EMT Chapter 28 - Head and Spine Injuries
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Questions and Answers

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:

  • Hyperflexion
  • Hyperextension
  • Axial loading (correct)
  • Distraction
  • A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response?

  • 3 (correct)
  • 4
  • 2
  • 5
  • A tight-fitting motorcycle helmet should be left in place unless:

  • The helmet is equipped with a full face shield or visor.
  • It interferes with your assessment of the airway. (correct)
  • The patient complains of severe neck or back pain.
  • The patient must be placed onto a long backboard.
  • An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is:

    <p>A rapid deterioration of neurologic signs.</p> Signup and view all the answers

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

    <p>A rapid, thready pulse.</p> Signup and view all the answers

    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:

    <p>Suction his oropharynx for up to 15 seconds.</p> Signup and view all the answers

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

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

    In contrast to a cerebral concussion, a cerebral contusion:

    <p>Involves physical injury to the brain tissue.</p> Signup and view all the answers

    Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless:

    <p>It causes a problem managing the airway.</p> Signup and view all the answers

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

    <p>Brain and spinal cord.</p> Signup and view all the answers

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

    <p>Cervical, thoracic, lumbar, sacral, and coccygeal.</p> Signup and view all the answers

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

    <p>Eye opening, verbal response, and motor response.</p> Signup and view all the answers

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

    <p>The four-person log roll.</p> Signup and view all the answers

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

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

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

    <p>Pupillary constriction.</p> Signup and view all the answers

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

    <p>Rupture of the tympanic membrane following diffuse impact to the head.</p> Signup and view all the answers

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

    <p>The patient has been completely secured to the backboard.</p> Signup and view all the answers

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

    <p>Irregular rate, pattern, and volume of breathing with intermittent periods of apnea</p> Signup and view all the answers

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

    <p>Hypoxia and hypotension are the two most common causes of secondary brain injury.</p> Signup and view all the answers

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

    <p>Slow.</p> Signup and view all the answers

    Study Notes

    Mechanisms of Injury

    • Axial loading occurs when a person lands directly on their feet from a height, often causing injury to lower extremities and back.
    • Hyperextension spinal injuries frequently result from hangings.

    Head Injury Assessment

    • An abnormal flexion response in extremities indicates a motor response score of 3 on the Glasgow Coma Scale (GCS).
    • Rapid deterioration of neurological signs can suggest an expanding intracranial hematoma.
    • Common indicators of serious head injuries include CSF leakage from ears, decerebrate posturing, and widening pulse pressure; a rapid, thready pulse is not typical.

    Helmet and Patient Management

    • Tight-fitting motorcycle helmets should remain unless airway assessment is hindered by the helmet.
    • In cases of severe head trauma with airway issues, suctioning the oropharynx may be necessary for up to 15 seconds.

    Structural Considerations

    • The central nervous system comprises the brain and spinal cord.
    • The spinal column consists of five sections: cervical, thoracic, lumbar, sacral, and coccygeal, listed from top to bottom.
    • The sympathetic nervous system activation excludes pupillary constriction, which is typically a parasympathetic response.

    Moving and Immobilization Techniques

    • The ideal method to transfer an injured patient to a backboard is the four-person log roll technique.
    • Once a cervical collar is applied, it should only be removed if airway management is compromised.

    Breathing Patterns and Secondary Injuries

    • Irregular breathing, with variable patterns and apnea, signals increased intracranial pressure.
    • Secondary brain injury is often caused by hypoxia and hypotension, rather than being a direct result of the initial trauma.

    Patient Signs and Recommendations

    • A slow pulse in a patient with a head injury raises concern for significant brain injury.
    • If bloody fluid drains from an ear, it may indicate tympanic membrane rupture following head impact.

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    Test your knowledge on head and spine injuries with this EMT Chapter 28 quiz. Examine various types of injuries and understand their mechanisms through detailed flashcards. Perfect for EMT students who want to reinforce their understanding of critical concepts.

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