Chapter 28- Head and Spine Injuries

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Helmets must be removed in all of the following cases, EXCEPT:

When there are no impending airway or breathing problems.

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.

Which of the following head injuries would cause the patient’s condition to deteriorate MOST rapidly?

Epidural hematoma.

When the parasympathetic nervous system is activated:

The heart rate decreases and the blood vessels dilate.

When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear. This indicates:

Rupture of the tympanic membrane following diffuse impact to the head.

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

Brain and spinal cord.

In contrast to a cerebral concussion, a cerebral contusion:

Involves physical injury to the brain tissue.

The five sections of the spinal column, in descending order, are the:

Cervical, thoracic, lumbar, sacral, and coccygeal.

When immobilizing a seated patient with a short backboard or vest-style immobilization device, you should apply a cervical collar:

After assessing distal neurovascular functions.

The MOST reliable sign of a head injury is:

A decreased level of consciousness.

The spinal cord is encased in and protected by the:

Spinal canal.

After your partner assumes manual in-line stabilization of the patient’s head, you should:

Assess distal neurovascular status in the extremities.

In supine patients with a head injury, the head should be elevated _____ to help reduce intracranial pressure.

30 degrees.

Hyperextension injuries of the spine are MOST commonly the result of:


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


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

Pupillary constriction.

A short backboard or vest-style immobilization device is indicated for patients who:

Are in a sitting position and are clinically stable.

A reflex arc occurs when:

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

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


The effectiveness of positive-pressure ventilations when treating a head-injured patient can ONLY be determined by:

Immediate reassessment following the intervention.

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


It would be MOST appropriate to perform a focused secondary assessment on a patient who:

Fainted and fell to the ground from a standing position.

An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is:

A rapid deterioration of neurologic signs.

The cerebrospinal fluid (CSF) that circulates in between each meningeal layer:

Acts as a shock absorber for the brain and spinal cord.

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

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

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

Use rolled towels to immobilize the patient’s head.

The MOST common and serious complication of a significant head injury is:

Cerebral edema.

A temporary loss or alteration of part or all of the brain’s abilities to function without physical damage to the brain MOST accurately describes a(n):

Cerebral concussion.

Which of the following statements regarding a basilar skull fracture is correct?

The absence of raccoon eyes or Battle sign does not rule it out.

The _________ contain(s) about 75% of the brain’s total volume.


Bleeding within the brain tissue itself is called a(n):

Intracerebral hematoma.

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

It interferes with your assessment of the airway.

Which of the following nerves carry information from the body to the brain via the spinal cord?


hich of the following interventions may be used to help reduce intracranial pressure?

30-degree elevation of the head.

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

Eye opening, verbal response, and motor response.

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

Herniation of the brain stem.

Which of the following is NOT a symptom of a concussion?

Muscle tremors.

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

Ensure that you secure the torso before securing the head.

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

Depressed skull fractures.

A female patient with a suspected head injury has slow, shallow breathing. The MOST appropriate treatment for her includes:

Ventilation assistance to maintain an ETCO2 of 30 to 35 mm Hg.

Common signs and symptoms of a serious head injury include all of the following, EXCEPT:

A rapid, thready pulse.

The nervous system is divided into the central nervous system and the:

Peripheral nervous system.

An epidural hematoma is MOST accurately defined as:

Bleeding between the skull and dura mater.

The tough, fibrous outer meningeal layer is called the:

Dura mater.

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

Brain stem.

Injury to the head and neck may indicate injury to the:

Cervical spine.

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

The four-person log roll.

You respond to a 38-year-old man who fell while rock climbing. He is unconscious with an open airway. The respiration and pulse rates are within normal limits. His distal pulses are intact. You check his pupils and find that they are unequal. You know this could be a sign of:

Increased intracranial pressure.

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.

A 45-year-old male was working on his roof when he fell approximately 12 feet, landing on his feet. He is conscious and alert and complains of an ache in his lower back. He is breathing adequately and has stable vital signs. You should:

Immobilize his spine and perform a focused secondary exam.

Which of the following statements regarding motor nerves is correct?

They carry information from the CNS to the muscles.

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


Which of the following nerves allow sensory and motor impulses to be sent from one nerve directly to another?


In which of the following situations would the EMT be the LEAST likely to immobilize a patient’s spine?

No distracting injuries or evidence of intoxication.

Neck rigidity, bloody cerebrospinal fluid, and headache are associated with what kind of bleeding in the brain?

Subarachnoid hemorrhage.

Rapid deceleration of the head, such as when it impacts the windshield, causes:

Compression injuries or bruising to the anterior portion of the brain and stretching or tearing to the posterior portion of the brain.

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.

During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should:

Suction his oropharynx for up to 15 seconds.

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

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

Which of the following statements regarding secondary brain injury is correct?

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

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