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Paramedic Care Volume 5 - Trauma > Chapter 11 - Nervous System Trauma > Flashcards

Chapter 11 - Nervous System Trauma Flashcards

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1
Q

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

A

pg 285

Pia mater, arachnoid, dura mater

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2
Q

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

A

pg 285

dura mater

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3
Q

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

A

pg 286

falx cerebri.

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4
Q

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

A

pg 286

False

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5
Q

What is a function of the hypothalamus?

A

pg 286

Body temperature control

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6
Q

What is a function of the thalamus?

A

pg 150

Control of the ascending reticular activating system

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7
Q

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

A

pg 286

Control of respiration

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8
Q

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.

A

pg 287

True

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9
Q

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

A

pg 287

True

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10
Q

The normal intracranial pressure is

A

pg 287

less than 10 mmHg.

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11
Q

Perfusion through the cerebrum is a factor of intracranial pressure and

A

pg 287

mean arterial pressure

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12
Q

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

A

pg 287

autoregulation.

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13
Q

Which nerve is responsible for slowing the heart rate?

A

pg 288

CN-X

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14
Q

Which nerve is responsible for voluntary movement of the tongue

A

pg 288

CN-XII

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15
Q

Which nerve control eye movement?

A

pg 288

CN 3/4/6

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16
Q

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

A

pg 289

lumbar.

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17
Q

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

A

pg 289

ascending tracts.

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18
Q

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

A

pg 289

white matter.

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19
Q

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

A

pg 290

True

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20
Q

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

A

pg 291

thoracic spine.

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21
Q

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

A

pg 292

Cervical Spine.

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22
Q

The S-1 nerve root controls the

A

pg 292

small toe.

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23
Q

The T-10 nerve root controls the

A

pg 292

umbilicus

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24
Q

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?

A

pg 292

C-3

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25
Q

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

A

pg 294

contrecoup.

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26
Q

Which of the following is considered a focal injury

A. Cerebral contusion
B. Epidural hematoma
C. Subdural hematoma
D. Intracerebral hemorrhage
E. All of the above

A

pg 294

E. All of the above

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27
Q

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

A

pg 294

Epidural hematoma

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28
Q

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

A

pg 294

Subdural hematoma

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29
Q

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

A

pg 295

Concussion.

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30
Q

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)

A

pg 295

concussion & epidural hematoma

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31
Q

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

A

pg 295

True

32
Q

All of the following result in indirect injury to the brain, EXCEPT

A. diminishing circulation to brain tissue.

B. hypertension.

C. hypoxia.

D. hypercarbia.

E. displacement of brain tissue.

A

pg 296

B. hypertension.

33
Q

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

A

pg 296

Venous blood

34
Q

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

A

pg 296

Cerebral artery dilation

35
Q

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

A

Pg 297

tentorium incisura.

36
Q

Cushing’s triad includes

A

pg 298

Erratic Respirations

Increasing BP

Slowing Heart Rate

37
Q

Which of the following respiratory patterns is NOT indicative of brain injury?

Eupnea

Cheyne-Stokes respirations

Ataxic respirations

Agonal respirations

Central neurogenic hyperventilation

A

pg 298

Eupnea

38
Q

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

A

pg 298

bulge.

39
Q

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

A

pg 298

False

40
Q

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

A

pg 299

transection.

41
Q

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

A

pg 299

central cord syndrome.

42
Q

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

A

pg 299

Brown-Sequard syndrome.

43
Q

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

A

pg 300

True

44
Q

What are signs sign associated with neurogenic shock?

A

pg 301

Priapism

Decreased heart rate

Decreased peripheral vascular resistance

Warm skin below the injury

45
Q

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

A

pg 301

Autonomic hyperreflexia syndrome

46
Q

An episode of transient quadriplegia usually lasts less than

A

pg 154

15 minutes.

47
Q

Pediatric patients display different spinal injury patterns than adults for all of the following
reasons, EXCEPT

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.

A

pg 301

B. calcified, wedge-shaped vertebrae.

48
Q

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

A

pg 303

35 to 40 mmHg.

49
Q

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

A

pg 303

Zero

50
Q

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

A

pg 303

96%

51
Q

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

A

pg 303

25 breaths per minute.

52
Q

What are signs indicative of cerebral herniation?

A

pg 304

Increasing blood pressure

Erratic respirations

Decreasing heart rate

Dilated and fixed pupil

53
Q

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

A

pg 304

Slowing pulse rate & Increasing pulse strength

54
Q

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

A

pg 304

consensual reactivity.

55
Q

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

A

pg 305

paralysis.

paresthesia.

paraparesis

anesthesia

56
Q

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

A

pg 306

False

57
Q

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

A

pg 306

eye opening, verbal response, and motor response.

58
Q

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?

A

pg 306

GCS of 14

59
Q

The highest Glasgow Coma Scale score is

A

pg 306

GCS 15

60
Q

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?

A

pg 306

GCS of 8

61
Q

Priapism secondary to spinal injury is the result of

A

pg 308

unopposed parasympathetic stimulation.

62
Q

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

A

pg 308

photophobia.

63
Q

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

A

pg 309

Recovery position with the head of the stretcher raised 30 degrees

64
Q

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

A

pg 309

With the head of the spine board elevated 30 degrees

65
Q

All of the following are indications for rapid-sequence intubation EXCEPT for a patient who

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.

A

pg 309

is completely unresponsive.

66
Q

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.

A

pg 309

False

67
Q

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

A

Pg 308

90 mmHg

68
Q

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

A

pg 310

Succinylcholine

69
Q

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

A

pg 310

False

70
Q

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

A

pg 310

Flumazenil

71
Q

Which of the following actions of atropine make it a desirable adjunct to rapid-sequence
intubation?

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.

A

pg 310

E. All of the above.

72
Q

Which of the following is used in the prehospital setting for the treatment of spine injuries?

Mannitol

Furosemide

Methylprednisolone

Dexamethasone

None of the above

A

pg 311

None of the above

73
Q

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

A

pg 310

Atropine

74
Q

Dextrose is administered to the head injury patient

A

pg 311

for hypoglycemia only.

75
Q

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

A

pg 311

Dopamine

Paramedic Care Volume 5 - Trauma (11 decks)

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