Deck 38: Head, Face, Neck, and Spine Trauma
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Deck 38: Head, Face, Neck, and Spine Trauma
1
The area of the brain which controls hearing and smell is the
A) parietal lobe.
B) temporal lobe.
C) frontal lobe.
D) occipital lobe.
A) parietal lobe.
B) temporal lobe.
C) frontal lobe.
D) occipital lobe.
temporal lobe.
2
What is the function of the region of the brain referred to in this image? 
A) It connects parts of the brain with one another by means of tracts, and influences respiration.
B) It is responsible for precise control of muscle movements, maintenance of posture, and maintaining balance.
C) It is involved in the regulation of heart rate, blood vessel diameter, coughing and swallowing.
D) It connects the cerebellum with the cerebrum, and acts a relay for auditory and visual impulses.

A) It connects parts of the brain with one another by means of tracts, and influences respiration.
B) It is responsible for precise control of muscle movements, maintenance of posture, and maintaining balance.
C) It is involved in the regulation of heart rate, blood vessel diameter, coughing and swallowing.
D) It connects the cerebellum with the cerebrum, and acts a relay for auditory and visual impulses.
It connects parts of the brain with one another by means of tracts, and influences respiration.
3
The structure of the eye referred to in this image 
A) converts light rays into electrical impulses.
B) contains smooth muscles that attach to the lens of the eye.
C) contains photoreceptor cells called rods and cones.
D) delivers oxygen and nutrients to the retina.

A) converts light rays into electrical impulses.
B) contains smooth muscles that attach to the lens of the eye.
C) contains photoreceptor cells called rods and cones.
D) delivers oxygen and nutrients to the retina.
delivers oxygen and nutrients to the retina.
4
What statement is correct about this type of injury? 
A) Significant loss of blood is not a concern with this injury.
B) This injury may destabilize the position of the tongue.
C) Spinal stabilization is not always recommended for this injury.
D) Teeth lost in this injury must be handled by the root.

A) Significant loss of blood is not a concern with this injury.
B) This injury may destabilize the position of the tongue.
C) Spinal stabilization is not always recommended for this injury.
D) Teeth lost in this injury must be handled by the root.
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5
This type of sight-threatening injury is known as 
A) ligament collapse.
B) chamber leak.
C) hyphmea.
D) blepharitis.

A) ligament collapse.
B) chamber leak.
C) hyphmea.
D) blepharitis.
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6
You have arrived at a scene where a 20 year old male had an accident while pole vaulting. He has symptoms consistent with stridor and subcutaneous emphysema. What type of injury is he most likely suffering from?
A) Fracture of the larynx
B) Fracture of the sphenoid
C) Fracture of the hypoglossal canal
D) Fracture of the frontal sinuses
A) Fracture of the larynx
B) Fracture of the sphenoid
C) Fracture of the hypoglossal canal
D) Fracture of the frontal sinuses
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7
Signs of Cushing's triad are associated with
A) decreased systolic blood pressure, decreased breathing pattern and decreased heart rate.
B) increased systolic blood pressure, abnormal breathing pattern and decreased heart rate.
C) increased systolic blood pressure, increased breathing pattern and increased heart rate.
D) decreased systolic blood pressure, abnormal breathing pattern and increased heart rate.
A) decreased systolic blood pressure, decreased breathing pattern and decreased heart rate.
B) increased systolic blood pressure, abnormal breathing pattern and decreased heart rate.
C) increased systolic blood pressure, increased breathing pattern and increased heart rate.
D) decreased systolic blood pressure, abnormal breathing pattern and increased heart rate.
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8
Which of the following statements regarding brain hematomas is correct?
A) Signs and symptoms of an active subdural hematoma are often difficult to recognize.
B) Patients with brain hematomas may develop increased breathing rates as a result of hypoxia.
C) A gradual hematoma occurs when veins between the dura and cerebral cortex tear.
D) Patients who are alcoholics are at risk for acute hematomas due to falling injuries.
A) Signs and symptoms of an active subdural hematoma are often difficult to recognize.
B) Patients with brain hematomas may develop increased breathing rates as a result of hypoxia.
C) A gradual hematoma occurs when veins between the dura and cerebral cortex tear.
D) Patients who are alcoholics are at risk for acute hematomas due to falling injuries.
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9
What type of hematoma is often associated with tearing of an artery?
A) Epidural hematoma
B) Menigeal hematoma
C) Intracerebral hematoma
D) Subdural hematoma
A) Epidural hematoma
B) Menigeal hematoma
C) Intracerebral hematoma
D) Subdural hematoma
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10
Which of the following statements about in-line stabilization is correct?
A) You can gently pull on the patient's neck to complete the stabilization.
B) A cervical collar should be applied if the patient develops neck muscle spasms.
C) Palms must be placed behind the neck with thumbs on each side of the head.
D) You should be prepared to hold the stabilization for a significant length of time.
A) You can gently pull on the patient's neck to complete the stabilization.
B) A cervical collar should be applied if the patient develops neck muscle spasms.
C) Palms must be placed behind the neck with thumbs on each side of the head.
D) You should be prepared to hold the stabilization for a significant length of time.
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11
A rigid C-collar
A) is used only to provide support to patients that have been secured to a long backboard.
B) may be used to remind healthcare professionals that the patient may have a possible spinal injury.
C) may be used if the collar is too loose only in an emergency situation when the patient's life is in danger.
D) is used to provide complete stabilization of the neck once manual stabilization is no longer used.
A) is used only to provide support to patients that have been secured to a long backboard.
B) may be used to remind healthcare professionals that the patient may have a possible spinal injury.
C) may be used if the collar is too loose only in an emergency situation when the patient's life is in danger.
D) is used to provide complete stabilization of the neck once manual stabilization is no longer used.
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12
When a three-person logroll is performed
A) rescuer 1 will size and apply the cervical collar on the patient.
B) rescuer 3 will place hands on the patient's hip and lower leg.
C) rescuer 1 will maneuver the backboard and its position to the patient.
D) rescuer 2 will place hands on the patient's shoulder and waist.
A) rescuer 1 will size and apply the cervical collar on the patient.
B) rescuer 3 will place hands on the patient's hip and lower leg.
C) rescuer 1 will maneuver the backboard and its position to the patient.
D) rescuer 2 will place hands on the patient's shoulder and waist.
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13
You are at a scene where a 2 year old girl needs to be stabilized due to a suspected spinal injury. During the stabilization process you should
A) secure her legs with ankle straps.
B) secure her feet to the board last.
C) use tape to secure her pelvis.
D) place padding across her upper torso under the shoulder blades.
A) secure her legs with ankle straps.
B) secure her feet to the board last.
C) use tape to secure her pelvis.
D) place padding across her upper torso under the shoulder blades.
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14
What should you do if a patient vomits while immobilized on a board?
A) Turn the board and patient together to clear the airway.
B) Lift the board and patient up towards a vertical incline.
C) Use a cloth to quickly clean out the inside of the patient's mouth.
D) All of these are correct.
A) Turn the board and patient together to clear the airway.
B) Lift the board and patient up towards a vertical incline.
C) Use a cloth to quickly clean out the inside of the patient's mouth.
D) All of these are correct.
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15
An important step in the stabilization of a seated patient is to
A) tighten the top chest strap right after the patient is moved.
B) secure the patient's legs first to prevent spinal movement.
C) loosen the groin strap right after the patient is moved.
D) apply a rigid collar right before in-line stabilization begins.
A) tighten the top chest strap right after the patient is moved.
B) secure the patient's legs first to prevent spinal movement.
C) loosen the groin strap right after the patient is moved.
D) apply a rigid collar right before in-line stabilization begins.
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16
Your 26 year old female patient has a severe head injury. She has a deep cut to her scalp, elevated blood pressure and is confused. During her assessment and treatment you should
A) administer oxygen through a nasal cannula if hypoxia is suspected.
B) maintain her oxygen saturation at a level of 90% or above.
C) use an initial GCS assessment followed by an AVPU assessment.
D) ensure that she remains in a stable position flat on the ground.
A) administer oxygen through a nasal cannula if hypoxia is suspected.
B) maintain her oxygen saturation at a level of 90% or above.
C) use an initial GCS assessment followed by an AVPU assessment.
D) ensure that she remains in a stable position flat on the ground.
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17
You are attending to a 42 year old man who fell 25 feet. He is unable to follow commands and has unequal pupil sizes. How would you rate this man's injuries on the Glasgow coma scale score?
A) 9-12
B) 13-15
C) 16-20
D) 3-8
A) 9-12
B) 13-15
C) 16-20
D) 3-8
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18
The structure which is referred to in this image, responsible for the arterial blood supply to the face, is the_________ carotid artery.

A) superior
B) common
C) external
D) internal

A) superior
B) common
C) external
D) internal
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19
Which of the following statements about injuries to these regions of the spine is correct? 
A) Tetraplegia may occur if both of these regions are injured.
B) A complete injury occurs when both of these regions are injured.
C) The most common spinal injuries occurs in one of these regions.
D) Injury in one of these regions may cause paraplegia to occur.

A) Tetraplegia may occur if both of these regions are injured.
B) A complete injury occurs when both of these regions are injured.
C) The most common spinal injuries occurs in one of these regions.
D) Injury in one of these regions may cause paraplegia to occur.
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20
You have arrived on scene where a 23 year old man sustained a head injury from a falling object. He has coup and countercoup bruising on his head and is behaving abnormally. From these signs and symptoms, the man is most likely suffering from what type of condition?
A) Cerebral Hematoma
B) Cerebral contusion
C) Catecoup
D) Concussion
A) Cerebral Hematoma
B) Cerebral contusion
C) Catecoup
D) Concussion
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21
You are at a scene where a patient must be stabilized in a standing position. Which of the following statements is correct about this process?
A) The board needs to be grasped at the same level as the patient's waist.
B) Rescuer 2 is responsible for manual stabilization of the patient's neck.
C) The patient is secured to the board once the board is on the ground.
D) Rescuer 1 is responsible for reassessing the patient's vital signs.
A) The board needs to be grasped at the same level as the patient's waist.
B) Rescuer 2 is responsible for manual stabilization of the patient's neck.
C) The patient is secured to the board once the board is on the ground.
D) Rescuer 1 is responsible for reassessing the patient's vital signs.
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22
You are at a scene where a 22 year old woman has been in an accident on her moped. She is lying on the ground, breathing well, and still wearing her helmet. In this instance you should
A) leave her helmet in place while she is stabilized.
B) leave her helmet in place until you begin stabilization.
C) call for backup assistance before removing her helmet.
D) None of these are correct.
A) leave her helmet in place while she is stabilized.
B) leave her helmet in place until you begin stabilization.
C) call for backup assistance before removing her helmet.
D) None of these are correct.
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23
The region of the skull referred to in this image is 
A) temporal bone.
B) sphenoid bone.
C) ethmoid bone
D) occipital bone.

A) temporal bone.
B) sphenoid bone.
C) ethmoid bone
D) occipital bone.
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24
The most commonly fractured bones of the face are the
A) nasal bones.
B) maxillary bones.
C) zygomatic bones.
D) occipital bones.
A) nasal bones.
B) maxillary bones.
C) zygomatic bones.
D) occipital bones.
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25
Your patient's left eye is hanging from the socket. You should
A) place a sterile moistened 4 X 4 dressing around the eye and then cover the eye with a cup.
B) attempt to place the eye back in the socket with a gloved hand only one time.
C) use a sterile moistened 4 X 4 dressing to place the eye back in the socket and tape a bandage over the eye.
D) use saline solution to wet the eye and the inside of a cup and then cover the eye with the cup.
A) place a sterile moistened 4 X 4 dressing around the eye and then cover the eye with a cup.
B) attempt to place the eye back in the socket with a gloved hand only one time.
C) use a sterile moistened 4 X 4 dressing to place the eye back in the socket and tape a bandage over the eye.
D) use saline solution to wet the eye and the inside of a cup and then cover the eye with the cup.
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26
The pia mater
A) is a tough layer of meningeal tissue on the inner surface of the cranium.
B) acts as a means of exchange for nutrients and wastes.
C) contains blood vessels which supply blood to nervous tissue.
D) is the middle meningeal layer of connective tissue surrounding the brain.
A) is a tough layer of meningeal tissue on the inner surface of the cranium.
B) acts as a means of exchange for nutrients and wastes.
C) contains blood vessels which supply blood to nervous tissue.
D) is the middle meningeal layer of connective tissue surrounding the brain.
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27
The portion of the brain which receives and interprets nerve impulses from sensory receptors is the
A) occipital lobe.
B) temporal lobe.
C) fontal lobe.
D) parietal lobe.
A) occipital lobe.
B) temporal lobe.
C) fontal lobe.
D) parietal lobe.
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28
What structure is identified in the following image? 
A) Subarachnoid space
B) Arachnoid mater
C) Subdural space
D) Dural fold

A) Subarachnoid space
B) Arachnoid mater
C) Subdural space
D) Dural fold
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29
The delicate meningeal layer, which contains few blood vessels, referred to in this image is the 
A) pia mater.
B) dura mater.
C) arachnoid mater.
D) dorsal mater.

A) pia mater.
B) dura mater.
C) arachnoid mater.
D) dorsal mater.
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30
The portion of the brain, referred to in this image, which has an influence on respiration is the 
A) midbrain.
B) medulla oblongata.
C) pons.
D) corpus callosum.

A) midbrain.
B) medulla oblongata.
C) pons.
D) corpus callosum.
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31
The portion of the brain that is involved in the regulation of vomiting, coughing, respiration and heart rate is the
A) cerebellum.
B) medulla oblongata.
C) transverse process.
D) diencephalon.
A) cerebellum.
B) medulla oblongata.
C) transverse process.
D) diencephalon.
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32
A division of the peripheral nervous system (PNS) that plays an important role in the body's fight-or-flight response is the
A) sympathetic division.
B) somatic division.
C) parasympathetic division.
D) autonomic division.
A) sympathetic division.
B) somatic division.
C) parasympathetic division.
D) autonomic division.
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33
Which of the following statements regarding scalp injuries is correct?
A) An adult with a scalp injury is at a high risk for shock from blood loss.
B) A brain injury may occur from the effects of a scalp injury.
C) Greater pressure should be applied to a scalp injury than other soft tissue injuries.
D) Scalp injuries may be treated with bandages that wrap under the jaw.
A) An adult with a scalp injury is at a high risk for shock from blood loss.
B) A brain injury may occur from the effects of a scalp injury.
C) Greater pressure should be applied to a scalp injury than other soft tissue injuries.
D) Scalp injuries may be treated with bandages that wrap under the jaw.
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34
Your 47 year old female patient is bleeding from her head. She has increased blood pressure, slow heart rate, pupils of unequal size and nausea. You should
A) administer oxygen at 5 liters per minute through a nasal cannula.
B) raise the head of her backboard to 30 degrees after she has stabilized.
C) treat life-threatening injuries after the secondary survey is complete.
D) periodically change the blood soaked dressings on her head.
A) administer oxygen at 5 liters per minute through a nasal cannula.
B) raise the head of her backboard to 30 degrees after she has stabilized.
C) treat life-threatening injuries after the secondary survey is complete.
D) periodically change the blood soaked dressings on her head.
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35
What is the name of the artery responsible for supplying blood to the brain?
A) Maxillary artery
B) Internal carotid artery
C) Vertebral artery
D) External carotid artery
A) Maxillary artery
B) Internal carotid artery
C) Vertebral artery
D) External carotid artery
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36
What is the clear gel which occupies the posterior compartment of the eye?
A) Aqueous body
B) Vitreous humor
C) Cillary
D) Choroid
A) Aqueous body
B) Vitreous humor
C) Cillary
D) Choroid
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37
Which of the followings statements is correct about the pictured condition? 
A) Patients may develop this type of condition without suffering eye trauma.
B) A patient's eyesight typically remains unaffected by this condition.
C) Elevating a patient's head should be avoided when treating this condition.
D) This type of condition requires patching only the injured eye to reduce bleeding.

A) Patients may develop this type of condition without suffering eye trauma.
B) A patient's eyesight typically remains unaffected by this condition.
C) Elevating a patient's head should be avoided when treating this condition.
D) This type of condition requires patching only the injured eye to reduce bleeding.
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38
You are attending to a 16 year old boy who has been hit by a baseball on the left side of his face during a game. He is bleeding from his left nostril, cannot move his left eye upward and the left side of his cheek is numb. You should suspect a
A) blowout fracture.
B) hyphema.
C) head injury.
D) zygomatic fracture.
A) blowout fracture.
B) hyphema.
C) head injury.
D) zygomatic fracture.
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39
A 34 year old woman has been in a motor vehicle crash. She has a bruised cheek, her right eye is drooping and bruised, and her mouth and nose are bleeding. What type of injury has this patient most likely sustained?
A) Ethmoid bone fracture
B) Frontal sinus fractures
C) Blowout fracture
D) Midface fractures
A) Ethmoid bone fracture
B) Frontal sinus fractures
C) Blowout fracture
D) Midface fractures
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40
A 47 year old man injured his eye at a construction site. When you examine the eye, you can see grit and foreign materials sticking to the lens. You should
A) Hold the patient's eyelid open while you flush the eye.
B) Flush the eye with cool water for at least 20 minutes.
C) Cover the eye with a dry pad after it has been flushed.
D) Continue to flush the eye en route to a medical facility.
A) Hold the patient's eyelid open while you flush the eye.
B) Flush the eye with cool water for at least 20 minutes.
C) Cover the eye with a dry pad after it has been flushed.
D) Continue to flush the eye en route to a medical facility.
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41
A 37 year old male has a sharp piece of wood impaled in his neck. The open neck wound is bleeding heavily. According to the text, you should FIRST:
A) apply pressure to both carotid arteries and then apply a dressing.
B) use a gloved finger to apply pressure to the wound and control bleeding.
C) cover the wound with a dressing and change blood soaked dressings.
D) remove the penetrating object and then quickly bandage the wound.
A) apply pressure to both carotid arteries and then apply a dressing.
B) use a gloved finger to apply pressure to the wound and control bleeding.
C) cover the wound with a dressing and change blood soaked dressings.
D) remove the penetrating object and then quickly bandage the wound.
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42
Which of the following statements about a concussion is correct?
A) A concussion is not normally associated with the development of a brain injury.
B) The symptoms of a concussion generally disappear within 12 hours.
C) A concussion is defined by a brief loss of consciousness in the patient.
D) Maximum memory loss usually occurs immediately after the concussion injury.
A) A concussion is not normally associated with the development of a brain injury.
B) The symptoms of a concussion generally disappear within 12 hours.
C) A concussion is defined by a brief loss of consciousness in the patient.
D) Maximum memory loss usually occurs immediately after the concussion injury.
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43
Which of the following statements about a cerebral contusion is correct?
A) A cerebral contusion is a brain injury which affects large areas of brain tissue.
B) Symptoms of a cerebral contusion are not associated with bruise location.
C) Bruising from a cerebral contusion may occur on the opposite side of the impact.
D) Prolonged unconsciousness is not a normal symptom of cerebral contusion.
A) A cerebral contusion is a brain injury which affects large areas of brain tissue.
B) Symptoms of a cerebral contusion are not associated with bruise location.
C) Bruising from a cerebral contusion may occur on the opposite side of the impact.
D) Prolonged unconsciousness is not a normal symptom of cerebral contusion.
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44
Your 56 year old unconscious male patient was struck by a car while walking. He is bleeding from his ears and nose and is snoring. You should
A) insert an oral airway using a modified jaw thrust and administer 100% oxygen.
B) stop the flow of cerebrospinal fluid from his ears and nose with a secure sterile dressing.
C) stabilize the patient on a backboard and raise the head of the backboard to 70 degrees.
D) measure and insert a correct size nasal airway and administer 100% oxygen.
A) insert an oral airway using a modified jaw thrust and administer 100% oxygen.
B) stop the flow of cerebrospinal fluid from his ears and nose with a secure sterile dressing.
C) stabilize the patient on a backboard and raise the head of the backboard to 70 degrees.
D) measure and insert a correct size nasal airway and administer 100% oxygen.
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45
Your 28 year old unconscious male patient has fallen off a roof and his neck is bent at an abnormal angle. While you attempt in-line stabilization, he begins to have difficulty breathing. In this instance you should
A) continue in-line stabilization and then used rolled towels or blankets to secure his head.
B) stop movement and stabilize his head in the position it was found with a cervical collar.
C) continue in-line stabilization and then apply a cervical collar to keep his head in line.
D) stop movement and stabilize his head in the position it was found using rolled towels.
A) continue in-line stabilization and then used rolled towels or blankets to secure his head.
B) stop movement and stabilize his head in the position it was found with a cervical collar.
C) continue in-line stabilization and then apply a cervical collar to keep his head in line.
D) stop movement and stabilize his head in the position it was found using rolled towels.
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46
Which of the following statements about a skull fracture is correct?
A) A compound skull fracture occurs when the scalp is cut and the skull is fractured.
B) An outpressed skull fracture occurs when pieces of the skull are broken outward.
C) An inline skull fracture occurs when broken pieces of skull move into the brain.
D) A lowline skull fracture occurs when the base of the skull is broken and bruised.
A) A compound skull fracture occurs when the scalp is cut and the skull is fractured.
B) An outpressed skull fracture occurs when pieces of the skull are broken outward.
C) An inline skull fracture occurs when broken pieces of skull move into the brain.
D) A lowline skull fracture occurs when the base of the skull is broken and bruised.
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47
Which of the following statements about spinal cord injuries is correct?
A) The majority of spinal cord injuries occur to the thoracic and lumbar spine.
B) The spinal cord does not have to be severed for damage to occur.
C) A spinal cord injury always includes an injury to the spinal column.
D) All of these are correct.
A) The majority of spinal cord injuries occur to the thoracic and lumbar spine.
B) The spinal cord does not have to be severed for damage to occur.
C) A spinal cord injury always includes an injury to the spinal column.
D) All of these are correct.
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48
What is the best indicator of a brain injury?
A) Impaled or implanted objects in the head
B) Altered or decreasing mental status
C) Memory loss or confusion
D) Open wounds on the head
A) Impaled or implanted objects in the head
B) Altered or decreasing mental status
C) Memory loss or confusion
D) Open wounds on the head
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49
If a patient suffers an injury that causes bleeding within the skull, what happens?
A) Pressure within the skull will continue to rise without outside intervention.
B) Pressure builds and then resides as the brain slowly absorbs the blood.
C) The brain avoids dangerous pressure when blood is released through the ears.
D) The brain avoids dangerous pressure when blood is released through the nose.
A) Pressure within the skull will continue to rise without outside intervention.
B) Pressure builds and then resides as the brain slowly absorbs the blood.
C) The brain avoids dangerous pressure when blood is released through the ears.
D) The brain avoids dangerous pressure when blood is released through the nose.
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Your 47 year old male patient has a long nail impaled through his cheek and the blood is causing him to cough. You should
A) leave the object alone and apply direct pressure to the wound on the inside of the cheek.
B) leave the object alone and apply direct pressure to the wound on the outside of the cheek.
C) remove the object and apply direct pressure to the wound on the outside of the cheek.
D) remove the object and apply direct pressure to the wound on the inside of the cheek.
A) leave the object alone and apply direct pressure to the wound on the inside of the cheek.
B) leave the object alone and apply direct pressure to the wound on the outside of the cheek.
C) remove the object and apply direct pressure to the wound on the outside of the cheek.
D) remove the object and apply direct pressure to the wound on the inside of the cheek.
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