EMT Chapter 29 Head and Spine Injuries

An injured brain begins to swell initially due to:

A. intracranial pressure.

B. a coup-contrecoup injury.

C. cerebral edema.

D. an epidural hematoma.

C. cerebral edema

When placing a patient onto a long backboard, the EMT at the patient's _________ is in charge of all patient movements.

A. head

B. lower extremities

C. waist

D. chest

A. head

The frontal and parietal bones of the skull are especially susceptible to:

A. nondisplaced skull fractures.

B. depressed skull fractures.

C. basilar skull fractures.

D. linear skull fractures.

B. depressed skull fractures

During your primary assessment of a semiconscious 30-year-old female with closed head trauma, you note that she has slow, irregular breathing and a slow, bounding pulse. As your partner maintains manual in-line stabilization of her head, you should:

A. instruct him to assist her ventilations while you perform a rapid assessment.

B. perform a focused secondary assessment of the patient's head and neck.

C. immediately place her on a long backboard and prepare for rapid transport.

D. apply 100% oxygen via a nonrebreathing mask and obtain baseline vital signs.

A. instruct him to assist her ventilations while you perform a rapid assessment

An epidural hematoma is most accurately defined as:

A. bleeding between the dura mater and brain.

B. an injury caused by a damaged cerebral artery.

C. bleeding between the skull and dura mater.

D. venous lacerations that occur within the brain.

C. bleeding between the skull and dura mater

You should be most suspicious that a patient has experienced a significant head injury if his or her pulse is:

A. weak.

B. rapid.

C. slow.

D. irregular.

C. slow

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

A. the patient has been secured to the ambulance stretcher.

B. an appropriately sized cervical collar has been applied.

C. the head has been stabilized with lateral immobilization.

D. the patient has been completely secured to the backboard.

D. the patient has been completely secured to the backboard

Which of the following head injuries would cause the patient's condition to deteriorate most rapidly?

A. Intracerebral hematoma

B. Subdural hematoma

C. Cerebral contusion

D. Cerebral concussion

A. intracerebral hematoma

Common signs of a skull fracture include all of the following, except:

A. mastoid process bruising.

B. superficial scalp lacerations.

C. ecchymosis around the eyes.

D. noted deformity to the skull.

B. superficial scalp lacerations

When immobilizing a child on a long backboard, you should:

A. place padding under the child's shoulders as needed.

B. secure the head prior to securing the torso and legs.

C. place the child's head in a slightly extended position.

D. defer cervical collar placement to avoid discomfort.

A. place padding under the child's shoulders as needed

The tough, fibrous outer meningeal layer is called the:

A. arachnoid mater.

B. pia mater.

C. gray mater.

D. dura mater.

D. dura mater

The central nervous system (CNS) is composed of the:

A. meninges and spinal cord.

B. brain and spinal cord.

C. cerebellum and brain.

D. cerebrum and meninges.

B. brain and spinal cord

The hormone responsible for the actions of the sympathetic nervous system is:

A. thyroxine.

B. aldosterone.

C. insulin.

D. epinephrine.

D. epinephrine

Which of the following breathing patterns is most indicative of increased intracranial pressure?

A. Increased rate and depth with the distinct odor of acetone on the patient's breath

B. Increased rate with a normal inspiratory time and a prolonged expiratory time

C. Slow, shallow occasional gasps that progress to prolonged periods of apnea

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

D. irregular rate, pattern, and volume of breathing with intermittent periods of apnea

Which of the following sets of vital signs depicts Cushing triad?

A. Blood pressure, 200/100 mm Hg; pulse, 140 beats/min; respirations, 28 breaths/min

B. Blood pressure, 90/50 mm Hg; pulse, 120 beats/min; respirations, 10 breaths/min

C. Blood pressure, 190/110 mm Hg; pulse, 55 beats/min; respirations, 30 breaths/min

D. Blood pressure, 80/40 mm Hg; pulse, 30 beats/min; respirations, 32 breaths/min

C. blood pressure, 190/110mmHg; pulse, 55 beats/min; respirations, 30 breaths/min

If you do not have the appropriate-size cervical collar, you should:

A. use rolled towels to immobilize the patient's head.

B. defer cervical immobilization and apply lateral head blocks.

C. place sandbags on either side of the patient's head.

D. ask the patient to keep his or her head in a neutral position.

A. use rolled towels to immobilize the patient's head

When opening the airway of a patient with a suspected spinal injury, you should use the:

A. tongue-jaw lift maneuver.

B. jaw-thrust maneuver.

C. head tilt-neck lift maneuver.

D. head tilt-chin lift maneuver.

B. jaw-thrust maneuver

You are assessing a man who has a head injury and note that cerebrospinal fluid is leaking from his ear. You should recognize that this patient is at risk for:

A. hypovolemic shock.

B. permanent hearing loss.

C. bacterial meningitis.

D. sudden hypotension.

C. bacterial meningitis

Following a head injury, a 20-year-old female opens her eyes spontaneously, is confused, and obeys your commands to move her extremities. You should assign her a GCS score of:

A. 13.

B. 14.

C. 12.

D. 15.

B. 14

A reflex arc occurs when:

A. the brain interprets sensory information that it receives from peripheral and cranial nerves and sends a signal to the muscles.

B. a sensory nerve sends a message to the brain, but the motor nerve fails to send the appropriate response to the body.

C. the motor nerves function automatically without receiving a message from the CNS.

D. a sensory nerve detects an irritating stimulus and bypasses the brain by sending a direct message to the motor nerve.

D. a sensory nerve detects an irritating stimulus and bypasses the brain by sending a direct message to the motor nerve