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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:
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?
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:
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:
An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is:
Common signs and symptoms of a serious head injury include all of the following, EXCEPT:
Common signs and symptoms of a serious head injury include all of the following, EXCEPT:
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:
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:
Hyperextension injuries of the spine are MOST commonly the result of:
Hyperextension injuries of the spine are MOST commonly the result of:
In contrast to a cerebral concussion, a cerebral contusion:
In contrast to a cerebral concussion, a cerebral contusion:
Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless:
Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless:
The central nervous system (CNS) is composed of the:
The central nervous system (CNS) is composed of the:
The five sections of the spinal column, in descending order, are the:
The five sections of the spinal column, in descending order, are the:
The Glasgow Coma Scale (GCS) is used to assess:
The Glasgow Coma Scale (GCS) is used to assess:
The ideal procedure for moving an injured patient from the ground to a backboard is:
The ideal procedure for moving an injured patient from the ground to a backboard is:
What part of the nervous system controls the body's voluntary activities?
What part of the nervous system controls the body's voluntary activities?
When activated, the sympathetic nervous system produces all of the following effects, EXCEPT:
When activated, the sympathetic nervous system produces all of the following effects, EXCEPT:
When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear. This indicates:
When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear. This indicates:
When immobilizing a trauma patient's spine, the EMT manually stabilizing the head should not let go until:
When immobilizing a trauma patient's spine, the EMT manually stabilizing the head should not let go until:
Which of the following breathing patterns is MOST indicative of increased intracranial pressure?
Which of the following breathing patterns is MOST indicative of increased intracranial pressure?
Which of the following statements regarding secondary brain injury is correct?
Which of the following statements regarding secondary brain injury is correct?
You should be MOST suspicious that a patient has experienced a significant head injury if his or her pulse is:
You should be MOST suspicious that a patient has experienced a significant head injury if his or her pulse is:
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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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