusion?
Actual physical injury to the brain
What is a contusion?
Actual physical injury to the brain
What is a contusion?
Actual physical injury to the brain
