Anatomy and Neurological Signs Quiz
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Questions and Answers

What is the initial IV dose of fentanyl for a 10 year old patient?

  • 22 mcg / 0.4mL (correct)
  • 25 mcg / 0.5mL
  • 13 mcg / 0.3mL
  • 19 mcg / 0.4mL

    • Which of the following is NOT a danger sign in a patient with a fracture or dislocation?

  • Pallor – pale skin distal to the injury
  • Paralysis – inability to move distal to the injury
  • Poikilothermic - the limb distal to the injury is the same temp as the air temp (correct)
  • Pulses – diminished or absent distal to the injury

    • What type of fracture normally occurs in young children?

  • Colles’s
  • Pathological
  • Prosthetic
  • Greenstick (correct)

    • Which IS NOT an effect of traction in managing a fractured femur?

    <p>Has minimal effect on pain</p> Signup and view all the answers

    Is it true that cling wrap is wrapped tightly around the whole circumferential area of a burn?

    <p>False</p> Signup and view all the answers

    What is subluxation?

    <p>A partial dislocation of the articulating surfaces of a joint</p> Signup and view all the answers

    In what situation should joint injuries be realigned?

    <p>Only realigned if there is no distal pulse or sensation</p> Signup and view all the answers

    What is the hourly fluid rate for a 5-year-old child with 25% TBSA burns?

    <p>103mL/hr</p> Signup and view all the answers

    Which is NOT a phase of the inflammatory response?

    <p>Strengthening phase</p> Signup and view all the answers

    When testing for a ruptured ACL, which of the following is NOT included?

    <p>Pain on the lateral malleolus</p> Signup and view all the answers

    What is Cushing’s triad characterized by in a patient with middle brain compression?

    <p>Increasing bradycardia, deep rapid respirations, widening pulse pressure</p> Signup and view all the answers

    Which part of the vertebral column are you palpating when touching along a patient’s back?

    <p>The spinous process</p> Signup and view all the answers

    What does an inability to feel a touch on the big toe in a motorbike accident victim indicate?

    <p>Spinal cord lesion at L5</p> Signup and view all the answers

    What does one dilated and nonreactive pupil alongside a normal reacting pupil suggest?

    <p>Uncal herniation</p> Signup and view all the answers

    What may be a cause of hypotension in a patient after an isolated spinal injury?

    <p>Loss of sympathetic outflow through the thoracic segment</p> Signup and view all the answers

    What would be the effect on cerebral blood flow for a 100kg patient requiring ventilation at 20 VPM with a TV of 800ml?

    <p>Decrease in cerebral blood flow</p> Signup and view all the answers

    True or False: Decerebrate posturing presents with extended upper extremities, pronation, and extended lower extremities.

    <p>True</p> Signup and view all the answers

    Which of the following can cause unequal pupils?

    <p>Ocular trauma or injury</p> Signup and view all the answers

    Which family of snakes includes the dangerous Australian land snakes?

    <p>Elapid</p> Signup and view all the answers

    Which statement about colubrids is true?

    <p>They are solid-toothed and rear-fanged snakes.</p> Signup and view all the answers

    What is NOT associated with myotoxin effects?

    <p>Hypotension</p> Signup and view all the answers

    Which statement regarding Western Brown snake envenomation is false?

    <p>Envenomation leads to increased appetite.</p> Signup and view all the answers

    Ptosis is defined as which of the following?

    <p>Drooping eyelid</p> Signup and view all the answers

    Piloerection, muscle spasms, and nausea are effects of envenomation from which spider?

    <p>Funnel web spider</p> Signup and view all the answers

    Which spider bite requires the use of a pressure immobilization bandage?

    <p>Funnel web spider</p> Signup and view all the answers

    What is the primary effect of blue-ringed octopus venom?

    <p>Blockade of voltage-gated Na+ channels</p> Signup and view all the answers

    What is a crush injury typically characterized by?

    <p>Muscle cell damage from pressure</p> Signup and view all the answers

    Which of the following accurately describes crush syndrome?

    <p>Systemic effects resulting from crush-related muscle damage</p> Signup and view all the answers

    Which statement about myoglobin is correct?

    <p>Myoglobin is directly toxic to renal tubular cells</p> Signup and view all the answers

    What cervical vertebra is primarily affected by a hangman’s fracture?

    <p>C2</p> Signup and view all the answers

    What is the estimated time before cardiac arrest occurs when hanging?

    <p>10 to 20 minutes</p> Signup and view all the answers

    Which phase of an explosion is most commonly associated with blast-related injuries?

    <p>All of the above</p> Signup and view all the answers

    What characterizes compartment syndrome?

    <p>High pressure buildup in closed fascia space</p> Signup and view all the answers

    Which of the following is NOT an intracellular metabolite released during a crush injury?

    <p>Calcitrate</p> Signup and view all the answers

    Study Notes

    Anatomy

    • The medial malleolus is a bony prominence on the inner ankle.
    • The tibial plateau is the top surface of the tibia bone.
    • The tibial tuberosity is a bony bump on the front of the shin bone (tibia).
    • The humeral head is the top portion of the upper arm bone (humerus).

    Cushing’s Triad

    • Cushing’s triad is a group of signs that indicate increased pressure within the skull.
    • Cushing’s triad is characterised by the following:
      • Hypertension (high blood pressure)
      • Bradycardia (slow heart rate)
      • Bradypnea (slow respiratory rate)
      • Irregular respirations
      • Pinpoint pupils (constricted pupils)

    Spinal Column

    • The spinous process is the bony projection on the back of each vertebra that can be palpated.

    Neurological Injuries

    • Spinal Cord Lesions
      • A spinal cord lesion at L5 can affect sensation in the big toe.
    • Unequal Pupils
      • One dilated and unresponsive pupil, with the other reacting normally, is indicative of uncal herniation.
    • Hypotension and Spinal Injuries
      • Hypotension after an isolated spinal injury may be due to a loss of sympathetic outflow through the thoracic segments.

    Traumatic Brain Injury (TBI)

    • Ventilation and Cerebral Blood Flow
      • High-volume ventilation (20 VPM, 800ml TV) in a patient with a TBI can lead to an increased cerebral blood flow.
    • Decerebrate Posturing
      • Decerebrate posturing is a hallmark of brain injury that presents with extended upper extremities, pronation, and extended lower extremities.

    Burn Management

    • Burn Formulas
      • The Parkland formula is used for calculating fluid replacement for burn patients.
    • Early Management and Mortality
      • Early management of burns can decrease mortality.
    • Cling Wrap Use
      • Cling wrap should not be used to wrap the whole circumference of a burn, it can restrict blood flow.

    Fracture Management

    • Fracture Types
      • Greenstick fractures are common in young children.
    • Traction
      • Traction used to manage a fractured femur is not effective for pain management.
    • Avulsions
      • Avulsions are forcible tearing of a body part.
      • When managing an avulsed part, the tissue should be placed back in its normal location if possible.
    • Dislocations
      • A shoulder dislocation can cause damage to the axillary nerve.
    • Joint Injuries
      • Joint injuries should not be realigned unless there is no distal pulse or sensation.

    Medications

    • Fentanyl
      • The initial IV dose of fentanyl for a 10-year-old patient is 25 mcg/0.5 mL.
    • Ketamine
      • The IV ketamine dose for a 6-year-old is 2.8 mg/2.8 mL.
    • GTN
      • Glyceryl trinitrate (GTN) can be used in the management of burns related to pulmonary edema.

    Crush Injuries and Syndrome

    • Crush Injury
      • Crush injuries are the result of pressure/crushing causing muscle cell damage.
    • Crush Syndrome
      • Crush syndrome is comprised of the systemic manifestation of muscle cell damage resulting from pressure/crushing.
    • Myoglobin and The Kidneys
      • Myoglobin released during crush injury is directly toxic to the renal tubular cells.
    • Hangman’s Fracture
      • A hangman’s fracture occurs in the C2 vertebra.
    • Time to Cardiac Arrest with Hanging
      • Cardiac arrest can occur between 5 to 10 minutes after hanging.
    • Blast Injuries
      • Blast-related injuries can be divided into primary, secondary, and tertiary categories.

    Compartment Syndrome

    • Definition
      • Compartment syndrome is defined as the build-up of pressure in a closed fascia space.
      • This occurs when the pressure within the compartment exceeds the capillary pressure, restricting blood flow to the area.
    • Causes
      • The build-up of pressure in the compartment is caused by an influx of sodium, water, and extracellular calcium into the sarcoplasm.
    • Muscle Death
      • Muscle death can occur within one hour of compartment syndrome.
    • Signs and Symptoms
      • Signs of compartment syndrome include:
        • Pain out of proportion to the injury
        • Swelling
        • Tenderness
        • Tightness
        • Paresthesia (numbness or tingling)
        • Paralysis

    Snake Bites

    • Elapid Snakes
      • The Elapid family of snakes includes dangerous Australian land snakes and are front-fanged.
    • Colubrid Snakes
      • Colubrids are a group of rear-fanged snakes usually lacking sophisticated venom delivery systems.

    Spider Bites

    • Mouse Spider Venom
      • The venom of the mouse spider is similar to that of the funnel web spider.
    • Cutaneous Necrotic Lesions
      • Cutaneous necrotic lesions can occur in multiple species of spiders.
    • Myotoxins
      • Myotoxins can cause muscle weakness and pain.
    • Neurotoxins
      • Vipers, Crotalids, and pit viper venom affect presynaptically.
    • Western Brown Snake Envenomation
      • Common features of Western Brown snake envenomation include headache, nausea, abdominal pain, and cardiac toxicity.
    • Taipan Envenomation
      • Convulsions are a feature of taipan envenomation, especially in children.
    • Ptosis
      • Ptosis is a drooping eyelid.
    • Spider Envenomation - Effects
      • Red back spider envenomation can cause piloerection, muscle spasms, tachycardia, hypertension, nausea, and vomiting.
    • Funnel Web Spider Envenomation
      • A pressure immobilisation bandage should be applied in cases of funnel web spider envenomation.

    Octopus Bites

    • Blue-ringed Octopus Venom
      • Blue-ringed octopus venom blocks voltage-gated sodium channels, preventing action potentials.

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    Description

    Test your knowledge on key anatomical structures and neurological signs related to conditions like Cushing's triad. This quiz covers bony landmarks, important cranial signs, and effects of spinal cord lesions. Perfect for students of anatomy and neurology!

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