Chapter 28 Flashcards by Gail I

nervous system is a complex network of nerve cells that enables all parts of the body to function 
includes: 
... 
... 
several billion ...

brain
spinal cord
nerve fibers

How well did you know this?

Not at all

Perfectly

the nervous system is well protected:
the brain is protected by the …
the spinal cord is protected by the …
despite this protection, serious injuries can damage the nervous system

skull; spinal canal

How well did you know this?

Not at all

Perfectly

the nervous system is divided into two anatomic parts:
… system
… system

central nervous

peripheral nervous

How well did you know this?

Not at all

Perfectly

(CNS) includes the … and …
the brain controls the body and is the center of …
brain is divided into three major areas: …, …, …

brain; spinal cord; consciousness; cerebrum; cerebellum; brainstem

How well did you know this?

Not at all

Perfectly

(CNS) …: controls a wide variety of activities, including most voluntary motor function and conscious though
…: coordinates balance and body movements
..: controls most functions necessary for life

cerebrum
cerebellum
brainstem

How well did you know this?

Not at all

Perfectly

(CNS) spinal cord: made up of fibers that extend from the brain’s …
carries messages between the brain and the body via the … and … of the spinal cord

nerve cells; grey and white matter

How well did you know this?

Not at all

Perfectly

(CNS) protective coverings:
brain and spinal cord are covered with thick, bony structures
the CNS is further protected by the …:
… (dura mater) is a tough, fibrous layer that forms a sac to contain the CNS
inner two layers (… and ..) contain the blood vessels

meninges; outer layer; arachnoid mater; pia mater

How well did you know this?

Not at all

Perfectly

(CNS) CSF: produced in a chamber inside the brain called the …
primarily acts as a …

third ventricle; shock absorber

How well did you know this?

Not at all

Perfectly

(peripheral NS) … pairs of spinal nerves–> conduct impulses from the skin and other organs to the …, conduct motor impulses from the spinal cord to the …
… pairs of cranial nerves–> transmit info directly to/from the brain

31; spinal cord; muscles; 12

How well did you know this?

Not at all

Perfectly

(peripheral NS) two types of peripheral nerves:
… nerves: carry only one type of info from the body to the brain via the spinal cord
… nerves: carry info from the CNS to the muscles

sensory; motor

How well did you know this?

Not at all

Perfectly

(peripheral NS) connecting nerves: found only in the … and …
connect the sensory and motor nerves with …
allow the exchange of …

brain; spinal cord; short fibers; simple messages

How well did you know this?

Not at all

Perfectly

nervous system controls virtually all the body’s activities, including:
… activities
… activities (consciously performed)
… activities (not under conscious control)

reflex
voluntary
involuntary

How well did you know this?

Not at all

Perfectly

connecting nerves in the spinal cord form a …–> if a sensory nerve detects an irritating stimulus, it bypasses the brain and sends the message directly to a …

reflex arc; motor nerve

How well did you know this?

Not at all

Perfectly

… nervous system handles voluntary activities
… nervous system handles body functions–> … ns reacts to stress with a fight-or-flight response
… ns has the opposite effect on the body

somatic; autonomic; sympathetic; parasympathetic

How well did you know this?

Not at all

Perfectly

(skeletal system) skull: the skull is composed of the …, which protects the brain, and the …
brain connects to the spinal cord

cranium; facial bones

How well did you know this?

Not at all

Perfectly

(skeletal system) skull contd:
four major bones make up the cranium: …, …, … regions, and … region
face is composed of 14 bones: …, …, …, …, and … bones

occiput; temples; parietal; frontal; maxilla; zygoma; mandible; nasal; frontal

How well did you know this?

Not at all

Perfectly

(skeletal system) spinal column:
body’s central supporting structure
… vertebrae are divided into five sections
vertebrae are connected by … and separated by cushions, called …
spinal column is almost entirely surrounded by …

33; ligaments; intervertebral disks; muscles

How well did you know this?

Not at all

Perfectly

(head injuries) traumatic insult to the head that may result in injury to soft tissue, bony structures, or the brain:
head injuries account for more than … of all traumatic deaths
fatal injuries invariably involve the …
be alert to the fact that the patient may have sustained additional trauma

half; brain

How well did you know this?

Not at all

Perfectly

(head injuries) closed injuries: the … has been injured but there is no opening into the brain
open injuries: often caused by .. trauma, may be bleeding and exposed brain tissue

brain; penetrating

How well did you know this?

Not at all

Perfectly

(head injuries) … are the most common MOI; other common MOIs include …, .., and ..-related injuries

motor vehicle crashes; assault; falls; sports

How well did you know this?

Not at all

Perfectly

scalp lacerations:
can be minor or serious
small lacerations can lead to significant … especially in children

blood loss

How well did you know this?

Not at all

Perfectly

(skull fracture) may be open/closed, depending on whether there is an overlying laceration of the scalp
signs of skull fracture include:
patient’s head appears …
visible … in the skull
… (bruising) under the eyes (raccoon eyes) or behind one ear over the mastoid process (battle’s sign)

deformed; cracks; ecchymosis

How well did you know this?

Not at all

Perfectly

(skull fracture) linear skull fractures: account for about …% of all skull fractures; radiographs are required to diagnose a linear skull fracture because there are often no … signs

80; physical

How well did you know this?

Not at all

Perfectly

(skull fracture) depressed skull fractures: result from high-energy direct trauma to the head by a blunt trauma. … may be driven into the brain, resulting in injury

bony fragments

(skull fracture) basilar skull fracture: associated with high-energy trauma signs include ... drainage from the ears, ... and ...

CSF; raccoon eyes; Battle's sign

traumatic brain injuries: most serious of all head injuries two broad categories: ... (direct) brain injury results instantaneously from impact to the head ... (indirect) brain injury increases the severity of the direct injury

primary; secondary

``` traumatic brain injuries: secondary injuries may be caused by: ... ... ... ... .. ... ... ```

``` hypoxia hypotension cerebral edema intracranial hemorrhage increased intracranial pressure cerebral ischemia infection ```

traumatic brain injuries: can result from blunt/penetrating trauma ... injury: initial impact injures front part of brain, head falling back against headrest injures rear part of brain ... (swelling of the brain) may not develop until several hours following the initial injury

coup-countercoup | cerebral edema

(intracranial pressure) accumulation of blood within the skull or swelling of the brain can rapidly lead to an increase in ICP: increased ICP squeezes the brain against ... within the cranium

bony prominences

``` (intracranial pressure) signs of increased icp: abnormal ... patterns decreased ... rate ... ... ... decreased ... ... ... or ... pupils ... posturing increased or widened ... ... reflex ```

``` respiratory; pulse headache nausea vomiting alertness bradycardia sluggish; nonreactive decerebrate blood pressure cushing ```

(intracranial pressure) intracranial hemorrhage: bleeding inside the skull also increases the ICP bleeding can occur: between the ... and ... beneath the ... but outside the brain within the ... itself

skull; dura mater; dura mater; tissue of the brain

(intracranial pressure) epidural hematoma: accumulation of blood between the ... and ... nearly always the result of a blow to the head--> produced by a ... fracture of the thin ... bone

skull; dura mater; linear; temporal

(intracranial pressure) subdural hematoma: accumulation of blood beneath the dura mater but outside the brain occurs after ... or injuries involving strong ... forces

falls; deceleration

(intracranial pressure) intracerebral hematoma: bleeding within the brain tissue itself can occur following a ... injury to the head or because of rapid .. forces

penetrating; deceleration

(intracranial pressure) subarachnoid hemorrhage: bleeding occurs into the subarachnoid space, where the CSF circulates results in ... and signs of ... common causes include trauma or ...

bloody CSF; meningeal irritation; rupture of an aneurysm

a blow to the head or face may cause ... of the brain--> considered a mild TBI temporary loss or alteration of part or all of the brain's abilities to function without ... to the brain about 90% of patients do not experience a loss of consciousness a patient may be ... or hav e... usually lasts only a short time. assume that a patient with signs/symptoms of a concussion has a more serious injury until proven otherwise

concussion; physical damage; confused; amnesia

contusion: more serious than a concussion involves ... to brain tissue may sustain long-lasting and even ... damage a patient may exhibit any or all of the signs of brain injury

physical injury; permanent

brain injuries can also arise from medical conditions, such as ... or ...

blood clots; hemorrhages

spine injuries: ... injuries can result from a fall: forces that compress the patient's vertebral body can cause ... of disks motor vehicle crashes can ... the spine ... injuries of the spine result from rapid acceleration forces

compression; herniation; overextend; rotation-flexion

spine injuries: when the spine is pulled along its length (...), it can cause ... any one of these unnatural motions can result in fractures or ... when bones of the spine are altered from traumatic forces, they can fracture or move out of place

hyperextension; fractures; neurologic deficit

always suspect a possible head/spinal injury with: ... collisions ... collisions ... .. ... trauma to the head, neck, black, or torso

``` motor vehicle pedestrian-motor vehicle falls blunt trauma penetrating ```

``` always suspect a possible head/spinal injury with CONTD: .. injuries ... ... injuries ... accidents ```

rapid deceleration hangings axial loading diving

primary assess: spinal immobile considerations: assess patient in the ..., assess scene to determine risk of injury backboard often places patient in an ... position for a long period of time

position found; anatomically incorrect

primary assess: assessing for signs and symptoms of a head/spine injury: ask about CC ... or ... speech, ... questioning, or ... in responsive patients in the setting of trauma, assume your patient has a head injury until your assessment proves otherwise

confused; slurred; repetitive; amnesia

primary assess: assessing for signs and symptoms of a head/spine injury CONTD: .. patients should be assumed to have a spinal injury patients with a decreased level of responsiveness should be considered to have a spinal injury based on their ...

unresponsive trauma; chief complaint

primary assess airway and breathing: irregular breathing may result from ... on the brai n oxygen is always indicated for patients with ... and ... injuries

increased pressure; head; spinal

secondary assess: perform baseline assessment using the ... record levels of consciousness that .. or ...

Glasgow coma scale; fluctuate; deteriorate

``` cushing's triad: increased ... decreased .... rate irregular ... (Cheyne stokes or Biot) perform controlled ... of your patient at a rate of ... breaths/min ```

``` blood pressure heart respirations hyperventilation 20 ```

cervical collars provide preliminary, ... support

partial

(prep for transport) supine patients; secure to a long backboard or ... another procedure to move a patient from the ground to backboard is the ... you may also slide the patient onto a backboard or vacuum matt

vacuum mattress; four-person log roll

vacuum mattress: an alternative to the long backboard molds to the specific contours of patient's body provides ... excellent for the elderly or a patient with .... of the spine can be used on a supine, sitting or standing patient

thermal insulation | abnormal curvature

``` sitting patients: use a ... to restrict movement of the cervical and thoracic spine then secure it to the long board exceptions include situations in which: you or the patient is in danger you need immediate access to ... the patient's injuries justify ... ```

short backboard; other patients; urgent removal

Standing patients: Immobilize the patient to a long backboard before proceeding with assessment. Establish manual, in-line stabilization and apply a cervical collar. Position the board ... directly behind the patient. Carefully lower the patient as a unit under the direction of the EMT at the head.

upright;

Short backboards Vest-type device and rigid short board Designed to immobilize and restrict movement of the ..., ..., and ... Used to immobilize ... patients found in a sitting position

head; neck; torso; noncritical

Long backboards: Provide full body spinal immobilization and motion restriction to the ..., ..., ..., ..., and ...Used to immobilize patients found in any position

head; neck; torso; ;pelvis; extremities

A helmet that fits well prevents the patient’s head from moving and should be left on, provided: There are no impending ...or ... problems. It does not interfere with assessment and treatment of airway or ventilation problems. You can properly .. the spine.

airway; breathing; immobilize

Remove a helmet if: It is a ... It makes assessing or managing airway problems difficult. It prevents you from properly immobilizing the spine. It allows excessive ... The patient is in ...

full-face helmet; head movement.; cardiac arrest

helmet removal: preferred method involves removing a helmet with at least ... people Alternate method: The advantage is that it allows the helmet to be removed with the application of less ... , therefore reducing the likelihood of motion occurring in the neck. The disadvantage is that it is slightly more ...

2; force; time consuming.

``` Alternate method of helmet removal: Remove the chin strap. Remove the face mask. Pop the jaw pads out of place. Place your fingers ... the helmet. Hold the .. with one hand and the ... with the other. Insert ... behind the occiput. ```

inside; jaw; occiput; padding