Deck 26: The Head, Face, Eyes, Ears, Nose, and Throat

Question 1

Please check all the sports that are identified with a high risk for head injuries.

A) Soccer
B) Cycling
C) Martial arts
D) Basketball
E) Ice hockey
F) Equestrian
G) Softball
H) Skiing
I) Gymnastics

Answer 1

Soccer
Cycling
Martial arts
Ice hockey
Equestrian
Skiing
Gymnastics

Question 2

Please check all of the following that could be a cause of an epistaxis.

A) Direct blow
B) High humidity
C) Food
D) Allergies
E) Rubbing against an opposing player
F) A foreign body lodged in the nose
G) A sinus infection

Answer 2

Direct blow
High humidity
Allergies
A foreign body lodged in the nose
A sinus infection

Question 3

Select all the sports with reported high risks of head injury.

A) Boxing
B) Tennis
C) Baseball
D) Gymnastics
E) Ice hockey
F) Martial arts
G) Basketball
H) Bicycling
I) Wrestling

Answer 3

Boxing
Gymnastics
Ice hockey
Martial arts
Bicycling
Wrestling

Question 4

Select all of the types of errors that are marked for a maximum error score of 10.

A) Hands lifted off iliac crest.
B) Hands lifted off waistline.
C) Opening of one eye
D) Opening of eyes
E) Moving hip into > 50 degrees abduction
F) Moving hip into > 30 degrees abduction
G) Remaining out of testing position >3 seconds
H) Remaining out of tesing position >5 seconds
I) Lifting forefoot or heel
J) Lifting toe or rocking back on heel

Question 5

What is the most important consideration in reducing injuries to the head and surrounding area?

A) Standardizing the design and quality of all helmets
B) Putting warning labels on all protective equipment for this area of the body
C) Eliminating protective headgear to reduce the athlete's want to make contact with this part of the body
D) Educating the athlete in proper techniques and the dangers associated with brain injuries
E) Limiting contact sports to post-adolescent sporting activities

Question 6

The skull is composed of how many bones?

A) 20
B) 22
C) 24
D) 26
E) 28

Question 7

Which of the following parts of the brain coordinates all voluntary muscle activities and interprets sensory impulses in addition to controlling higher mental functions?

A) Cerebrum
B) Cerebellum
C) Thalamus
D) Hypothalamus
E) Hippocampus

Question 8

What structure of the meningeal membranes helps contain the spinal fluid?

A) Subdural space
B) Pia mater
C) Arachnoid space
D) Dura mater
E) Subarachnoid space

Question 9

Which of the following areas should be included in an on-the-field neurological exam for head injury?

A) Meningeal testing
B) Cerebellar testing
C) Spinal testing
D) Brain stem testing
E) Medulla oblongata testing

Question 10

If a patient is unconscious after sustaining a head injury, what is the best method of removal from the playing arena?

A) Spine board
B) EMS
C) Ambulatory aid method
D) Manual conveyance method
E) Stair chair

Question 11

In the Balance Error Scoring System (BESS), which of the following is the angle of hip flexion at which the patient must maintain the contralateral limb during the single-leg stance?

A) 10 to 20 degrees
B) 20 to 30 degrees
C) 30 to 40 degrees
D) 40 to 50 degrees
E) 50 to 60 degrees

Question 12

Which of the following questions can be asked during the history section of a head assessment to determine antegrade amnesia?

A) Can you remember walking off the field?
B) Can you remember the score or who we played last week?
C) Can you tell me what happened to you?
D) Does your head hurt?
E) Can you move your hands and feet?

Question 13

In the observation section of a head assessment, what would be considered an incorrect action to perform?

A) Is the patient able to determine who the opponent is?
B) Does the patient have delayed motor responses?
C) Do the patient's eyes track smoothly?
D) Does the patient elicit a normal emotional response?
E) Is the patient's scalp swollen or bleeding?

Question 14

In the case of a suspected head injury, an on-the-field neurological exam should be performed. Which of the six major areas of the exam is missing from this list?
? Cerebral testing
? Motor testing
? Cranial nerve testing
? Reflex testing
? Cerebellar testing

A) Ocularmotor testing
B) Manual muscle testing
C) Balance testing
D) Sensory testing
E) Dermatomal testing

Question 15

Which of the following is an incorrect component of a head assessment when testing the function of the eyes?

A) Checking for equal pupil sizes
B) Testing for blurred vision
C) Smooth tracking of the eyes
D) Reaction to light variance
E) Reaction to fluorescein strip

Question 16

Which of the following is one of the domains of the Vestibular/Ocular Motor Screening (VOMS) assessment?

A) Angle of divergence of vision
B) Horizontal and vertical saccades
C) Width of the field of vision
D) Blurriness of sight
E) Rate of dilation of pupils

Question 17

What is being performed for a head assessment in the following figures?

A) Balance Error Scoring System (BESS)
B) Romberg test
C) Cranial nerve testing
D) Motor testing
E) Strength testing

Question 18

What is the most serious problem associated with skull fractures?

A) Rupture of the orbital floor due to blood accumulation
B) Leakage of cerebrospinal fluid from the ear, or Battle's sign
C) Skull deformity
D) Severe headache and nausea
E) Intracranial bleeding from embedded bone fragments in the brain

Question 19

On what account(s) have classification systems for grades of concussions been updated and modified?

A) Updates and modifications are because of the increase of severity typically associated with sports-related concussions.
B) Updates and modifications are because loss of consciousness occurs in less than 10 percent of all concussions.
C) Updates and modifications are because amnesia is found in less than 30 percent of all concussions.
D) Updates and modifications are because the occurrences for both amnesia and unconsciousness are below 30 percent for all concussions.
E) Updates and modifications are because the Glasgow Coma Scale is outdated and not relevant to the signs and symptoms of a concussion.

Question 20

After sustaining a cerebral injury, what must the athlete be free of before returning to competition?

A) Tinnitus
B) Nystagmus
C) All symptoms
D) Headache
E) Photophobia

Question 21

What is the usual window of returning to baseline measures for patients who have sustained mild head injuries?

A) A couple of hours following trauma
B) 12-36 hours
C) 36-72 hours
D) 72-120 hours
E) 120-168 hours

Question 22

Since 2009, all 50 states passed some form of concussion legislation that minimally stated:

A) The athlete is allowed to return to play on the day of the injury.
B) The athlete is not allowed to return to play on the day of the injury.
C) The athlete is allowed to return to play on the later on the day of the injury, if asymptomatic.
D) The athlete is allowed to remain in the game if only one concussion symptom is present.
E) The athlete may return to play/practice with a nurse's medical clearance.

Question 23

Once a patient has sustained an initial cerebral concussion, how much greater is the likelihood of her incurring a second one compared to an individual who has never sustained a concussion?

A) 1-2 times greater
B) 2-3 times greater
C) 3-6 times greater
D) 6-9 times greater
E) 9-12 times greater

Question 24

According to the graduated return-to-play protocol for postconcussion syndrome, which of the following is the amount of time it generally takes an asymptomatic athlete to progress to the next level of rehabilitation?

A) Eight hours
B) Sixteen hours
C) Twenty-four hours
D) Forty-eight hours
E) Seventy-two hours

Question 25

Which of the following complications associated with skull fractures requires immediate hospitalization?

A) Rupture of the orbital floor due to blood accumulation
B) Leakage of cerebrospinal fluid from the ear, or Battle's sign
C) Skull deformity
D) Severe headache and nausea
E) Intracranial bleeding from embedded bone fragments in the brain

Question 26

Which of the following specific head injuries includes an etiology of a direct blow to an athlete's moving head when it strikes some fixed object, that results in impact deceleration of the brain?

A) Skull fracture
B) Cerebral concussion
C) Cerebral contusion
D) Epidural hematoma
E) Subdural hematoma

Question 27

Which of the following specific head injuries has distinctive signs and symptoms of a persistent headache, impaired memory, lack of concentration, anxiety and irritability, giddiness, fatigue, depression, and visual disturbances that may begin immediately or within several days following the initial trauma?

A) Epidural hematoma
B) Skull fracture
C) Cerebral contusion
D) Second impact syndrome
E) Post-concussion syndrome

Question 28

Which of the following specific head injuries is managed as a life-threatening emergency that must be addressed within approximately five minutes by dramatic lifesaving measures performed in an emergency care facility?

A) Cerebral concussion
B) Malignant brain edema syndrome
C) Second-impact syndrome
D) Scalp injury
E) Skull fracture

Question 29

With a scalp injury, what would warrant the need for a physician referral?

A) If the wound will not quit bleeding after 10 minutes.
B) If the wound has impacted dirt within it.
C) If the wound cannot be located on the scalp.
D) If the wound is more than ½ inch in length and 1/8 inch in depth.
E) If the wound is not closable with steri-strips or butterfly closures.

Question 30

Which of the following specific head injuries has an etiology of a direct blow to the head when the athlete's moving head strikes some fixed object, which results in impact deceleration of the brain?

A) Skull fracture
B) Mild traumatic brain injury
C) Cerebral contusion
D) Postconcussion syndrome
E) Subdural hematoma

Question 31

Which of the following specific facial injuries presents with a locked-open position of the jaw, with jaw movement being almost impossible?

A) Mandibular fracture
B) Mandibular dislocation
C) Temporomandibular joint dysfunction
D) Maxillary fracture
E) Maxillary dislocation

Question 32

Which of the following structures is most likely to be involved in a "Lefort fracture"?

A) The chin
B) The ridge of an eyebrow
C) The lateral wall of an eye socket
D) The mandible
E) The lateral wall of the nasal cavity

Question 33

Which of the following is a sign of facial lacerations?

A) Abrupt increase in the secretion of sweat
B) Discrepancy in the zygomatic complex
C) Obvious tearing of the dermis
D) Swelling of the front of the face
E) Inflammation of the synovial capsule

Question 34

Which of the following structures is most often the source of hemorrhages of the nose?

A) The cribriform plate of the ethmoid
B) The horizontal plate of the palatine bone
C) The posterior portion of the superior concha
D) The highly vascular anterior aspect of the nasal septum
E) The termination of the nasolacrimal duct

Question 35

Which of the following is the least amount of time it takes for a septal hematoma to show up after a nasal injury?

A) 5-10 hours
B) 6-12 hours
C) 8-16 hours
D) 10-20 hours
E) 24-48 hours

Question 36

Which of the following statements is correct regarding a tooth fracture?

A) A uncomplicated crown fracture requires immediate treatment by a dentist
B) A complicated crown fracture requires immediate treatment by a dentist
C) If a root fracture occurs, an athlete should not continue to play the game
D) Fractured teeth always occur with a concussion
E) An athlete can continue to play with an type of tooth fracture as long as they do not exhibit any other signs of a bone fracture of concussion

Question 37

If a patient has a luxation of the tooth, what does this mean?

A) The tooth has been knock out of their mouth.
B) The tooth has been fractured.
C) The tooth is not fractured but is very loose and has moved either forward or backward.
D) The tooth is slightly loose.
E) The tooth is fractured and the piece that remains in the mouth is very loose.

Question 38

Which of the following methods would be incorrect in trying to stop a epistaxis?

A) A piece of rolled gauze placed between the upper lip and gum
B) A cold compress placed over the nose
C) Place pressure over the affected nostril
D) Tilting the head slightly back with a cold compress over the nose
E) Place gauze that contains tannic acid in the nostril

Question 39

A LeFort fracture effects which of the following structures of the face?

A) A fracture of only the maxilla
B) A fracture of only the mandible
C) A fracture of the maxilla and mandible
D) A fracture of only the orbital bone
E) A fracture of the zygomatic arch and one or more facial bones

Question 40

A patient reports after a plane trip to Hawaii complaining of nausea, vomiting, dizziness, and extreme pain in the ear. What would be a plausible clinical diagnosis?

A) Otitis externa
B) Otitis media
C) Rupture of the tympanic membrane
D) Pinna
E) Impacted cerumen

Question 41

The problem demonstrated in this figure of the ear is commonly referred to as which of the following?

A) Auricular hematoma
B) Otitis externa
C) Otitis media
D) Pinna
E) Impacted cerumen

Question 42

What sports in collegiate and secondary schools have the highest incidences of eye injuries?

A) Women's softball and volleyball
B) Women's field hockey and basketball
C) Men's football and baseball
D) Men's basketball and track and field
E) Men's baseball and women's softball

Question 43

Which of the following best describes a hyphema?

A) An eye infection
B) A retinal detachment
C) Pink eye
D) Collection of blood within the anterior chamber
E) Stye

Question 44

If a patient has swelling of the whole eyelid with itching or burning, what condition may be present?

A) Stye
B) Acute conjunctivitis
C) Rupture of the globe of the eye
D) Corneal abrasion
E) Hypema

Question 45

If a patient can not breathe and is expiring frothy blood after getting hit in the throat with a baseball, which of the following would most likely be the sustained injury?

A) A fracture of throat cartilage
B) A fractured clavicle
C) Solar plexus injury
D) A fracture of a rib
E) A rupture of their vocal chords

Question 46

Which of the following bacteria causes blepharitis?

A) Clostridium
B) Staphylococcus
C) Streptococcus
D) Enterococcus
E) Campylobacter

Question 47

If a patient is able to read line four on the shown figure, what does this result mean?

A) The patient is able to stand 20 feet away and read what a person with 20/20 vision could read at 50 feet away
B) The patient is able to stand 50 feet away and read what a person with 20/20 vision could read at 20 feet away
C) The patient is able to see 50% of what a person with 20/20 vision could see
D) The patient is able to see 30% of what a person with 20/20 vision could see
E) The patient is four times more likely to have vision problems

Question 48

Upon reading a patient's chart it is reported the patient is experiencing diplopia. What does this mean?

A) The patient is seeing flashes of light.
B) The patient is hearing high-pitched noises.
C) The patient is seeing double.
D) The patient has watery eyes.
E) The patient is having trouble hearing.

Question 49

Which of the following would be considered an inappropriate symptom of a maxillary fracture?

A) Epistaxis
B) Malocclusion
C) Diplopia
D) Auras
E) Numbness in the lip

Question 50

What does the King-Devick test measure?

A) The patient's ability to rapidly respond to cognitive questions
B) The patient's ability to rapidly react to verbal commands
C) The patient's ability to rapidly perform physical agility skills
D) The patient's ability to rapidly perform concussion sideline testing
E) The patient's ability to rapidly move the eyes while reading