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AEMCA Study Guide > Final Exam > Flashcards

Final Exam Flashcards

1
Q

What is a Linear Skull Fracture?

A
  • Most common type of skull fracture
  • Break in the bone, but does not actually move it
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2
Q

What are Basilar Skull Fractures?

A
  • Occur at the base of the skull
  • Normally present with periorbital ecchymosis and mastoid bruising
  • Watch out for CSF drainage from ears and nose
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3
Q

What are Depressed Skull Fractures?

A
  • Parts of skull become sunken (or depressed) from trauma
  • Can compress brain tissue and impair blood supply
  • ICP often becomes high
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4
Q

What should you be concerned about if someone sustained damage to the LEFT TEMPORAL REGION of their head?

A
  • Possible tear to the meningeal artery
  • This can result in an epidural hematoma or aneurysm
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5
Q

What is an Epidural Hematoma?

A

When blood accumulates underneath the skull and ON TOP OF DURA MATER

  • Type of TBI
  • Tear of middle meninges artery
  • Most commonly associated with Linear skull fractures
  • Usually associated with lucid intervals

Signs and symptoms can develop RAPIDLY. include nausea, vomiting, confusion and LOC.

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6
Q

What is a Subdural Hematoma?

A

When blood accumulates between DURA and the ARACHNOID

  • Can form from a cut on the brain itself
  • Can form from venous bleeds -> blood can accumulate slowly
  • May be acute or sub-acute
  • More common than epidural hematomas

Symptoms include headaches, confusion, LOC, and seizures

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7
Q

What is a Subarachnoid Hemorrhage?

A

A type of bleeding that occurs between the brain and arachnoid mater.

Usually caused by a ruptured brain aneurysm, which causes blood to leak into the subarachnoid space, causing pressure and damage to brain tissue.

Most common bleed associated with head trauma. Blood mixes with CSF, preventing hematoma formation.

S&S: Severe headache (thunderclap/worst), neck stiffness, nausea, vomiting, confusion, LOC.

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8
Q

What type of hemorrhage frequently occurs to those on anticoagulants, but can still be caused by trauma?

A

Subdural hemorrhage

  • Occurs 6 times more frequently than epidural hematoma post trauma
  • Common in elderly/alcoholics due to brain atrophy
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9
Q

What is a vital component to brain health?

A

Glucose.

Lack of glucose in blood supply leads to diminished metabolism and eventual brain death (think hypoglycaemia).

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10
Q

What is the Thalamus?

A

The “information relay station”

  • All incoming motor and sensory information (with the exception of smell) passes through the thalamus before being directed to the cerebral cortex.
  • Located in the central region between the cerebral cortex and brain stem.
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11
Q

What is the Hypothalamus?

A

Structure deep within the brain.

Maintains body homeostasis by regulating a wide variety of physiological functions, such as:

  • Hunger and thirst
  • Body temperature
  • Sleep/wake cycles
  • Hormone production and release
  • Located at the base of the brain, just above the brain stem.
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12
Q

Difference between Arterial Bleeds and Venous Bleeds?

A

Arterial bleeds are:

  • Bright red (oxygenated blood)
  • Spurting blood in pulsating manner

Venous bleeds are:

  • Dark red (deoxygenated blood)
  • Steady flow (no spurting)
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13
Q

What is Actual (Absolute) Hypovolemia?

A

Actual loss of fluid volume from body (bleeding, dehydration, excessive sweating)

Can lead to decreased total volume of blood in the body.

S&S: Low BP, rapid HR, decreased urine output

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14
Q

What is Relative Hypovolemia?

A

Shift of fluid volume from bloodstream to interstitial fluid spaces WITHOUT actual loss of fluid from the body.

Occurs in sepsis and anaphylaxis; blood vessels become more permeable in these conditions, resulting in blood leaking out of the bloodstream and into surrounding tissues.

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15
Q

As per BLS, what are the steps of controlling bleeds?

A

Pressure dressing > second pressure dressing > tourniquet > 2nd tourniquet > hemostatic dressing

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16
Q

Where are you allowed to put hemostatic dressings?

A

Groin, axillae, extremities

NOTHING in the abdomen and head area

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17
Q

What do you see when the Oculomotor Nerve (CN 3) is damaged?

A
  • Diplopia (double vision)
  • Mydriasis (dilated pupils)
  • Ptosis (upper eyelid drooping)
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18
Q

What happens when the Optic Nerve (CN 2) is damaged?

A
  • Can lead to temporary or permanent vision loss
  • Glaucoma is the most common optic nerve disorder
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19
Q

Common S&S with hyperglycaemic patients?

A

IF DKA:

Deep, rapid respirations
Dehydration
Acetone breath

IF REGULAR HYPERGLYCEMIA:

3 P’s: Polyuria (Excessive Urination), Polydipsia (Excessive Thirst), Polyphagia (Excessive Hunger)

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20
Q

Common S&S with hypoglycaemic patients?

A

Elevated insulin levels
Rapid onset
Cool, clammy skin

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21
Q

What are two treatments you can do for an open pneumothorax injury?

A

Seal the wound with a 3-sided occlusive dressing OR
Commercial occlusive dressing with a one way valve (Asherman Seal)

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22
Q

Common S&S with patients who have a massive hemothorax?

A
  • Shock with flat neck veins
  • Reduced or muffled air sounds
  • Narrow pulse pressure
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23
Q

What is Cor Pulmonale?

A
  • Pulmonary heart disease
  • Affects heart and lungs
  • Right-sided heart failure
  • Occurs when right side of heart is unable to pump blood effectively due to high blood pressure in the pulmonary arties (the blood vessels that carry blood from the heart to the lungs)
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24
Q

What normally causes Cor Pulmonale?

A

Lung diseases that result in low oxygen in the blood

  • COPD (leading cause), cystic fibrosis, sleep apnea, PE
  • Patients will present with SOB, fatigue, chest pain, peripheral edema

In COPD patients, cor pulmonale occurs due to chronic Hypoxic Pulmonary Vasoconstriction (HPV) due to alveolar wall obstruction

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25
Q

The pressure differential between systolic and diastolic is called?

A

Pulse pressure

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26
Q

What are the most pertinent things to know before inserting an NPA?

A
  • Pt has to be approximately 5 years of age or older
  • Designed to be inserted into the right nare first
  • Requires lube prior to insertion
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27
Q

BVM order of construction starting AT THE PATIENT?

A

Swivel adapter > Extension tubing > Inline adapter > Biofilter > ETCO2 adapter

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28
Q

What size do manufactures make all adapters that medics use when attaching to a ventilation mask, supraglottic airway or intubation tube?

A

15 mm

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29
Q

Compared to adults, how is the pediatric airway different?

A
  • Larynx is more anterior
  • Larynx is cone shaped
  • Narrowest part of Larynx is at the cricoid ring
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30
Q

What is Grave’s Disease?

A

Autoimmune disorder that causes hyperthyroidism

  • Commonly caused by an autoimmune reaction: the body’s immune system mistakenly attacks the thyroid gland, causing it to produce too much hormone.

S&S: weight loss, rapid heartbeat, nervousness, and fatigue.

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31
Q

What is Addison’s Disease?

A

Disorder of the adrenal glands (located on top of the kidneys).

  • Often caused by an autoimmune reaction in which the body’s immune system mistakenly attacks the adrenal glands.
  • Adrenal glands do not produce enough cortisol and aldosterone, leading to:

Fatigue, weight loss, low blood pressure, and darkening of the skin.

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32
Q

What does a yellow-green sputum indicate?

A

Bacterial infection

33
Q

What does rusty/dark sputum indicate?

A

Pneumonia

34
Q

What does blood tinged sputum indicate?

A

Pulmonary edema

35
Q

3 D’s of Epiglottitis?

A
  • Dysphagia (difficulty swallowing)
  • Drooling
  • Distress (respiratory distress)
36
Q

What is the RCA (Right Coronary Artery)?

A

Supplies blood to the right side of the heart.

  • RA
  • RV
  • SA node
37
Q

What is the LCA (Left Coronary Artery)?

A

Supplies blood to the left side of the heart.

38
Q

What are the two main branches of the LCA?

A

Left Circumflex Artery and Left Anterior Descending Artery (LAD)

39
Q

What does the Left Circumflex Artery do?

A

Supplies blood to the posterior and lateral parts of the heart, including:

  • LA
  • Lateral and inferior wall of LV
40
Q

What does the Left Anterior Descending Artery (LAD) do?

A

Supplies blood to the anterior portion of the heart, including:

  • LV
  • Interventricular septum
  • Part of the RV

*Very important artery as it supplies blood to a large area of the heart muscle. Blockage in this artery can lead to an MI and sudden death; commonly referred to as the “widowmaker artery”.

41
Q

What are the two feedback loops that compete with one another when it comes to increased cranial pressure?

A

Cushing’s reflex and Cerebral Perfusion Pressure (CPP) autoregulation.

  • When there is an increase in ICP, the Cushing reflex causes an increase in systemic blood pressure, which can increase CPP
  • However, CPP autoregulation tries to maintain a constant blood flow to the brain by causing cerebral vasodilation, which can decrease CPP.

These two mechanisms can compete with one another, and the net effect on CPP will depend on the relative strength of the two mechanisms.

42
Q

What happens in the long run when these two feedback loops continuously compete with one another?

A

If the ICP continues to increase, the Cushing reflex response can cause an increase in systemic blood pressure, which in turn can increase CPP.

However, if the CPP autoregulation mechanism fails, the cerebral blood vessels can become maximally dilated, resulting in an inability to compensate for the increased ICP. As a result, the cerebral blood flow may become inadequate, leading to brain ischemia, hypoxia, and eventually brain damage or death.

43
Q

What are the S&S of Cerebral Herniation Syndrome?

A
  • Dilation of pupil on same side
  • Altered LOC
  • Decerebrate posturing
  • Bradycardia
  • Paralysis on opposite side of body

*Hyperventilate these patients at 1:3 (20-25 breaths per min)

44
Q

What is a concussion?

A

A type of Closed Head Injury.

Mild blows to the head or body that causes sudden movement of the brain inside the skull.

  • Short term memory loss
  • Headache
  • Confusion
45
Q

What is a Diffuse Axonal Injury (DAI)?

A

Widespread (diffuse) damage to brain’s axons (stretching, shearing, tearing of nerve fibers)

  • Often results in a vegetative state
  • Due to severe rotational or acceleration-deceleration injury (think MVC and falls)
  • Subarachnoid bleeding with irritation to surrounding tissues (herniation possible)

S&S: Seizure, coma, vomiting

46
Q

What is an Anoxic Brain Injury?

A

When brain is deprived of oxygen for extended periods of time (ex: cardiac arrest, airway obstruction, drowning)

  • Spasm of cerebral arteries
  • After 4-6 minutes of anoxia, irreversible damage occurs

Restore blood pressure and oxygen as soon as you can. After 4-6 minutes, restoring BP and O2 will NOT restore perfusion

47
Q

Nerves in the _______ do not regenerate.

A

Spinal cord

48
Q

What happens if the spinal cord is fully transected?

A

Irreversible loss of function below the level of injury

*Partial transection may allow for some recovery

49
Q

Any ______ of the _______ must be relieved quickly to _________

A

Compression, spinal cord, maintain blood supply

50
Q

S&S of Neurogenic Shock?

A
  • Bradycardic response to BP
  • Warm and dry skin
  • No significant blood loss
  • Paralysis and loss of spinal reflexes
51
Q

S&S of Hypovolemic Shock?

A
  • Tachycardia in response to BP
  • Cool, pale and diaphoretic skin
  • Evident blood loss
  • Usually not associated with paralysis
52
Q

Deviation in size of pupils indicate?

A

CNS involvement or hypoxia

53
Q

Fixed dilated pupils indicate?

A

Cerebral anoxia or brainstem involvement

54
Q

Six general causes of coma?

A

Metabolic (Hypoglycemia/DKA, Anoxia)
Respiratory System (COPD, toxic inhalation)
Drugs (Narcotics, Alcohol, Hallucinogens)
Infection (Meningitis, sepsis)
Cardiovascular System (Shock, Stroke, Hypertensive encephalopathy)
Structural (Head trauma, brain tumour)

55
Q

Which neurotransmitter is predominantly responsible for impulse transmission at the neuromuscular junctions in the ANS AND PNS?

A

Acetylcholine (ACh)

56
Q

Patient with a GCS of 12 is considered to have what severity of head injury?

Mild, Moderate or Severe?

A

Moderate (9-12)

57
Q

Patient with a GCS of 14 is considered to have what severity of head injury?

Mild, Moderate, or Severe?

A

Mild (13-15)

58
Q

Patient with a GCS of 6 is considered to have what severity of head injury?

Mild, Moderate, or Severe?

A

Severe (3-8)

59
Q

Degeneration of nerves that control muscle activity in the brain and spinal cord is known as?

A

Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease.

  • Progressive neurodegenerative disorder that affects motor neurons responsible for voluntary muscle movement.
  • No cure for ALS; treatment focused on managing symptoms and improving quality of life.
60
Q

Which area of the brain regulates respiratory and cardiac function?

A

Medulla Oblongata, which is located at the brainstem.

  • Contains two vital centers
  • Respiratory center: regulates breathing
  • Cardiac center: regulates heart rate and blood pressure
61
Q

The spinal cord starts at the medulla and ends at the level of?

A

1st Lumbar Vertebrae

62
Q

Which structure allows CSF to exit the subarachnoid space and enter the bloodstream?

A

Arachnoid Villi

63
Q

Degeneration or nerve damage to the nerve cells in the basal ganglia is known as what?

A

Parkinson’s Disease.

  • Neurodegenerative disorder that affects movement, balance, and coordination.
  • Occurs when the dopamine-producing neurons in the basal ganglia region of the brain start to degenerate, leading to a shortage of dopamine, a neurotransmitter that helps regulate movement.

S&S: Tremors, stiffness, slowness of movement, and difficulty with balance and coordination.

64
Q

A headache that is a result of stress or persistent noise is known as what?

A

Tension headache

  • Most common type of headache
  • “Tight band” around the head
  • Treated with analgesics
65
Q

A severe, incapacitating headache accompanied with nausea, vomiting, and possible sensitivity to light, sound or smell is known as what?

A

Migraines

  • Intense, throbbing pain, often on one side of the head (unilaterally)
  • Lasts 2-72 hours
  • Preceded by an aura (visual disturbances) or even GI disturbances
66
Q

A headache with severe pain around one eye accompanied with tearing and nasal congestion is known as what?

A

Cluster headaches

  • Occurs in bursts
  • Lasts half an hour to 2 hours
  • Often caused by abnormalities in body’s biological clock (hypothalamus)
67
Q

A headache with pain/pressure in the forehead, nasal area, and eyes is known as what?

A

Sinus headaches

  • Inflammation or congestion of nasal cavities (Frontal, Ethmoid, Maxillary, Sphenoid Sinuses)
  • Inflammation can occur from allergies, infections, or changes in air pressure
68
Q

What are the purposes of the two physical examination tests: Kernig’s Sign and Brudzinski’s Sign?

A

To assess for signs of meningeal irritation or inflammation in patients with suspected meningitis or other central nervous system infections.

69
Q

What is Kernig’s Sign?

A

Passively flexing the patient’s hip and knee to 90 degrees while they are lying on their back and then attempting to straighten the leg at the knee joint.

  • If patient experiences pain and resistance to this movement, it may indicate meningeal irritation or inflammation.
70
Q

What is Brudzinski’s Sign?

A

Flexing the patient’s neck towards their chest while they are lying on their back.

  • If this movement causes involuntary flexion of the patient’s hips and knees, it may also indicate meningeal irritation or inflammation.
71
Q

What is the Babinski Reflex?

A

Abnormal response where the toes will instead spread apart and the big toe will move upward.

  • Indicative of certain neurological conditions, such as injury to the spinal cord or brain
72
Q

An inherited disorder that progressively degenerates muscle fibers is known as what?

A

Muscular Dystrophy

  • Genetic disorder that affect the muscles, causing weakness and wasting over time
  • No cure
73
Q

What is PEEP and how does it work?

A

PEEP stands for Positive-End-Expiratory Pressure.

  • Ventilation technique used in patients with respiratory failure
  • During mechanical ventilation, PEEP applies a small amount of positive pressure to airway at end of expiration
  • This keeps airway open and improve gas exchange in the lungs.

PEEP helps to prevent lung collapse by keeping alveoli partially inflated.
Excessive PEEP can cause barotrauma and damage lung tissue, be mindful of this

74
Q

What is Distributive Shock? What are the types of Distributive Shock?

A

Abnormal distribution of blood flow to the body’s tissues and organs. 3 main types:

  • Septic shock: Severe infection triggers inflammatory response. Blood vessels dilate and become more permeable, decreasing BP and impairing tissue perfusion.
  • Anaphylactic shock: Allergic reaction to substance such as medication or food. Reaction triggers release of histamine and other chemicals. Blood vessels dilate and become more permeable, decreasing BP and impairing tissue perfusion.
  • Neurogenic shock: Damage to spinal cord or brainstem, which disrupts the normal function of ANS. Results in vasodilation and decrease in BP, impairing tissue perfusion.
75
Q

What is Obstructive Shock? What are types of Obstructive Shock?

A

Obstruction of blood flow in circulatory system:

  • Cardiac tamponade: excessive fluid in pericardium. This compresses the heart and impairs its ability to pump blood effectively.
  • Tension Pneumothorax: Air accumulates in pleural space. This causes pressure to build up and compress the lungs, heart, and other structures in chest cavity.
  • Pulmonary Embolism: Blockage in one of the pulmonary arteries in lungs, often from a blood clot. This impairs blood flow to lungs and decreases oxygenation (NOT a ventilation issue, but a perfusion issue)
76
Q

What is the Bohr Effect?

A

Shift RIGHT

  • Increase H+
  • Increased CO2
  • Increased 2,3 BPG
  • Increased Temp
  • Decreased Affinity of O2 (Hb)

Net result? HIGHER O2 DISSOCIATION

Can result from exercise, smoking, higher altitudes

77
Q

What is the Haldane Effect?

A

Shift LEFT

  • Decreased H+
  • Decreased CO2
  • Decreased 2,3 BPG
  • Decreased Temp
  • Increased Affinity of O2 (Hb)

Net result? LOWER O2 DISSOCIATION

78
Q

What are S&S of Pre-Eclampsia?

A
  • BP > 140/90 (severe eclampsia = diastolic BP >110)
  • Generalized edema
  • Complaints of headache, nausea, abdomen pain (with or w/o vomiting) blurred vision, rapid weight gain
79
Q

What does AEIOUTIPS stand for? And what is it used for?

A

A - Alcohol, Acidosis, Arrhythmias
E - Endocrine, electrolytes
I - Infection
O - Overdose/oxygen (lack of)
U - Uremia (urine in the blood)
T - Trauma, Temperature (hypo/hyperthermia)
I - Insulin
P - Poisoning, psychiatric
S - Stroke, seizure, syncope

This is used to determine possible causes for altered LOA

AEMCA Study Guide (6 decks)

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