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CH 29-30
| Question | Answer |
|---|---|
| The nervous system is: | a complex network of nerve cells that enables all parts of the body to function |
| the nervous system includes: | brain, spinal cord and nerves and nerve fibers |
| The nervous system is divided into two anatomic parts: | Central nervous system and Peripheral nervous system |
| central nervous system includes: | the brain and spinal cord |
| the brain is divided into 3 major parts: | cerebrum, cerebellum and the brain stem |
| cerebrum: | controls a wide variety of activities, including most voluntary motor function and conscious thought. Contains about 75% of the brain’s total volume. Divided into two hemispheres with four lobes |
| Cerebellum: | Coordinates balance and body movements |
| Brainstem: | Controls most functions necessary for life. Best-protected part of the CNS |
| Spinal cord: | Made up of fibers that extend from the brain’s nerve cells. Carries messages between the brain and the body via the grey and white matter of the spinal cord |
| Protective coverings: | The entire CNS is contained within a protective framework. The thick, bony structures of the skull and spinal canal withstand injury very well. The CNS is further protected by the meninges. |
| Meninges: | Outer layer (dura mater) is a tough, fibrous layer that forms a sac to contain the CNS. Inner two layers (arachnoid mater and pia mater) contain the blood vessels. |
| Cerebrospinal fluid (CSF): | Produced in a chamber inside the brain called the third ventricle. Approximately 125 to 150 mL of CSF in the brain at any time. Primarily acts as a shock absorber. |
| 31 pairs of spinal nerves in CNS: | Conduct impulses from the skin and other organs to the spinal cord. Conduct motor impulses from the spinal cord to the muscles. |
| The peripheral nervous system is: | a complex network of motor and sensory nerves |
| The brachial plexus: | controls the arms |
| the lumbosacral plexus: | controls the legs |
| 12 pairs of cranial nerves in PNS: | Transmit information directly to or from the brain. Perform special functions in the head and face, including sight, smell, taste, hearing, and facial expressions |
| Two types of peripheral nerves: | sensory nerves and motor nerves |
| sensory nerves PNS: | Carry only one type of information from the body to the brain via the spinal cord |
| motor nerves PNS: | Carry information from the CNS to the muscles |
| Connecting nerves PNS: | Found only in the brain and spinal cord. Connect the sensory and motor nerves with short fibers. Allow the exchange of simple messages |
| Voluntary activities are: | activities we consciously perform. |
| Involuntary activities are: | the actions that are not under conscious control. |
| Somatic (voluntary) nervous system: | handles voluntary activities. |
| Autonomic (involuntary) nervous system: | handles body functions. |
| Sympathetic nervous system: | reacts to stress with a fight-or-flight response. |
| Parasympathetic nervous system: | has the opposite effect on the body. |
| Autonomic (involuntary) nervous system is divided into two sections: | sympathetic and parasympathetic nervous systems |
| the face is composed of 14 bones: | maxillae, zygomas, mandible, and orbit. |
| Four major bones make up the cranium: | occipital, temporal, parietal, and frontal. |
| Signs of skull fracture include: | head seems deformed. Visible cracks in the skull. Ecchymosis (bruising) that develops under the eyes (raccoon eyes). Ecchymosis that develops behind one ear over the mastoid process (Battle sign) |
| Depressed skull fractures results from: | high-energy direct trauma to the head with a blunt object |
| Basilar skull fractures results from: | diffuse impact to the head. Signs include CSF drainage from the ears, raccoon eyes, and Battle sign |
| Open skull fractures results from: | trauma to multiple body systems. brain tissue might be exposed |
| Primary brain injury results instantaneously from: | impact to the head. |
| Secondary brain injury increases: | the severity of the primary injury. |
| Secondary brain injury may be caused by: | Hypoxia. Hypotension. Cerebral edema. Intracranial hemorrhage. Increased intracranial pressure. Cerebral ischemia. Infection |
| A coup-contrecoup injury can result from: | striking a windshield. |
| Signs of increased intracranial pressure: | Cheyne-Stokes respirations. Ataxic (Biot) respirations. Decreased pulse rate, headache, nausea, vomiting, decreased alertness, bradycardia, sluggish or nonreactive pupils, decerebrate posturing, and increased or widened blood pressure. Cushing reflex |
| Epidural hematoma: | Accumulation of blood between the skull and dura mater. Nearly always the result of a blow to the head that produces a linear fracture |
| Subdural hematoma: | Accumulation of blood beneath the dura mater but outside the brain. Occurs after falls or injuries involving strong deceleration forces. May or may not be skull fracture |
| Intracerebral hematoma: | Bleeding within the brain tissue itself. Can occur following a penetrating injury to the head or because of rapid deceleration forces |
| Subarachnoid hemorrhage: | Bleeding occurs into the subarachnoid space, where the CSF circulates. Results in bloody CSF and signs of meningeal irritation. Common causes include trauma or rupture of an aneurysm. |
| Cushing triad: | Increased blood pressure (hypertension), Decreased heart rate (bradycardia), Irregular respirations (Cheyne-Stokes respirations or Biot respirations), Manage shock, administer oxygen, and ventilate as necessary, avoiding hyperventilation |
| Ventilation: | the body’s ability to move air in and out of the chest and lung tissue |
| Oxygenation: | the process of delivering oxygen to the blood by diffusion from the alveoli following inhalation into the lungs |
| The mediastinum contains: | heart, great vessels, esophagus, and trachea |
| contusion: | bruise |
| Tidal volume is: | the amount of air moved into or out of the lungs in a single breath |
| Minute ventilation is: | calculated by multiplying the tidal volume by the number of breaths per minute |
| pneumothorax: | collapsed lung |
| Simple pneumothorax: | Commonly due to blunt trauma that results in fractured ribs. Can often worsen, deteriorate into tension pneumothorax, or develop complications. does not result in major changes in pts cardiac physiology |
| Tension pneumothorax: | Results from ongoing air accumulation in the pleural space. Increased pressure in the chest. Commonly caused by a blunt injury where a fractured rib lacerates a lung or bronchus |
| hemothorax: | Blood collects in the pleural space from bleeding around the rib cage or from a lung or great vessel |
| Hemopneumothorax: | the presence of air and blood in the pleural space |
| cardiac tamponade: | Protective membrane (pericardium) around the heart fills with blood or fluid. The heart cannot pump an adequate amount of blood. |
| flail chest: | Caused by compound rib fractures that detach a segment of the chest wall. Detached portion moves opposite of normal |
| Pulmonary contusion: | Should always be suspected in a patient with a flail chest. Pulmonary alveoli become filled with blood, leading to hypoxia |
| Traumatic asphyxia: | Characterized by distended neck veins, cyanosis in the face and neck, and hemorrhage in the sclera of the eye |
| Blunt myocardial injury: | Bruising of the heart muscle |
| Commotio cordis: | Injury caused by a sudden, direct blow to the chest during a critical portion of the heartbeat |
| In contrast to a cerebral concussion, a cerebral contusion: | involves physical injury to the brain tissue. |
| Common signs of a skull fracture include all of the following, except: | superficial scalp lacerations. |
| A reflex arc occurs when: | a sensory nerve detects an irritating stimulus and bypasses the brain by sending a direct message to the motor nerve. |
| An injured brain begins to swell initially due to: | cerebral edema |
| The Glasgow Coma Scale (GCS) is used to assess: | eye opening, verbal response, and motor response. |
| A patient who cannot remember the events that preceded his or her head injury is experiencing: | retrograde amnesia |
| Hyperextension injuries of the spine are most commonly the result of: | hangings |
| You are assessing a man who has a head injury and note that cerebrospinal fluid is leaking from his ear. You should recognize that this patient is at risk for: | bacterial meningitis |
| The tough, fibrous outer meningeal layer is called the: | dura mater |
| When controlling bleeding from a scalp laceration with a suspected underlying skull fracture, you should: | avoid excessive pressure when applying the bandage. |
| During your primary assessment of a semiconscious 30-year-old female with closed head trauma, you note that she has slow, irregular breathing and a slow, bounding pulse. As your partner maintains manual in-line stabilization of her head, you should: | instruct him to assist her ventilations while you perform a rapid assessment. |
| During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should: | suction his oropharynx for up to 15 seconds. |
| When assessing a conscious patient with a mechanism of injury that suggests spinal injury, you should: | determine if the strength in all extremities is equal. |
| A tight-fitting motorcycle helmet should be left in place unless: | unless it interferes with your assessment of the airway |
| A man jumped from the roof of his house and landed on his feet. He complains of pain to his heels, knees, and lower back. This mechanism of injury is an example of: | axial loading |
| A high school football player was injured during a tackle and complains of neck and upper back pain. He is conscious and alert and is breathing without difficulty. The EMT should: | leave his helmet and shoulder pads in place |
| An epidural hematoma is most accurately defined as: | bleeding between the skull and dura mater |
| The body's functions that occur without conscious effort are regulated by the _________ nervous system. | autonomic |
| A rapid, irregular pulse following blunt trauma to the chest is most suggestive of a: | myocardial contusion. |
| Hemoptysis is defined as: | coughing up blood |
| Pleural fluid is contained between the: | visceral and parietal pleurae |
| The thoracic cavity is separated from the abdominal cavity by the: | diaphragm |
| Following blunt trauma to the chest, an 18-year-old female presents with respiratory distress, shallow breathing, and cyanosis. Her blood pressure is 80/50 mm Hg and her pulse is 130 beats/min and thready. You should: | provide ventilation assistance with a bag valve mask. |
| When a person is lying supine at the end of exhalation, the diaphragm: | might rise as high as the nipple line. |
| The phrenic nerves control the diaphragm and exit the spinal cord at: | C3, C4 and C5 |
| Following a stab wound to the L anterior chest, a 25-year-old male presents with a decreased level of consciousness and signs of shock. Which of the following additional assessment findings should increase your index of suspicion for a cardiac tamponade? | Engorged jugular veins |
| To avoid exacerbating a patient's injury, it is especially important to use extreme caution when providing positive-pressure ventilation to patients with a: | pneumothorax |
| If a person's tidal volume decreases, but his or her respiratory rate remains unchanged: | minute volume will decrease |
| Irritation or damage to the pleural surfaces that causes sharp chest pain during inhalation is called: | pleurisy |
| Ur at a MVC. 50 yr old F was removed from her car PTA. Bystanders removed her say she wasnt wearing seatbelt. Pt is unresponsive, tachy, & diaphoretic. U see bilaterally clear & = breath sounds, midline trachea, and collapsed jugular veins. U think what? | laceration of the aorta. |
| Ur transporting a stable patient w a possible pneumothorax. The pt is receiving high-flow o2 and has an o2 of 95%. During ur reassessment, you find the pt is now confused, LBP, and profusely diaphoretic. What is most likely causing this? | Compression of the aorta and vena cava |
| A 37-year-old male was pinned between a flatbed truck and a loading dock. On exam, you find bruising to the chest, distended neck veins, bilaterally diminished breath sounds, and bilateral scleral hemorrhaging. You should: | aggressively manage his airway |
| The ________ nerves supply the diaphragm. | phrenic |
| Elevation of the rib cage during inhalation occurs when: | the intercostal muscles contract. |
| A spinal cord injury at the level of C7 would most likely result in: | paralysis of the intercostal muscles. |
| A 28 yr old M was struck in the chest with a baseball bat during an altercation. He is conscious and alert and complains of severe chest pain. U reveal a large area of ecchymosis over the sternum and a rapid, irregular pulse. In + to providing o2, u? | prepare for immediate transport |
| Pneumothorax is defined as: | accumulation of air in the pleural space. |
| A flail chest occurs when: | a segment of the chest wall is detached from the thoracic cage. |
| Patients with rib fractures will commonly: | breathe rapidly and shallowly. |
Created by:
bhicks701