Chapter 28 Workbook

Question 1

Layers of bone within the nasal cavity

Answer 1

Turbinates

Question 2

The light-sensitive area of the eye where images are projected

Answer 2

Retina

Question 3

The eyeball

Answer 3

Globe

Question 4

The eardrum

Answer 4

Tympanic membrane

Question 5

The external, visible part of the ear

Answer 5

Pinna

Question 6

The tough, fibrous, white portion of the eye

Answer 6

Sclera

Question 7

Naturally occurring unequal pupils

Answer 7

Anisocoria

Question 8

The transparent tissue layer in front of the pupil and iris

Answer 8

Cornea

Question 9

A bony mass at the base of the skull about 1 inch (2.54 cm) behind the opening to the ear

Answer 9

Mastoid process

Question 10

Muscle and surrounding tissue behind the cornea that dilate and constrict the pupil

Answer 10

Iris

Question 11

The transparent part of the eye through which images are focused on the retina

Answer 11

Lens

Question 12

Connects the middle ear to the oropharynx

Answer 12

Eustachian tube

Question 13

A small, rounded, fleshy bulge that lies immediately anterior to the ear canal

Answer 13

Tragus

Question 14

Cranial nerve that transmits visual information to the brain

Answer 14

Optic nerve

Question 15

A circular opening in the middle of the iris that admits light to the back of the eye

Answer 15

Pupil

Question 16

As an EMT, your objective when treating patients with face and neck injuries is to do all of the following EXCEPT:
A. prevent further injury
B. manage any acute airway problems
C. control bleeding
D. disregard the cervical spine

Answer 16

D. disregard the cervical spine

Question 17

The head is divided into two parts: the cranium and the:
A. brain
B. face
C. skull
D. medulla oblongata

Answer 17

B. face

Question 18

The brain connects to the spinal cord through a large opening at the base of the skull known as the:
A. eustachian tube
B. spinous process
C. foramen magnum
D. vertebral foramina

Answer 18

C. foramen magnum

Question 19

Approximately ________ of the nose is composed of bone. The remainder is composed of cartilage.
A. nine-tenths
B. two-thirds
C. three-quarters
D. one-third

Answer 19

D. one-third

Question 20

Motion of the mandible occurs at the:
A. temporomandibular joint
B. mastoid process
C. chin
D. mandibular angle

Answer 20

A. temporomandibular joint

Question 21

You respond to a 71-year-old woman who is unresponsive. You try to get her to respond but have no success. Her airway is open, and she is breathing at a rate of 14 breaths/min. You know that you can check a pulse on either side of the neck. You know that the jugular veins and several nerves run through the neck next to the trachea. What structure are you trying to locate to take a pulse?
A. Hypothalamus
B. Subclavian arteries
C. Cricoid cartilage
D. Carotid arteries

Answer 21

D. Carotid arteries

Question 22

The ________ connects the cricoid cartilage and thyroid cartilage.
A. larynx
B. cricoid membrane
C. cricothyroid membrane
D. thyroid membrane

Answer 22

C. cricothyroid membrane

Question 23

You respond to a 68-year-old man who was involved in a motor vehicle collision. He is unresponsive, and as you approach, you notice that he is not breathing. He was unrestrained and has massive facial injuries. When you check his airway, it is obstructed. Which of the following is NOT likely to cause an upper airway obstruction in a patient with facial trauma?
A. Heavy bleeding
B. Loosened teeth or dentures
C. Soft-tissue swelling
D. Inflamed tonsils

Answer 23

D. Inflamed tonsils

Question 24

You are dispatched to a residential neighborhood for a 6-year-old girl who was bitten by the family pet. The mother meets you at the door with the girl, who is crying uncontrollably and has blood covering the right side of her head. You look at the child and notice that her lower right ear has been completely avulsed. You control the bleeding with direct pressure and bandage the injury. You follow the blood trail back to where the incident occurred and find the avulsed part. How do you manage the avulsed tissue?
A. Wrap the skin in a sterile dressing, place it in a plastic bag, and keep it cool.
B. Place the skin in a plastic “biohazard” bag and dispose of it properly.
C. Place the skin in a plastic bag filled with ice and transport it to the emergency department.
D. Leave it at the scene to be disposed of later.

Answer 24

A. Wrap the skin in a sterile dressing, place it in a plastic bag, and keep it cool.

Question 25

The nasal cavity is divided into two chambers by the: A. frontal sinus B. middle turbinate C. zygoma D. nasal septum

Answer 25

D. nasal septum

Question 26

You are called to the home of a 48-year-old woman who has a history of high blood pressure and now has a major nosebleed. She is alert and oriented and converses freely with you. Her respirations and pulse are within normal limits. Her blood pressure is 194/108 mm Hg. You have been able to rule out trauma. How would you manage the nosebleed? A. Apply a sterile dressing. B. Pinch the nostrils together. C. Place the patient in a supine position. D. Have the patient hold ice in her mouth.

Answer 26

B. Pinch the nostrils together.

Question 27

The middle ear is connected to the nasal cavity by the: A. frontal sinus B. zygomatic process C. eustachian tube D. superior trachea

Answer 27

C. eustachian tube

Question 28

Which of the following is NOT a sign or symptom of a laryngeal injury? A. Hoarseness B. Difficulty breathing C. Subcutaneous emphysema D. Wheezing

Answer 28

D. Wheezing

Question 29

Which of the following is NOT a sign of a possible facial fracture? A. Bleeding in the mouth B. Absent or loose teeth C. Bleeding from the forehead D. Loose and/or moveable bone fragments

Answer 29

C. Bleeding from the forehead

Question 30

The presence of air in the soft tissues of the neck that produces a crackling sensation is called: A. the “Rice Krispies” effect B. a pneumothorax C. rales D. subcutaneous emphysema

Answer 30

D. subcutaneous emphysema

Question 31

Which of the following statements is NOT true regarding the treatment of bleeding from a neck injury? A. Apply a circumferential bandage around the neck. B. Apply pressure to the bleeding site using a gloved fingertip. C. Apply a sterile occlusive dressing. D. Use gauze to secure the dressing in place.

Answer 31

A. Apply a circumferential bandage around the neck.

Question 32

What is the main purpose of eye blinking? A. Clean the eye B. Prevent eye muscle atrophy C. Natural reflex to bright light D. Refocus the eye

Answer 32

A. Clean the eye

Question 33

When flushing an eye with saline to remove a foreign object, it is important to remember to: A. flush from the outside of the eye in toward the nose B. flush from the top of the eye toward the bottom C. flush from the nose side of the eye toward the outside D. flush only along the bottom of the eye

Answer 33

C. flush from the nose side of the eye toward the outside

Question 34

When stabilizing a large foreign object in the eye, you should first cover the eye with a moist dressing, then: A. irrigate the eye with saline B. surround the object with a doughnut-shaped collar made from gauze C. apply tape around the object and then secure the tape to the forehead D. place an ice pack over the eye to reduce swelling

Answer 34

B. surround the object with a doughnut-shaped collar made from gauze

Question 35

When a patient has a chemical burn to the eye, you should irrigate the eye for at least 5 minutes; however, if the burn was caused by an alkali or strong acid, you should irrigate for: A. 10 minutes B. 15 minutes C. 20 minutes D. 25 minutes

Answer 35

C. 20 minutes

Question 36

True/False Injuries to the face often lead to airway problems.

Answer 36

True

Question 37

True/False Care for facial injuries begins with standard precautions and the ABCs.

Answer 37

True

Question 38

True/False Exposed eye or brain injuries are covered with a dry dressing.

Answer 38

False

Question 39

True/False Clear fluid in the outer ear is normal.

Answer 39

False

Question 40

True/False Any crushing injury of the upper part of the neck likely involves the larynx or the trachea.

Answer 40

True

Question 41

True/False Soft-tissue injuries to the face are common.

Answer 41

True

Question 42

True/False The opening through which the spinal cord leaves the head is called the occiput.

Answer 42

False

Question 43

True/False The muscle that allows movement of the head is the temporomandibular.

Answer 43

False

Question 44

True/False Standard precautions for assessing face and throat injuries should include eye protection and a face mask.

Answer 44

True

Question 45

True/False Stabilization and maintenance of an airway can be difficult in patients with facial injuries.

Answer 45

True

Question 46

True/False Unequal pupil size could possibly indicate a brain injury.

Answer 46

True

Question 47

True/False Gentle irrigation will usually wash out foreign material stuck in the cornea.

Answer 47

False

Question 48

True/False Retinal injuries caused by exposure to extremely bright light are generally painless and may result in permanent damage.

Answer 48

True

Question 49

True/False You should never exert pressure on or manipulate an injured eye in any way.

Answer 49

True

Question 50

True/False Bleeding into the anterior chamber of the eye is commonly called conjunctivitis.

Answer 50

False

Question 51

True/False When dealing with an injured eye, you should always remove contact lenses before treatment.

Answer 51

False

Question 52

True/False Open injuries to the larynx can occur as the result of a stabbing.

Answer 52

True

Question 53

True/False Broken teeth and lacerations to the tongue cause minimal bleeding and are not concerning.

Answer 53

False

Question 54

True/False Oxygen and airway management are important for all patients with face and neck injuries.

Answer 54

True

Question 55

Pulsations in the neck are felt in the ________ vessels.

Answer 55

carotid

Question 56

The ________ vertebrae are in the neck.

Answer 56

cervical

Question 57

The ________ regions of the cranium are located on the lateral portion of the head.

Answer 57

temporal

Question 58

The ________ connects the oropharynx and the larynx with the main air passages of the lungs.

Answer 58

trachea

Question 59

The rings of the trachea are made of ________.

Answer 59

cartilage

Question 60

The Adam’s apple is more prominent in ________ than in ________.

Answer 60

men, women

Question 61

The __________ __________ is a large opening at the base of the skull.

Answer 61

foramen magnum

Question 62

Blunt trauma that causes fractures to the orbit is commonly called a(n) __________ __________.

Answer 62

blowout fracture

Question 63

Trauma to the face and skull that results in the posterior wall of the nasal cavity becoming unstable is caused by __________ __________ __________.

Answer 63

basilar skull fracture

Question 64

When dealing with an avulsed tooth, handle it by its ____________ and not by the ____________.

Answer 64

crown, root

Question 65

A(n) __________ __________ results when an open vein sucks air into it and the air travels to the heart.

Answer 65

air embolism

Question 66

Answer 66

The Face A. Nasal bone B. Zygoma C. Maxilla D. Mandible

Question 67

Answer 67

The Larynx A. Laryngeal prominence (Adam’s apple) B. Thyroid cartilage C. Cricothyroid membrane D. Cricoid cartilage E. Trachea

Question 68

Answer 68

The Eye A. Anterior compartment filled with aqueous humor B. Posterior compartment filled with vitreous humor C. Anterior chamber D. Posterior chamber E. Vein F. Iris G. Cornea H. Pupil I. Artery J. Lens K. Optic nerve L. Retina M. Choroid N. Sclera

Question 69

Answer 69

The Ear A. Pinna B. External auditory canal C. Tympanic membrane D. Cochlea E. Hammer F. Anvil G. Stirrup

Question 70

Short Answer Describe bleeding-control methods for facial injuries.

Answer 70

Apply direct manual pressure with a dry dressing. Use roller gauze around the circumference of the head to hold the pressure dressing in place. Make sure you do not apply excessive pressure if there is a possibility of an underlying skull fracture.

Question 71

Short Answer Describe bleeding-control methods for lacerations to veins or arteries in the neck.

Answer 71

1. Apply direct pressure to the bleeding site using a gloved fingertip if necessary to control bleeding. 2. Apply a sterile occlusive dressing to ensure that air does not enter a vein or artery. 3. Secure the dressing in place with roller gauze, adding more dressings if needed. 4. Wrap the gauze around and under the patient’s shoulder. To avoid possible airway and circulation problems, do not wrap the gauze around the neck.

Question 72

Short Answer Explain the physical exam process for evaluation of the eye.

Answer 72

Start on the outer aspect of the eye and work your way in toward the pupil. Examine the eye for any obvious foreign matter. Observe for discoloration of the eye. Evaluate the clarity of the patient’s vision. Assess for redness of or bleeding into the iris. Look for symmetry between the two eyes. Assess the pupils for equal size and reaction to light. Determine if unequal pupils are caused by physiologic or pathologic issues. Determine if the patient is able to follow your finger with his or her eyes. Assess visual acuity by having the patient read print. Question about blurry vision or sensitivity to light.

Question 73

Short Answer List three important guidelines to use when treating an eye laceration.

Answer 73

1. Never exert pressure on or manipulate the injured eye (globe) in any way. 2. If part of the eyeball is exposed, gently apply a moist, sterile dressing to prevent drying. 3. Cover the injured eye with a protective metal eye shield, cup, or sterile dressing. Apply soft dressings to both eyes, and provide prompt transport to the hospital.

Question 74

Short Answer List five eye indications that suggest a closed head injury

Answer 74

1. One pupil larger than the other 2. The eyes not moving together or pointing in different directions 3. Failure of the eyes to follow the movement of your finger as instructed 4. Bleeding under the conjunctiva, which obscures the sclera of the eye 5. Protrusion or bulging of one eye

Question 75

Ambulance Calls You are dispatched to assist a small child who was attacked by his family’s dog. The dog bit the child’s face and neck repeatedly, then grabbed him by the neck and shook him violently. The mother found the boy “making funny breathing sounds” and called for help. She has removed the dog from the area. How would you best manage this patient?

Answer 75

Depending on where the dog’s teeth have punctured the skin, you may have a variety of soft-tissue injuries and swelling. If you notice the presence of subcutaneous emphysema, the dog punctured or perforated the child’s trachea. You must also assume the presence of cervical spine injuries and take appropriate precautions. Assess his level of consciousness, airway, breathing, and circulation. Control any bleeding and apply other dressings, as needed, after airway management is accomplished and while en route to the hospital. Always follow local protocols.

Question 76

Ambulance Calls You are dispatched to a 37-year-old man with a large laceration to the right side of his neck. Bleeding is dark and heavy. He is alert but weak. How would you best manage this patient?

Answer 76

Apply direct pressure to the bleeding site using gloved fingertips and a sterile occlusive dressing. Secure the dressing in place and apply pressure, if necessary. You may need to treat for shock. Provide prompt transport with the patient immobilized to a long backboard, and apply high-flow oxygen en route.

Question 77

Ambulance Calls You are dispatched to a Little League baseball game to assist an assault victim. Apparently, emotions were running high when two parents began to argue. You arrive to find a 40-year-old man with a bloody nose. How would you best manage this patient?

Answer 77

You should determine what objects were used to cause injury to this man’s face. Baseball bats would be readily available and would increase your index of suspicion. You should determine the presence of head and neck pain. If the area of injury is limited to his nose, and the need for spinal precautions is not indicated, you can instruct the patient in controlling his bleeding by ensuring that he pushes on the cartilage of his nose and does not lean his head backward. Swallowing blood will cause nausea. Do not allow the patient to blow his nose, and consider using ice, as needed, to reduce swelling and pain. Transport according to local protocols.

Question 78

You have responded to a motor vehicle collision and find a 21-year-old man who has massive facial trauma. He is bleeding heavily and is unconscious. The first thing that you do in your treatment of this patient is to: A. take cervical spine precautions B. open the airway C. assess his breathing D. take standard precautions

Answer 78

D. take standard precautions

Question 79

You have responded to a motor vehicle collision and find a 21-year-old man who has massive facial trauma. He is bleeding heavily and is unconscious. The first thing that you do in your treatment of this patient is to: How often would you reassess his vitals during your ongoing assessment? A. Every 3 minutes B. Every 5 minutes C. Every 10 minutes D. Every 15 minutes

Answer 79

B. Every 5 minutes

Question 80

You have a patient who has severe epistaxis. You have been able to rule out trauma. How would you position this patient to help control the bleeding? A. Supine B. Prone C. Sitting leaning back D. Sitting leaning forward

Answer 80

D. Sitting leaning forward

Question 81

You have a patient who has had a tooth knocked out. You find the tooth. How would you transport it to the hospital? A. In saline B. In dextrose C. In ice D. In a dry sterile dressing

Answer 81

A. In saline

Question 82

You respond to a child who has placed a pebble in his ear. He is complaining that his ear hurts. You should: A. remove the pebble with a cotton-tipped applicator B. have the child try to shake the pebble out C. leave the pebble in the ear and transport D. not load the patient because this is not an emergency

Answer 82

C. leave the pebble in the ear and transport