Chapter 29 Head and Spine Injuries

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

Somatic

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

increase in heart rate, shunting of blood to vital organs, dilation of the bronchiole smooth muscle.

What is true regarding secondary brain injury?

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

What breathing patterns are MOST indicative of increased intracranial pressure?

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

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:

axial loading

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

it causes a problem managing the airway

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

eye opening, verbal response, and motor response

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

the four-person log roll

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

it interferes with your assessment of the airway

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

the patient has been completely secured to the backboard

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

3

The _________ is the best-protected part of the CNS and controls the functions of the cardiac and respiratory systems.

brain stem

In a patient with a head injury, hypertension, bradycardia, and Biot respirations indicate:

herniation of the brain stem

Which of the following statements regarding motor nerves is correct?

They carry information from the CNS to the muscles

The tough, fibrous outer meningeal layer is called the:

dura mater

Fractures that commonly occur in the temporoparietal region of the skull and that are not associated with deformities to the skull; account for 80% of skull fractures; also referred to as nondisplaced skull fractures.

linear skull fractures

The inability to remember events leading up to a head injury.

retrograde amnesia

Actions that we consciously perform, in which sensory input or conscious thought determines a specific muscular activity.

voluntary activities

An abnormal breathing pattern associated with increased intracranial pressure that is characterized by deep, rapid breathing; this pattern is similar to Kussmaul respirations, but without an acetone breath odor.

central neurogenic hyperventilation

An injury to the brain and its associated structures that is a direct result of impact to the head.

primary injury

Injury to the head often caused by a penetrating object in which there may be bleeding and exposed brain tissue.

open head injury

Fractures that usually occur following diffuse impact to the head (eg, falls, motor vehicle crashes); generally result from extension of a linear fracture to the base of the skull and can be difficult to diagnose with a radiograph.

basilar skull fractures

An accumulation of blood beneath the dura mater but outside the brain.

subdural hematoma

Inability to remember events after an injury.

anterograde amnesia

Injury in which the brain has been injured but the skin has not been broken and there is no obvious bleeding.

closed head injury

Bleeding within the brain tissue (parenchyma) itself; also referred to as an intraparenchymal hematoma.

intracerebral hematoma

Three distinct layers of tissue that surround and protect the brain and the spinal cord within the skull and the spinal canal.

meninges

A head position in which the patient's eyes are looking straight ahead and the head and torso are in line.

eyes forward position

An accumulation of blood between the skull and the dura mater.

epidural hematoma

The pressure within the cranial vault.

intracranial pressure

The recommended procedure for moving a patient with a suspected spinal injury from the ground to a long backboard or other spinal precaution device.

four-person log roll

Injuries in which load is applied along the vertical or longitudinal axis of the spine, which results in load being transmitted along the entire length of the vertebral column; for example, falling from a height and landing on the feet in an upright position.

axial loading injuries

Bruising behind an ear over the mastoid process that may indicate a skull fracture.

battle sign

Bruising under the eyes that may indicate a skull fracture.

racoon eyes

A traumatic insult to the brain capable of producing physical, intellectual, emotional, social, and vocational changes.

traumatic brain injury

A brain injury that occurs when force is applied to the head and energy transmission through brain tissue causes injury on the opposite side of original impact.

coup-contrecoup brain injury

Swelling of the brain.

cerebral edema

Bleeding into the subarachnoid space, where the cerebrospinal fluid circulates.

subarachnoid hemorrhage

A temporary loss or alteration of part or all of the brain's abilities to function without actual physical damage to the brain.

concussion

Tough, elastic structures between adjoining vertebrae that act as shock absorbers.

intervertebral disks

The aftereffects of the primary injury; includes abnormal processes such as cerebral edema, increased intracranial pressure, cerebral ischemia and hypoxia, and infection; onset is often delayed following the primary brain injury.

secondary injury

Actions of the body that are not under a person's conscious control.

involuntary activities

the symptom triad of increased systolic blood pressure, decreased pulse rate, and irregular respirations

cushing reflex

Forces that compress the patient's vertebral body can cause herniation of disks

compression injuries

The brain, a part of the central nervous system (CNS), is divided into the:

cerebrum, cerebellum, and brainstem

As you are assessing a 24-year-old man with a large laceration to the top of his head, you should recall that:

blood loss from a scalp laceration may contribute to hypovolemic shock in adults.

A patient who experiences an immediate loss of consciousness followed by a lucid interval has a(n):

epidural hematoma

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):

concussion

A young male was involved in a motor vehicle accident and experienced a closed head injury. He has no memory of the events leading up to the accident but remembers that he was going to a birthday party. What is the correct term to use when documenting his memory loss?

Retrograde amnesia

A distraction injury to the cervical spine would MOST likely occur following:

hanging-type mechanisms

During immobilization of a patient with a possible spinal injury, manual stabilization of the head must be maintained until:

the patient is fully immobilized on a long backboard

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 blood in his mouth. You should:

manually stabilize his head, log roll him onto his side, and suction his mouth

A man is found slumped over the steering wheel, unconscious and making snoring sounds, after an automobile accident. His head is turned to the side and his neck is flexed. You should:

manually stabilize his head and move it to a neutral, in-line position

You should NOT remove an injured football player's helmet if:

the face guard can easily be removed and there is no airway compromise