Quiz 9 - Head and Spine Trauma & Chest Trauma Flashcards
Dysrhythmias following a myocardial contusion are usually secondary to:
A. direct damage to the vasculature of the epicardium.
B. excess tachycardia that accompanies the injury.
C. aneurysm formation caused by vascular damage.
D. damage to myocardial tissue at the cellular level.
D. damage to myocardial tissue at the cellular level.
Commotio cordis is a phenomenon in which:
A. excessive pressure within the pericardial sac impairs cardiac contractility as well as venous return to the heart.
B. penetrating thoracic trauma perforates the atria or ventricles, causing acute rupture and massive hemorrhage.
C. myocardial tissue at the cellular level is damaged by blunt or penetrating trauma, resulting in cardiac arrest.
D. ventricular fibrillation is induced following blunt trauma to the chest during the heart’s repolarization period.
D. ventricular fibrillation is induced following blunt trauma to the chest during the heart’s repolarization period.
An open pneumothorax causes ventilatory inadequacy when:
A. the glottic opening is much larger than the open wound on the chest wall.
B. the heart stops perfusing the lung on the side of the open chest injury.
C. positive pressure created by expiration forces air into the pleural space.
D. negative pressure created by inspiration draws air into the pleural space.
D. negative pressure created by inspiration draws air into the pleural space.
Signs of neurogenic shock include all of the following, EXCEPT:
A. hypothermia.
B. diaphoresis.
C. bradycardia.
D. flushed skin.
B. diaphoresis.
When performing the standing takedown technique to immobilize a patient’s spine, the patient is secured to the long backboard with straps:
A. after he or she is lowered to the ground.
B. while still in the standing position.
C. after the board is placed on the stretcher.
D. after a cervical collar has been applied.
A. after he or she is lowered to the ground.
The occipital condyles are the:
A. key anatomic structures to which the meninges are attached.
B. passageways for the olfactory nerves to exit the nasal cavity.
C. horizontal bones of the cribriform plate that contain foramina.
D. points of articulation between the skull and vertebral column.
D. points of articulation between the skull and vertebral column.
A 16-year-old man collapsed after being struck in the center of the chest by a line drive during a high school baseball game. Your assessment reveals that he is pulseless and apneic. As your partner initiates one-rescuer CPR, your MOST important action should be to:
A. attach the ECG leads and be prepared to defibrillate.
B. perform intubation to secure the patient’s airway.
C. start an IV line and administer an antiarrhythmic drug.
D. rapidly assess the chest for signs of a sternal fracture.
A. attach the ECG leads and be prepared to defibrillate.
A robbery suspect was shot once in the left anterior chest by law enforcement personnel when he pulled a gun on them. The patient is exhibiting obvious signs of shock, is in significant respiratory distress, and is coughing up blood. Further assessment reveals collapsed jugular veins and absent breath sounds over the left hemithorax. After covering the gunshot wound with the appropriate dressing, you should:
A. administer 100% oxygen, administer 1 to 2 L of normal saline, and transport to a trauma center for an emergency pericardiocentesis.
B. perform a needle thoracentesis to the left side of the chest, initiate rapid transport, and administer 20-mL/kg fluid boluses en route.
C. ventilate the patient with a demand valve, transport to a trauma center, and run two large-bore IV lines wide open while en route to the hospital.
D. provide oxygenation and ventilation support, transport at once, and maintain adequate perfusion with IV fluids while en route to a trauma center.
D. provide oxygenation and ventilation support, transport at once, and maintain adequate perfusion with IV fluids while en route to a trauma center.
A patient with diaphragmatic breathing without intercostal muscle use has MOST likely experienced a spinal injury above the level of:
A. C2.
B. C7.
C. T2.
D. C5.
C. T2.
A subdural hematoma is classified as acute if clinical signs and symptoms develop:
A. within 36 hours following the injury.
B. within 48 hours following the injury.
C. immediately following the injury.
D. within 24 hours following the injury.
D. within 24 hours following the injury.
Signs of meningeal irritation, such as nuchal rigidity, are MOST commonly seen in patients with a(n):
A. subarachnoid hemorrhage.
B. epidural hematoma.
C. subdural hematoma.
D. intracerebral hematoma.
A. subarachnoid hemorrhage.
Any patient with a presumptive diagnosis of a pneumothorax should:
A. be transported to a trauma center via air medical transport.
B. be considered unstable and reassessed every 5 minutes.
C. be intubated and ventilated at a rate of 15 breaths/min.
D. receive a prophylactic needle thoracentesis.
B. be considered unstable and reassessed every 5 minutes
In which of the following situations would it be MOST appropriate to apply a vest-type extrication device or a short backboard to a patient who is seated in his or her crashed motor vehicle?
A. Unconscious with obvious spinal deformity
B. Conscious with neck pain and stable vital signs
C. Conscious with bilateral femur fractures
D. Confused with lower back pain and tachycardia
B. Conscious with neck pain and stable vital signs
You are transporting a conscious and alert man who experienced an isolated blunt injury to the right anterolateral chest. His vital signs are stable, but he is dyspneic and his breath sounds are diminished over the apex of his right lung. In addition to administering high-flow oxygen, the MOST critical intervention for this patient involves:
A. administering a 500-mL normal saline bolus to maintain perfusion.
B. frequently reassessing him for signs of clinical deterioration.
C. positioning him on his right side to facilitate effective breathing.
D. performing a needle thoracentesis to release intrapleural tension.
B. frequently reassessing him for signs of clinical deterioration.
Injury to the temporal lobe on the left side would MOST likely cause:
A. visual disturbances.
B. sleep abnormalities.
C. abnormal speech.
D. lack of coordination.
C. abnormal speech.
Inability to feel or move below the level of the nipple line indicates injury to which spinal nerve root?
A. T4
B. L1
C. C7
D. T1
A. T4
