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This handout contains a quiz on head trauma. It features multiple-choice questions covering various aspects of brain injuries and emergency care.

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Handout 31-1 Student’s Name CHAPTER 31 QUIZ Write the letter of the best answer in the space provided. 1. The major components of the central nervous system are the brain and the...

Handout 31-1 Student’s Name CHAPTER 31 QUIZ Write the letter of the best answer in the space provided. 1. The major components of the central nervous system are the brain and the A. cranium. C. spinal cord. B. spinous process. D. dura mater. 2. If a patient tries to move away from or remove a painful stimulus, this response is termed A. purposeful movement. C. catatonic movement. B. nonpurposeful movement. D. decorticate movement. 3. The helmet-like structure that protects the brain is called the A. basilar skull. C. dura mater. B. cranial skull. D. meninges. 4. The weakest portion of the skull, which is made up of many separate bones, is called the A. basilar skull. C. parietal skull. B. temporal skull. D. occipital skull. 5. Because of the scalp’s rich blood supply, one likely result of a scalp injury is A. Battle’s sign. B. bleeding from the ears. C. cerebrospinal fluid leaking from the nose. D. profuse bleeding. 6. After taking Standard Precautions, the first step in providing emergency care to a patient with skull fractures and brain injuries is to A. apply a cervical collar. B. control bleeding with direct pressure. C. provide manual spine motion restriction of the head. D. transport the patient immediately. 7. A collection of blood within the skull or brain tissue is called a A. hematoma. C. concussion. B. contusion D. laceration. 8. Within the skull, the brain is cushioned in a dense serous substance called A. cerebrospinal fluid. C. pericardial fluid. B. meningeal fluid. D. peritoneal fluid. 9. All of the following structures are part of the brainstem except the A. pons. C. medulla. B. midbrain. D. arachnoid. 10. All of the following are highly vascular membranes separating the cranium and the brain except the A. subarachnoid space. C. dura mater. B. pia mater. D. arachnoid. ©2018 by Pearson Education, Inc. C H A P T E R 3 1 Head Trauma Prehospital Emergency Care, 11th Ed. Handout 31-1 (continued) 11. All of the following are signs of Cushing’s reflex except a(n) A. increase in blood pressure. C. increase in heart rate. B. decrease in heart rate. D. change in respiratory status. 12. The bruising and swelling of brain tissue that may accompany concussion is called a(n) A. contusion. C. epidural rupture. B. stroke. D. subdural avulsion. 13. The extreme emergency following a skull fracture in which arterial bleeding pools between the skull and the outermost protective covering of the brain is called a(n) A. subdural hematoma. C. contusion. B. laceration. D. epidural hematoma. 14. In documenting a possible head or spine injury, it is critical to note whether the patient, even briefly, lost A. his breath. C. his balance. B. consciousness. D. capillary refill. 15. A head injury in which the scalp is lacerated but there is no opening in the skull is a(n) A. open head injury. C. epidural hematoma. B. closed head injury. D. subdural hematoma. ©2018 by Pearson Education, Inc. C H A P T E R 3 1 Head Trauma Prehospital Emergency Care, 11th Ed. Handout 31-2 Student’s Name IN THE FIELD Review the following real-life situation. Then answer the questions that follow. At 1800 hours on a hot summer afternoon, you and your crew are called to a domestic dispute. Dispatch informs you that guns were involved in the incident. When you arrive, the police have secured the scene and it is safe. When you enter the scene, you find a 32-year-old male patient who is combative and responds only to painful stimuli. You note an entrance wound on the left parietal area. Primary assessment reveals an increasing blood pressure, decreasing heart rate, and altered respirations. 1. What are your initial management considerations? 2. Explain your transport decision. 3. Which interventions should be carried out while en route to the definitive care facility? ©2018 by Pearson Education, Inc. C H A P T E R 3 1 Head Trauma Prehospital Emergency Care, 11th Ed. Handout 31-3 Student’s Name CHAPTER 31 REVIEW Write the word or words that best complete each sentence in the space provided. 1. The major components of the are the brain and the spinal cord. 2. The serous substance called protects the brain and spinal cord against impact. 3. Because head injuries can be so serious, the EMT must always be alert for signs of the mechanism of injury during the ____________________ __________________________. 4. The skull is made up of plates of large, flat bones that are fused together to form a helmet-like covering. 5. Inside the skull, the brain is protected from injury by three layers of _____________. 6. The scalp has many _________________ __________________, so any scalp injury may bleed profusely. 7. hematoma is the most common type of head injury. 8. Bruising and swelling of the brain tissue, also known as a(n) ______________, occurs when the force of a blow is great enough to rupture blood vessels. 9. In addition to AVPU, some EMS systems use the for determining a patient’s level of responsiveness. 10. A late finding in a patient with a significant brain injury is that blood pressure and heart rate. 11. Two nonpurposeful responses that a patient with a head injury might make are and. 12. During the physical exam of a patient with a head injury, the EMT would examine the head for , , , or around the head and face. 13. The lowest level of responsiveness on the AVPU scale is. ©2018 by Pearson Education, Inc. C H A P T E R 3 1 Head Trauma Prehospital Emergency Care, 11th Ed. Handout 31-3 (continued) 14. A purplish discoloration of the soft tissues around one or both eyes is called and may be an indication of intracranial injury. 15. In documenting injuries to the head and spine, the EMT would carefully note any changes in the patient’s throughout assessment, treatment, and transport. ©2018 by Pearson Education, Inc. C H A P T E R 3 1 Head Trauma Prehospital Emergency Care, 11th Ed. Handout 31-4 Student’s Name HEAD TRAUMA: LISTING 1. List four different types of brain injuries. 2. List, in order from outer to inner, the meningeal layers. 3. List the three anatomic components of the brain, and give one function or characteristic of each. 4. List four mechanisms of injury that commonly produce head injuries. 5. List the three signs indicative of Cushing reflex. ©2018 by Pearson Education, Inc. C H A P T E R 3 1 Head Trauma Prehospital Emergency Care, 11th Ed. Handout 31-5 Student’s Name RECOGNIZING BRAIN STRUCTURE Demonstrate your familiarity with the anatomy of the brain by writing the names of the following structures in the appropriate places on the diagram below. Arachnoid Cerebellum Cerebral cortex Cranium Dura mater Medulla oblongata Pia mater Spinal cord ©2018 by Pearson Education, Inc. C H A P T E R 3 1 Head Trauma Prehospital Emergency Care, 11th Ed. CHAPTER 31 ANSWER KEY HANDOUT 31-1: Chapter 31 Quiz HANDOUT 31-4: Head Trauma: Listing 1. C 5. D 9. D 13. D 1. Any four: concussion, contusion, hematoma, 2. A 6. C 10. A 14. B laceration, diffuse axonal injury, brain herniation, 3. B 7. A 11. C 15. B epidural/subdural bleeds, open brain injuries, closed brain injuries, primary brain injuries, secondary brain 4. A 8. A 12. A injuries 2. Dura mater, arachnoid, pia mater. HANDOUT 31-2: In the Field 3. Cerebrum—largest portion of the brain, 1. Cervical spine motion restriction precautions; responsible for most conscious and sensory ABCs (airway, breathing, circulation). functions, emotions, personality. Cerebellum— 2. Based on the patient’s condition, mechanism of controls equilibrium and coordinates muscle injury, and mental status compromise, you should activity, controls muscle movement and immediately package and rapidly transport him. coordination, coordinates reflexes. Brainstem— 3. The interventions include continued airway most primitive and best protected management and oxygen administration; constant part of brain, controls most automatic evaluation of the level of consciousness; frequent functions of the body. obtaining of vital signs and comparison to the baseline 4. Motor vehicle crashes, assaults/violence, vital signs; wound management; frequent assessment of falls, sports injuries. neurologic status. If it is available, a request for 5. Increase in systolic blood pressure, decrease in advanced life support assistance would be appropriate. heart rate, change in respiratory pattern. HANDOUT 31-3: Chapter 31 Review HANDOUT 31-5: Recognizing Brain Structure 1. central nervous system 2. cerebrospinal fluid 3. scene size-up 4. cranial 5. meninges 6. blood vessels 7. Subdural 8. contusion 9. Glasgow Coma Scale 10. increases, decreases 11. flexion, extension 12. deformities, depressions, lacerations, impaled objects 13. unresponsive 14. raccoon sign (or periorbital ecchymosis) 15. mental status ©2018 by Pearson Education, Inc. C H A P T E R 3 1 Head Trauma Prehospital Emergency Care, 11th Ed.

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