Adult emergencies 3

Question 1

within the cranal vault there are 3 space occupying substances. what are they

Answer 1

brain tissue, CSF, Blood

Question 2

whati si the most widely accepted tool to assess LOC in a head injured patient

Answer 2

GCS

Question 3

Describe the components of the GCS

Answer 3

best eye, best verbal, best motor response to stimulus

Question 4

Why is using the GCS important

Answer 4

can pick up any trending

Question 5

what is the cause of a fixed and dilated pupil

Answer 5

pressure on the 3rd cranial nerve,the oculomotor nerve, usually from compression or herniation of the tentorium of the brain

Question 6

An epidural bleed us a what kind of bleed

Answer 6

arterial

Question 7

a sub dural bleed us what kind of bleed

Answer 7

venous

Question 8

of the 2 types of head bleeds which has more sudden onset

Answer 8

Arterial

Question 9

as pressure from swelling occurs in the cranial vault, you may see the classic cushings triad. What are these classic signs

Answer 9

increase in BP, Decrease in HR, Erratic respirations

Question 10

what is your first priority in the management of closed head injury

Answer 10

airway

Question 11

name 2 interventions that are done pre hospital which can increase ICP

Answer 11

suctioning, intubation, poor alignment, tight c collar

Question 12

your are assessing a patients “posturing”

describe decorticate and decerbrate

Answer 12

decorticate: flexing of upper extermities to protect the core
decerebrate: extension

Question 13

what are the 3 most important prehospital interventions to enhace the outcome of a Closed head injury patient are

Answer 13

good outcome from a bad CHI is directly related to airway maintenane, great oxygenation and pefussing pressure

Question 14

significant facial trauma can challenge the skills f the best Paramedic because

Answer 14

airway obstructions, difficulty maintaining an airway

Question 15

in facial injury a mojor distracter to a life threat is

Answer 15

lots of blood

Question 16

any patient with a major facial injury is considered to have an accompanying

Answer 16

head and neck injury

Question 17

which cranial nerve controls eye movement

Answer 17

number 3

Question 18

which type of facial fracture will produce total craniofacial separation

Answer 18

Le Fort 3

Question 19

which type of fracture causes enophthalmos

Answer 19

orbital fracture, also causes entrapment fo the eye, eye is unable to move due to bone fragments/ pressure impinging on the nerve

Question 20

list 3 things to assess for when suspicious of a mandible gracture

Answer 20

malocclusion, inability to open mouth, numbness on chin

Question 21

you are palpating for a zygoma gracture, what are you assesing for

Answer 21

flatness fo the cheek

Question 22

you are assessing a hockey player for a possible larynx fracture. what are symptom/s are you listening for

Answer 22

hoarsness, stridor

Question 23

what are symptom/s ou palpate for when looking for a larynx fracture

Answer 23

sub Q emphysema

Question 24

the most common facial fracture is

Answer 24

nasal fracture

Question 25

define transfer of energy

Answer 25

as relates to trauma, the transfer of energy from an external source to human tissue. the injury is dependant upon the amount of force applied, the type of tissue that the force is applies to

Question 26

transfer or energy to a hollow organ such as the small bowel will cause the bowel to

Answer 26

burst like a balloon

Question 27

transfer of energy to a solid organ such as the liver will cause the liver to

Answer 27

fracture

Question 28

the amount of energy required to fracture an adult femur is more than the amount of energy required to fracture an adult ulnar bone. Why

Answer 28

related to mass and density

Question 29

when MOI involves a shearing force, the greatest shear occurs where?

Answer 29

at the points of attachment

Question 30

what are several anatomical points where shearing forces can cause damage. Name 2 of these

Answer 30

Ligament of Trietz in abdomen, Ligamentum Atteriosum off the aorta

Question 31

what mechanism suggests why is a car crash at 70 MPH more deadly than a head on a 10 MPH

Answer 31

high velocity vs low velocity, the sudden deceleration of 70 mph vs 10 mph

Question 32

true or false, penetrating injury from a bullet always follows a straight pathway once in the body

Answer 32

false

Question 33

name 3 types of forces, besides shearing forces, which are involved in MOI's

Answer 33

comprssion, acceleration-deceleration, penetrating

Question 34

what is the best score on the GCS

Answer 34

15

Question 35

list the motor response in the GCS....remember 4.56

Answer 35

``` 6-obey comands 5-localize to stimuli 4-withdraws from stimuli 3-abnormal flexion-decorticate 2-extensor response-decerebrate 1-no response ```

Question 36

list the verbal response in the GCS

Answer 36

``` 5-alert and oriented 4-confused yet coherent, speech 3-inappropriate words and jumbles phrases 2-incomprehensible sounds 1-no sounds ```

Question 37

list the eye opening response in the GCS

Answer 37

4-spontaneous eye opening 3-eyes open to speech 2-eyes open to pain 1-no eye opening

Question 38

how much blood loss can occur in your pelvis

Answer 38

2L

Question 39

how much blood loss can occur in your thigh

Answer 39

1L

Question 40

how much blood loss can occur in your tibia

Answer 40

500ml

Question 41

where should you always splint a limb

Answer 41

above and below the injury

Question 42

when do you document CMS

Answer 42

before and after splinting

Question 43

what is volkmanns contracture

Answer 43

claw like contraction of hand and arm deformity from ischemia

Question 44

where is a boxer's fracture

Answer 44

5th metatarsal

Question 45

what organs can pelvic fractures damage

Answer 45

bladder, urethra, reproductive organs, and sacral nerve

Question 46

what are the six P's of compartment syndrome

Answer 46

1. Pain 2. Pallor 3. Pulses 4. Pressure 5. Paralysis 6. Parasthesia

Question 47

what is lafort 1 injury

Answer 47

separates hard palate, teeth, from maxilla

Question 48

what is lafort 2 injury

Answer 48

pyramid fracture of mid face separates nasal and lower maxilla from facial skull and cranial bones

Question 49

what is lafort 3 injury

Answer 49

separates the entire mid face from the cranium

Question 50

Name what each cranial nerve represents..1,2,3,6,7

Answer 50

``` 1- olfactory 2-optic 3- ocular movement 6-facial nerve 7- auditory nerve ```