Chapter 11 - Nervous System Trauma Flashcards by Al Townsend

Which of the following places the layers of the meninges in the correct order as they occur
from the cerebrum to the skull?

pg 285

Pia mater, arachnoid, dura mater

How well did you know this?

Not at all

Perfectly

The layer of the meninges that is strong and lines the interior of the cranium is the

pg 285

dura mater

How well did you know this?

Not at all

Perfectly

The structure that divides the cerebrum into left and right halves is the

pg 286

falx cerebri.

How well did you know this?

Not at all

Perfectly

T/F - The cerebellum is the center of conscious thought and perception

pg 286

False

How well did you know this?

Not at all

Perfectly

What is a function of the hypothalamus?

pg 286

Body temperature control

How well did you know this?

Not at all

Perfectly

What is a function of the thalamus?

pg 150

Control of the ascending reticular activating system

How well did you know this?

Not at all

Perfectly

Which of the following is a function of the medulla oblongata?

pg 286

Control of respiration

How well did you know this?

Not at all

Perfectly

T/F - While the brain accounts for only 2 percent of the total body weight, it requires 15 percent of
the cardiac output and 20 percent of the body’s oxygen supply.

pg 287

True

How well did you know this?

Not at all

Perfectly

T/F - The capillaries serving the brain are thicker and less permeable than those in the rest of the
body.

pg 287

True

How well did you know this?

Not at all

Perfectly

The normal intracranial pressure is

pg 287

less than 10 mmHg.

How well did you know this?

Not at all

Perfectly

Perfusion through the cerebrum is a factor of intracranial pressure and

pg 287

mean arterial pressure

How well did you know this?

Not at all

Perfectly

The reflex that increases the systemic blood pressure to maintain cerebral blood flow is called

pg 287

autoregulation.

How well did you know this?

Not at all

Perfectly

Which nerve is responsible for slowing the heart rate?

pg 288

CN-X

How well did you know this?

Not at all

Perfectly

Which nerve is responsible for voluntary movement of the tongue

pg 288

CN-XII

How well did you know this?

Not at all

Perfectly

Which nerve control eye movement?

pg 288

CN 3/4/6

How well did you know this?

Not at all

Perfectly

The region of the vertebral column in which the spinal cord ends is the

pg 289

lumbar.

How well did you know this?

Not at all

Perfectly

The nerve tissue(s) responsible for communicating sensory impulses to the brain is (are) the

pg 289

ascending tracts.

How well did you know this?

Not at all

Perfectly

The nerve tissue(s) consisting of nerve cell axons and making up the exterior portion of the
spinal cord is (are) the

pg 289

white matter.

How well did you know this?

Not at all

Perfectly

T/F - The structure of the meninges of the spinal column is similar to the structure of the meninges
of the cranium.

pg 290

True

How well did you know this?

Not at all

Perfectly

The region of the spine with the closest tolerance between the spinal cord and the interior of
the spinal foramen is the

pg 291

thoracic spine.

How well did you know this?

Not at all

Perfectly

The region of the spine that has one more pair of nerve roots than it does vertebrae is the

pg 292

Cervical Spine.

How well did you know this?

Not at all

Perfectly

The S-1 nerve root controls the

pg 292

small toe.

How well did you know this?

Not at all

Perfectly

The T-10 nerve root controls the

pg 292

umbilicus

How well did you know this?

Not at all

Perfectly

During your assessment of a patient, you find sensation is lost as you move from the lower
extremities all the way up to the level of the collar. This is probably due to an injury at which
spinal level?

pg 292

C-3

How well did you know this?

Not at all

Perfectly

The type of injury that causes damage to the brain on the side opposite the impact is called

pg 294 contrecoup.

Which of the following is considered a focal injury ## Footnote A. Cerebral contusion B. Epidural hematoma C. Subdural hematoma D. Intracerebral hemorrhage E. All of the above

pg 294 E. All of the above

Which of the following injuries is most likely to cause the patient to deteriorate rapidly?

pg 294 Epidural hematoma

Which of the following is an injury with venous bleeding into the arachnoid space?

pg 294 Subdural hematoma

What type head injury would you NOT expect to get worse with time?

pg 295 Concussion.

The injury that classically presents with unconsciousness immediately after an accident followed by a lucid interval and then a decreasing level of consciousness is most likely a(n)

pg 295 concussion & epidural hematoma

T/F - Indirect brain injury occurs as a result of, but after, initial injury.

pg 295 True

All of the following result in indirect injury to the brain, EXCEPT ## Footnote A. diminishing circulation to brain tissue. B. hypertension. C. hypoxia. D. hypercarbia. E. displacement of brain tissue.

pg 296 B. hypertension.

As intracranial hemorrhage begins, it first displaces which occupant of the cranium

pg 296 Venous blood

High levels of carbon dioxide in the blood will cause which of the following

pg 296 Cerebral artery dilation

Vomiting, changes in the level of consciousness, and pupillary dilation result from herniation of the upper brainstem through the

Pg 297 tentorium incisura.

Cushing's triad includes

pg 298 Erratic Respirations Increasing BP Slowing Heart Rate

Which of the following respiratory patterns is NOT indicative of brain injury? ## Footnote Eupnea Cheyne-Stokes respirations Ataxic respirations Agonal respirations Central neurogenic hyperventilation

pg 298 Eupnea

In the presence of increased intracranial pressure, the fontanelles of the infant will

pg 298 bulge.

T/F - A spinal cord concussion is likely to produce residual deficit.

pg 298 False

A patient who presents with quadriplegia, incontinence, and respiratory paralysis has most likely sustained which type of spinal cord injury?

pg 299 transection.

A spinal cord injury more commonly occurring in patients older than 50 years of age is

pg 299 central cord syndrome.

A penetrating spinal cord injury affecting one side of the cord is known as

pg 299 Brown-Sequard syndrome.

T/F - Spinal shock is a temporary form of neurogenic shock

pg 300 True

What are signs sign associated with neurogenic shock?

pg 301 Priapism Decreased heart rate Decreased peripheral vascular resistance Warm skin below the injury

Which of the following is associated with the resolution of shock due to cord injury and results in hypertension?

pg 301 Autonomic hyperreflexia syndrome

An episode of transient quadriplegia usually lasts less than

pg 154 15 minutes.

Pediatric patients display different spinal injury patterns than adults for all of the following reasons, EXCEPT ## Footnote A. underdeveloped neck muscles. B. calcified, wedge-shaped vertebrae. C. shallow, horizontally oriented facet joints. D. proportionately larger head. E. increased spinal elasticity and mobility.

pg 301 B. calcified, wedge-shaped vertebrae.

Capnography-guided ventilations for the patient without suspected cerebral herniation should keep the end-tidal CO2 readings at

pg 303 35 to 40 mmHg.

Endotracheal intubation is indicated in patients with a Simplified Motor Score of

pg 303 Zero

Oxygenation of the head injury patient, who is breathing adequately, should be guided by oximetry to maintain a saturation of at least

pg 303 96%

The approximate rate of ventilation for the infant head injury patient is

pg 303 25 breaths per minute.

What are signs indicative of cerebral herniation?

pg 304 Increasing blood pressure Erratic respirations Decreasing heart rate Dilated and fixed pupil

Which of the following is a probable sign of increasing intracranial pressure?

pg 304 Slowing pulse rate & Increasing pulse strength

When light intensity changes in one eye and both respond, this response is called

pg 304 consensual reactivity.

When assessing limb sensation in the spine-injured patient, you should check for

pg 305 paralysis. paresthesia. paraparesis anesthesia

T/F - A wide pulse pressure is a sign of cardiovascular compensation and decreasing intracranial pressure.

pg 306 False

The Glasgow Coma Scale measures a patient's level of consciousness by assessing

pg 306 eye opening, verbal response, and motor response.

During your assessment you determine that the patient exhibits confused speech, follows simple commands, and opens his eyes on his own. What Glasgow Coma Scale value would you assign?

pg 306 GCS of 14

The highest Glasgow Coma Scale score is

pg 306 GCS 15

A patient who responds only to pain by withdrawing, mutters incomprehensible words when shouted at loudly, and opens his eyes only to pain is given what Glasgow Coma Scale score?

pg 306 GCS of 8

Priapism secondary to spinal injury is the result of

pg 308 unopposed parasympathetic stimulation.

When a patient reports sensitivity to light, this is an example of

pg 308 photophobia.

If the head injury patient is found without any other suspected injuries, what positioning would be best for him?

pg 309 Recovery position with the head of the stretcher raised 30 degrees

If the patient has sustained an open neck injury with danger of air embolism, what positioning would be best for him?

pg 309 With the head of the spine board elevated 30 degrees

All of the following are indications for rapid-sequence intubation EXCEPT for a patient who ## Footnote A. is experiencing trismus. B. is at risk of rapid airway swelling. C. is completely unresponsive. D. none of the above. E. has serious oral trauma.

pg 309 is completely unresponsive.

T/F - Care for the patient with increasing intracranial pressure must NOT include aggressive fluid resuscitation, even if the patient's blood pressure drops below 80 mmHg.

pg 309 False

The minimum blood pressure necessary to maintain cerebral perfusion in the adult patient with serious head injury is

Pg 308 90 mmHg

Which paralytic increases intracranial pressure and should be used with caution, if at all, in head injury patients?

pg 310 Succinylcholine

T/F - Diazepam is used to premedicate patients prior to inserting a supraglottic airway.

pg 310 False

Which of the following drugs will reverse the effects of diazepam and midazolam?

pg 310 Flumazenil

Which of the following actions of atropine make it a desirable adjunct to rapid-sequence intubation? ## Footnote A. It reduces vagal stimulation. B. It reduces airway secretions. C. It reduces fasciculations. D. It helps maintain heart rate during intubation. E. All of the above.

pg 310 E. All of the above.

Which of the following is used in the prehospital setting for the treatment of spine injuries? ## Footnote Mannitol Furosemide Methylprednisolone Dexamethasone None of the above

pg 311 None of the above

To address bradycardia in the suspected spinally injured patient, which drug would you consider?

pg 310 Atropine

Dextrose is administered to the head injury patient

pg 311 for hypoglycemia only.

If a suspected spinally injured patient does not respond to fluid resuscitation, which drug would you consider?

pg 311 Dopamine