EMT chapter 29 trauma to the head, neck, and spine -Exam with complete solutions

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An injury to the cranium would directly affect: A. the bony structure making up the forehead, top, back, and upper sides of the skull. B. the two fused bones forming the upper jaw. C. the fluid ... that surrounds the brain and spinal cord. D. the part of the nervous system that controls involuntary functions. - ANSWER the bony structure making up the forehead, top, back, and upper sides of the skull. During your primary assessment, it is important to remember: A. that inadequate breathing may result from spinal cord damage from a thoracic spine injury. B. to open the airway of an unresponsive patient using the head-tilt, chin-lift method. C. to initiate immediate manual in-line spinal stabilization according to patient need. D. that the patient's skin may be cool, pale, and moist below the site of spinal cord injury and warm and dry above the site of injury. - ANSWER to initiate immediate manual in-line spinal stabilization according to patient need. Which of the following statements regarding the spinal cord is TRUE? A. The nerves that branch from the spinal cord at the vertebrae alternate from left to right. B. The spinal cord transmits and receives neural messages to and from the brain. C. The spinal cord lacks the membranes that surround the brain. D. If the spinal cord is severed, the body will experience widespread vasoconstriction. - ANSWER The spinal cord lacks the membranes that surround the brain. Which of the following findings during your primary assessment would be MOST suggestive of a brain injury? A. Rapid, weak pulse B. Poor responsiveness to verbal stimuli C. Difficulty in breathing D. Partial airway obstruction - ANSWER Poor responsiveness to verbal stimuli The hole where the spinal cord exits the cranium is called the: A. foramen magnum. B. brainstem. C. vertebral foramen. D. tentorium cerebri. - ANSWER foramen magnum The possible numerical range for the Glasgow Coma Scale is: A. 0 to 15. B. 3 to 15. C. 0 to 10. D. 3 to 10. - ANSWER 3 to 15. Which of the following would be a nontraumatic cause of brain injury? A. Rapid deceleration from a head-on collision B. Knife wound to the scalp C. Gunshot wound to the head D. Severe prolonged hypotension - ANSWER Severe prolonged hypotension When an individual sustains blunt force trauma to the head that results in a brief disruption of the neural network without any physical evidence or lasting residual effects, this would be termed a: A. brain contusion. B. cerebral hematoma. C. concussion. D. herniation. - ANSWER concussion. Another term for a compression injury to the spine is: A. flexion injury. B. axial loading. C. extension injury. D. ankylosing spondylitis. - ANSWER axial loading. If your patient is wearing a helmet, you should leave it in place if: A. there are no impending airway or breathing problems. B. the helmet has been damaged. C. the helmet is loose enough to allow you to assess the patient's head and neck. D. the helmet is too snug to remove easily. - ANSWER there are no impending airway or breathing problems. The three sections of the Glasgow Coma Scale (GCS) include: A. breathing effort. B. appearance. C. motor response. D. level of consciousness - ANSWER motor response Abnormally high pressure within the skull is known as: A. increased intracranial pressure. B. intracranial hemorrhage. C. cerebral hypertension. D. concussive injury. - ANSWER increased intracranial pressure. The steps in immobilizing a supine patient to a long backboard include: A. securing the patient's torso to the board before securing the head. B. using the logroll, a move that ideally is performed by at least two rescuers: one at the head and one at the hips. C. not placing padding on the board, as it might move the spine out of alignment. D. removing the cervical collar once the patient is immobilized on the board. - ANSWER securing the patient's torso to the board before securing the head. Your patient was unconscious for an extended period of time as a result of severe hypoglycemia. What is your primary concern for this patient? A. Malnutrition B. Nontraumatic brain injury C. Memory loss D. Dehydration - ANSWER Nontraumatic brain injury Which of the following is likely the MOST critical associated injury of serious blunt or penetrating trauma to the face? A. The threat to airway patency B. Mandibular dislocation C. Distortion of the facial landmarks D. The entrance of blood into the digestive tract - ANSWER The threat to airway patency In managing an open wound to the neck, what actions can you take while waiting for occlusive dressings to be obtained or opened? A. Apply direct pressure to the open wound with two fingers. B. Place your gloved hand over the wound to close it off from air entry. C. Place a standard, sterile 4 times ×4 gauze pad over the wound. D. Apply oxygen via a nonrebreather mask at 15 lpm. - ANSWER Place your gloved hand over the wound to close it off from air entry. You are on scene with a 24-year-old female car crash victim. During your assessment, she tells you that she can't feel all of her teeth. You note swelling to the jaw and misaligned teeth. Your primary concern in treating this patient is which of the following? A. Obtaining baseline set of vital signs B. Trending the patient's vital signs to identify signs of increased intracranial pressure C. Removing broken teeth from the airway D. Identifying the type of Le Fort fracture - ANSWER Removing broken teeth from the airway Which of the following is MOST likely to have associated spinal injury? A. Facial trauma B. Burn injury C. Extremity trauma D. Abdominal injury - ANSWER Facial trauma Emergency medical care of a patient with suspected spinal injury includes: A. palpating the cervical region for any deformities or tenderness. B. using manual cervical spine traction until a cervical collar can be applied. C. opening and maintaining the airway using the head-tilt, chin-lift method if the patient is responsive. D. using sandbags to immobilize the patient's head on the long backboard. - ANSWER palpating the cervical region for any deformities or tenderness. A large puncture wound or laceration to the neck must be immediately sealed with an occlusive dressing to prevent: A. excessive bleeding. B. airway compromise. C. cervical spine injury. D. an air embolus. - ANSWER an air embolus. Objects that are impaled into the head and interfere with transport should be: A. pushed through to the other side for removal. B. left in place and transported in a flat-bed vehicle. C. gently but firmly removed. D. stabilized and cut with minimal movement of the object. - ANSWER stabilized and cut with minimal movement of the object. You respond to the scene of an assault where you find a 26-year-old male patient with a knife impaled in the left lobe of his skull near the temporal membrane. He is alert but disoriented. How should you manage this patient's injury? A. Approximate the depth of insertion and carefully remove the knife. B. Stabilize the knife and carefully cut the handle off to prepare for transport. C. Stabilize the knife with bulky dressings. D. Perform a secondary assessment prior to stabilizing the knife. - ANSWER Stabilize the knife with bulky dressings. You and your EMT partner are equally trained and have similar experience as EMTs. Your partner suggests that the patient for whom you are caring does not need to have immobilization performed. You feel differently. What would be the best course of action? A. Do not immobilize the patient and discuss it later. B. Call your supervisor and ask him or her to make the decision. C. Refer to your local protocol. D. Call medical direction for expert consultation. - ANSWER Refer to your local protocol. You arrive on scene at a motor vehicle crash where you notice that the patient has severe bleeding from her head with gray matter showing. This type of injury is: - ANSWER an open skull fracture. When treating a patient with damage to the facial bones, you should have a high index of suspicion for: A. injury to the brain. B. cranial cohesion C. aphagia. D. thoracic separation. - ANSWER injury to the brain. What is the rationale for some EMS systems employing "selective use of spine immobilization" by some EMS systems? A. Providing spinal immobilization on patients wastes valuable time on scene. B. Immobilization of some patients may not be beneficial based on mechanism of injury and assessment findings. C. The spine can be effectively "cleared" in the field by prehospital providers. D. Selective use of spinal immobilization increases health care costs. - ANSWER Immobilization of some patients may not be beneficial based on mechanism of injury and assessment findings Your patient responds to painful stimulus with decorticate posturing (arms bent to his chest, fists clenched, and legs straight out), his eyes do not open to pain, and he makes incomprehensible sounds when you pinch him. What score would you give him on the Glasgow Coma Scale? A. 5 B. 3 C. 6 D. 4 - ANSWER 6 Paralysis of the extremities is a reliable sign of spinal cord injury: A. in pediatric patients. B. in patients who are conscious. C. if accompanied by paresthesia. D. if verbal response is also impaired. - ANSWER in patients who are conscious. You are treating a 22-year-old male who was stabbed in the neck during a bar fight. What is an important part of the treatment of this injury? A. Checking for subcutaneous emphysema B. [Show More]

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