Head & Neck Injuries

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Questions and Answers

Which components make up the central nervous system?

Cranium

Brain and spinal cord (correct)

Dura mater

Spinous process

What is the term for a patient's attempt to move away from a painful stimulus?

Purposeful movement (correct)

Catatonic movement

Nonpurposeful movement

Decorticate movement

What is the function of the cranial skull?

Facilitating hearing

Supporting facial structure

Protecting the brain (correct)

Providing attachment for muscles

Which part of the skull is considered the weakest?

Basilar skull Signup and view all the answers

What is a likely result of a scalp injury due to its rich blood supply?

Profuse bleeding Signup and view all the answers

What is the first step in providing emergency care to a patient with suspected skull fractures?

Applying a cervical collar Signup and view all the answers

What is a collection of blood within the skull or brain tissue called?

Hematoma Signup and view all the answers

Which structure is responsible for cushioning the brain within the skull?

Cerebrospinal fluid Signup and view all the answers

What is the term for the bruising and swelling of brain tissue that may accompany a concussion?

Contusion Signup and view all the answers

What is the emergency condition that involves arterial bleeding pooling between the skull and the outer protective covering of the brain?

Epidural hematoma Signup and view all the answers

In documenting a possible head or spine injury, which loss of function is critical to note?

Consciousness Signup and view all the answers

What type of head injury occurs when the scalp is lacerated but there is no opening in the skull?

Closed head injury Signup and view all the answers

What component of the nervous system is primarily affected in head trauma?

Brain and spinal cord Signup and view all the answers

Which protective substance surrounds the brain and spinal cord, helping absorb impact?

Cerebrospinal fluid Signup and view all the answers

What is the immediate concern when encountering a patient with a head injury and altered vital signs?

Airway management Signup and view all the answers

What vital sign changes might indicate a serious head injury?

Decreasing heart rate and blood pressure Signup and view all the answers

What is the most common type of head injury?

Hematoma Signup and view all the answers

Which of the following is NOT a layer protecting the brain inside the skull?

Serous Membrane Signup and view all the answers

What does AVPU stand for in assessing a patient's level of responsiveness?

Alert, Verbal, Pain, Unresponsive Signup and view all the answers

What is the purpose of examining a patient’s head for bruising during a physical exam?

To assess for potential skull fractures Signup and view all the answers

What condition is indicated by a purplish discoloration around the eyes in a patient with a head injury?

Raccoon eyes Signup and view all the answers

What physiological changes are late findings in patients with significant brain injuries?

Hypotension and bradycardia Signup and view all the answers

Which of the following would be considered a nonpurposeful response in a patient with a head injury?

Decerebrate posturing Signup and view all the answers

During assessment and treatment, what is crucial for EMTs to document regarding a patient's head injuries?

Changes in responsiveness Signup and view all the answers

What is the primary purpose of constant evaluation of the level of consciousness in a trauma patient?

To assess neurological functioning and response Signup and view all the answers

Which condition would warrant the request for advanced life support assistance in trauma care?

Deterioration in the patient's neurological status Signup and view all the answers

Which of the following is NOT a common source of head trauma?

Household chores Signup and view all the answers

What does an increase in systolic blood pressure and a decrease in heart rate potentially indicate in a trauma patient?

Increased intracranial pressure Signup and view all the answers

Which sign is commonly associated with head trauma and suggests potential basilar skull fracture?

Raccoon sign (periorbital ecchymosis) Signup and view all the answers

What is the correct order of the meningeal layers from outer to inner?

Dura mater, Arachnoid, Pia mater Signup and view all the answers

Which component of the brain is responsible for most conscious and sensory functions?

Cerebrum Signup and view all the answers

Which of the following is NOT a common mechanism of injury that produces head injuries?

Osteoporosis Signup and view all the answers

What are the three signs indicative of Cushing reflex?

Hypertension, bradycardia, altered respiration Signup and view all the answers

Which part of the brain is mainly responsible for controlling equilibrium and coordinating muscle activity?

Cerebellum Signup and view all the answers

Which of the following is a characteristic of the brainstem?

Regulates vital functions such as heartbeat Signup and view all the answers

Which statement correctly describes the function of the Arachnoid layer of the meninges?

It contains cerebrospinal fluid. Signup and view all the answers

Which of the following injuries is most likely a primary brain injury?

Concussion Signup and view all the answers

Which option does not indicate a sign or symptom in patients with spinal injuries?

hyperglycemia Signup and view all the answers

What part of the nervous system detects sensations such as pain?

peripheral nervous system Signup and view all the answers

Which nervous system controls involuntary functions like heartbeat and breathing?

autonomic nervous system Signup and view all the answers

Sports helmets typically open in which location?

front Signup and view all the answers

What is the other type of helmet most likely encountered in the prehospital environment alongside sports helmets?

football helmet Signup and view all the answers

The mechanism of injury that stretches and pulls apart the vertebrae and spinal cord is called?

distraction Signup and view all the answers

When is it appropriate to initiate motion restriction of the cervical spine in a trauma victim?

after opening the airway Signup and view all the answers

In spinal shock, how is a patient's skin typically described?

cool and dry Signup and view all the answers

Which type of paralysis is characterized by loss of function on one side of the body?

Hemiplegia Signup and view all the answers

What is the purpose of spinal motion restriction in emergency care?

To prevent further injury to the spinal cord Signup and view all the answers

In the context of spinal injuries, what does the term 'log roll' refer to?

A specific maneuver for moving a patient while maintaining spinal alignment Signup and view all the answers

Which of the following is NOT typically associated with spinal column and spinal cord trauma?

Increased blood pressure Signup and view all the answers

Which condition is characterized by an erection that is not associated with sexual arousal, commonly seen in spinal cord injuries?

Priapism Signup and view all the answers

What structural division of the nervous system is primarily responsible for processing sensory information and coordinating motor functions?

Central nervous system Signup and view all the answers

Which condition is characterized by a persistent erection of the penis resulting from spinal nerve damage?

Priapism Signup and view all the answers

What is the medical term for paralysis of the entire body resulting from spinal cord damage?

Quadriplegia Signup and view all the answers

Which part of the spine refers to the first seven bones in the neck?

Cervical vertebrae Signup and view all the answers

What is the first step to perform when providing spine motion restriction with a backboard?

Move the patient onto the long board without compromising the integrity of the spine. Signup and view all the answers

What is referred to as neurogenic shock, which inhibits neural transmissions to the arteries?

Spinal shock Signup and view all the answers

During patient positioning on a long backboard, what must not be discontinued until secured?

Cervical spine immobilization Signup and view all the answers

Instructing a patient for self-extrication from a motor vehicle, what is crucial for maintaining safety?

Instruct the patient to pivot his legs and body while seated. Signup and view all the answers

What are the two functional divisions of the nervous system?

Somatic and autonomic nervous systems Signup and view all the answers

During spine motion restriction with a cervical collar, what is the correct sequence after applying the collar?

Position the long spine board or full-body vacuum mattress. Signup and view all the answers

What type of paralysis is characterized by weakness or inability to move one side of the body?

Hemiplegia Signup and view all the answers

What is NOT a priority assessment when preparing a patient for spine motion restriction?

Secure the patient to the stretcher prior to assessments. Signup and view all the answers

Why is spine motion restriction important in a patient with paralyzed limbs?

To prevent further damage to the spine. Signup and view all the answers

What should be observed immediately after placing a patient in a supine position on the stretcher?

Assess the patient's motor and sensory function in the upper extremities. Signup and view all the answers

In what condition might you NOT need to apply spine motion restriction precautions?

A patient who sustains a minor fall without symptoms. Signup and view all the answers

What is the best practice when the patient is ready for self-extrication from a vehicle?

Have the patient rotate 180 degrees and sit back onto the stretcher. Signup and view all the answers

What is the primary function of the autonomic nervous system?

Controls involuntary bodily functions Signup and view all the answers

Which of the following is a sign of potential spinal cord injury?

Localized pain with palpation Signup and view all the answers

What initial step should be taken when assessing a patient with a suspected spinal injury?

Assess the cervical region and provide motion restriction Signup and view all the answers

How many cervical vertebrae are present in the human spinal column?

7 Signup and view all the answers

Which of the following components is NOT included in the continuing emergency care steps for a spinal injury?

Transporting the patient without a cervical collar Signup and view all the answers

What is an indication of priapism in a patient with a spinal cord injury?

Unexplained penial erection Signup and view all the answers

Which type of vertebrae are located in the thoracic region of the spinal column?

12 Signup and view all the answers

What symptom might indicate impairment of breathing due to spinal injury?

Shortness of breath Signup and view all the answers

Which part of the eye contains the aqueous humor?

Anterior chamber Signup and view all the answers

The emergency treatment for chemical burns to the eye primarily entails what action?

Plentiful irrigation Signup and view all the answers

Which structure of the eye is responsible for focusing light on the retina?

Lens Signup and view all the answers

What is the appropriate duration for irrigating an eye affected by an alkali chemical burn?

1½ hours Signup and view all the answers

Which bone in the face is not fused into immovable joints?

Mandible Signup and view all the answers

What signs and symptoms are typically associated with an orbital fracture?

Double vision Signup and view all the answers

The thin covering of the inner eyelids is called what?

Conjunctiva Signup and view all the answers

Which is an appropriate irrigant for treating a chemical burn to the eye?

Saline Signup and view all the answers

What does clear or bloody fluid draining from the ear typically indicate?

Skull fracture Signup and view all the answers

If a nose fracture is suspected, what should the EMT do first?

Apply direct pressure Signup and view all the answers

What is the primary concern for a patient with moderate bleeding from the face and neck?

Monitoring for shock Signup and view all the answers

When assessing a facial injury, which of the following should be prioritized?

Establishing airway patency Signup and view all the answers

In the scenario described, what would be the most suitable initial action for the EMT?

Calm the child and assess the injuries Signup and view all the answers

Which of the following is a key consideration when managing eyelid injuries?

Avoid using ice directly on the eye Signup and view all the answers

What should be a priority when treating a patient with a facial laceration?

Assessment for potential airway obstruction Signup and view all the answers

What is one of the first steps in managing the boy's injuries after assessing the bleeding?

Applying a pressure bandage to the neck Signup and view all the answers

What is a critical consideration when treating an eye injury?

Foreign object involvement Signup and view all the answers

What should be done if a foreign object is lodged in the eye?

Cover the eye and seek professional help Signup and view all the answers

What is the primary concern when treating facial fractures?

Potential airway compromise Signup and view all the answers

How long should an EMT irrigate the eye in cases of chemical burns?

15 minutes or until arrival at the hospital Signup and view all the answers

What should an EMT cover an injured eyelid with if an eyeball injury is not suspected?

A sterile dressing Signup and view all the answers

Which of the following injuries can lead to orbital fractures?

Blunt force trauma to the face Signup and view all the answers

What should be the first step in treating a chemical burn to the eye?

Irrigate the eye immediately Signup and view all the answers

What is a common complication with eye injuries?

Presence of foreign bodies Signup and view all the answers

What is the most critical initial action for an EMT when dealing with facial fractures?

Establish and maintain a patent airway Signup and view all the answers

How should an EMT handle a foreign object that is impaled in a patient's cheek?

Leave it in place and transport the patient Signup and view all the answers

When a patient loses a tooth, what is the recommended method for preserving it?

Place it in dry gauze Signup and view all the answers

In cases of severe facial trauma, what should be suspected aside from facial injuries?

Cervical spine injury Signup and view all the answers

What should an EMT do if an extruded eyeball is present?

Irrigate with saline and attempt replacement Signup and view all the answers

When dealing with a patient who has contact lenses, what should NOT be done after a chemical burn to the eye?

Remove the lenses immediately Signup and view all the answers

Which is true about injuries to specialized facial structures?

Injuries are rare despite their vulnerability Signup and view all the answers

What is the first step an EMT should take if fracture of the orbits is suspected?

Establish and maintain spine motion restriction Signup and view all the answers

What is the primary method for controlling bleeding in eye, face, and neck trauma?

Applying direct pressure with a bandage Signup and view all the answers

Which of the following structures is NOT typically assessed when evaluating a head or facial injury?

Pulmonary arteries Signup and view all the answers

What should be done if the lid skin is avulsed during trauma?

Preserve and transport it with the patient Signup and view all the answers

What sign indicates a potential fracture in the facial area?

Nasal discharge Signup and view all the answers

Which of the following paramedic assessments indicates a serious complication following facial trauma?

Double vision Signup and view all the answers

What is the correct immediate response to a neck wound in a trauma patient?

Apply a sterile dressing with direct pressure Signup and view all the answers

During assessment of facial trauma, which symptom suggests possible brain injury?

Marked decrease in vision Signup and view all the answers

What is the priority in managing a trauma patient with suspected airway compromise?

Assess breathing patterns Signup and view all the answers

Study Notes

Central Nervous System

Major components of the central nervous system are the brain and the spinal cord.

Brain Protection

The brain is protected by three layers of meninges: dura mater, arachnoid, and pia mater.

Skull

The helmet-like structure that protects the brain is called the cranial skull.
The weakest portion of the skull is called the basilar skull.

Scalp Injuries

Scalp injuries can lead to profuse bleeding due to its rich blood supply.
A scalp injury with no opening in the skull is considered a closed head injury.

Brain Injuries

A collection of blood within the skull or brain tissue is called a hematoma.
Bruising and swelling of brain tissue is termed a contusion.
An epidural hematoma is an arterial bleed that pools between the skull and the dura mater.
A subdural hematoma is when a bleed forms between the dura mater and arachnoid layers.

Signs and Symptoms

A late finding in a patient with a significant brain injury is an increase in blood pressure and a decrease in heart rate.
Cushing's Reflex is characterized by an increase in systolic blood pressure, a decrease in heart rate, and a change in respiratory pattern.
Bruising around the eyes, known as raccoon eyes or periorbital ecchymosis, can indicate an intracranial injury.

Assessment and Management

When assessing a head injury, note any changes in the patient's mental status throughout assessment, treatment, and transport.
It is critical to note if the patient has lost consciousness.
The Glasgow Coma Scale is used for determining a patient's level of responsiveness.
During the physical exam of a patient with a head injury, examine the head for deformities, depressions, lacerations, impaled objects, or bruising.
Standard Precautions should be taken before initiating emergency care for a patient with a head injury.
Manual spine motion restriction (MSMR) should be applied to prevent further spinal cord injury.
Provide immediate transport for patients with a head injury.
Ensure proper airway management and oxygen administration.
Monitor ABCs (airway, breathing, circulation).

Types of Brain Injuries

Concussion is a mild traumatic brain injury.
A contusion involves bruising and swelling of the brain tissue.
Hematoma is a collection of blood within the skull or brain tissue.
Laceration is a tearing or cut in the brain tissue.

Mechanisms of Injury

Common mechanisms of injury that cause head injuries include: motor vehicle crashes, assaults, falls, and sports injuries.

Spinal Injury and Spine Motion Restriction

Signs and symptoms of spinal injury:
- Paralysis
- Priapism
- Incontinence
- Hyperglycemia is NOT a sign or symptom of spinal injury
The nervous system:
- Central nervous system (CNS): brain and spinal cord
- Peripheral nervous system (PNS): nerves outside the brain and spinal cord
- Autonomic nervous system: controls involuntary functions (heartbeat, breathing)
- Somatic nervous system: controls voluntary functions (muscle movement)
Common types of helmets:
- Sports helmets
- Motorcycle helmets
Mechanism of injury:
- Distraction: stretching and pulling apart of vertebrae and spinal cord
Spine motion restriction:
- Initiate motion restriction before opening the airway.
- Cervical collar: applied first
- Short spine board: used for extrication
Spinal shock:
- Cool and sweaty skin is typical
- Inhibits neural transmissions to arteries and arterioles
- May be called neurogenic shock
Signs of spinal cord injury:
- Paralysis of extremity (most common and reliable)
- Priapism
The skeletal system:
- Provides framework, support, and motion
The spinal column:
- Made up of 33 vertebrae
- Cervical vertebrae (C1-C7): neck
- Thoracic vertebrae (T1-T12): chest
- Lumbar vertebrae (L1-L5): lower back
- Sacral vertebrae (S1-S5): sacrum
- Coccyx: tailbone
Procedures for spine motion restriction:
- Supine patient with backboard or full-body vacuum mattress:
  - Position long spine board or full-body vacuum mattress
  - Apply cervical collar
  - Place patient's head in neutral in-line position
  - Secure patient's legs to the board
  - Move patient onto the board
  - Secure patient's torso to the board
  - Secure patient's head to the board
- Self-extrication from a motor vehicle:
  - Assess for pain or tenderness
  - Instruct patient to maintain head/neck in neutral in-line position
  - Assess motor and sensory function in upper and lower extremities
  - Instruct patient to rotate 180 degrees
  - Instruct patient to pivot legs and body to get legs outside vehicle
  - Instruct patient to stand straight up
  - Apply cervical collar
  - Secure patient to stretcher
Incomplete spinal cord injury:
- May result in paralyzed arms and functional legs.
- Still requires spine motion restriction precautions.
Spider-web-cracked windshield:
- Indicates potential for driver's spine motion restriction.

Eye Anatomy

The anterior chamber of the eye contains aqueous humor
The sclera is the tough outer coat of the globe of the eye

Eye Injuries

Extrusion is an eye injury where the eye is pulled out of its socket.
Orbital fractures can cause double vision or decreased sensation in the face.
The conjunctiva is the thin covering of the inner eyelids.
Never attempt to remove a foreign object from the cornea
Irrigate a chemical burn to the eye for at least 20 minutes or up to 1.5 hours if the injury involves an alkali.
Saline is a good irrigant for chemical burns to the eye.
If an eyeball injury is not suspected, cover the injured eyelid with a cold compress to reduce swelling.
If a foreign object is lodged in the eyeball, do not attempt to remove it.

Facial Anatomy

The malar (cheek) bones are facial bones.
The mandible is the only facial bone not fused into immovable joints.
Many blood vessels in the face can cause profuse bleeding during facial injuries.

Facial Injuries

Orbital fractures may result in cervical spine trauma.
Facial fractures can cause airway compromise.
Maintain an open airway in patients with facial fractures.
Treat facial lacerations with direct pressure and dressings
With chemical burns to the eye, irrigate the eye for at least 20 minutes.
Never attempt to replace an extruded eyeball back into the socket.

Neck

The neck contains the carotid arteries and jugular veins.
When treating a neck wound, apply an occlusive dressing to prevent air from entering the wound.
Neck injuries may cause airway compromise or spine injuries.

Additional Information

Facial injuries are often complicated by contact lenses
Never attempt to remove contact lenses if there has been a chemical burn to the eye.
Always suspect cervical spine injury in cases of severe facial trauma.

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Description

Explore the essential components and protective structures of the central nervous system, including the brain and spinal cord. This quiz covers skull anatomy, types of brain injuries, and associated symptoms. Test your knowledge on how the brain is safeguarded against injuries and the implications of various hematomas.