chapter 31

Question 1

🩹 Describe the components, anatomy, and physiology of the nervous system (CNS and PNS).

Answer 1

• CNS (Central Nervous System): The brain and spinal cord. It’s the body’s control center.
• PNS (Peripheral Nervous System): All nervous tissue found outside the brain and spinal cord. It includes sensory and motor nerves that connect the CNS to the rest of the body.
• Physiology: Controls voluntary and involuntary activities, receives sensory input, and provides for higher mental functions.

Question 2

🩹 Differentiate between a head injury and a brain injury.

Answer 2

• A Head Injury is a traumatic insult to the head that may result in injury to soft tissue, bony structures, and/or the brain.
• A Traumatic Brain Injury (TBI) occurs when an external force causes the brain to move within the skull or the force causes the skull to break and directly injures the brain.

Question 3

🩹 Relate MOI to potential injuries of the head and spine.

Answer 3

• Blunt trauma (MVCs, falls, assaults) can cause concussions, contusions, skull fractures, and spinal column/cord injuries due to forces of acceleration, deceleration, and compression.
• Penetrating trauma (gunshots, stabbings) can cause open head injuries, brain lacerations, and direct spinal cord damage.

Question 4

🩹 Differentiate between closed and open head injuries.

Answer 4

• Closed Head Injury: The skull remains intact. The primary danger is increased intracranial pressure (ICP) from bleeding inside the skull.
• Open Head Injury: The skull is not intact (it is fractured or penetrated). There is a high risk of infection.

Question 5

🩹 What are the signs of a basilar skull fracture?

Answer 5

These are often delayed signs:
1. Battle’s Sign: Bruising behind the ear.
2. Raccoon Eyes: Bruising around the eyes.
3. Cerebrospinal Fluid (CSF): Clear or pinkish fluid leaking from the ears or nose.

Question 6

🩹 What is the emergency care for a head injury?

Answer 6

1. Maintain manual spinal stabilization.
2. Establish and maintain an open airway (use jaw-thrust maneuver). Have suction ready (vomiting is common).
3. Give 100% oxygen and assist ventilations if breathing is inadequate.
4. Control bleeding with direct pressure (but do not apply excessive pressure if a skull fracture is suspected).
5. Do not attempt to stop the flow of blood or CSF from the ears or nose. Cover loosely with a sterile dressing.

Question 7

🩹 What is the emergency care for an impaled object in the cheek?

Answer 7

An impaled object in the cheek is one of the few times an impaled object may be removed.
Only remove it if it interferes with care of the patient’s airway. After removing it, apply direct pressure to control the bleeding, both inside and outside the cheek.

Question 8

🩹 What is the emergency care for an open neck injury?

Answer 8

1. Immediately place a gloved hand over the wound to control bleeding and prevent an air embolism (air being sucked into the vein).
2. Cover the wound with an occlusive (airtight) dressing.
3. Apply a bulky dressing and pressure.
4. Never apply a circular bandage around the neck (can cause strangulation).

Question 9

🩹 Differentiate between a concussion and a cerebral contusion.

Answer 9

• Concussion: A TBI that results in a temporary loss of function. May or may not involve loss of consciousness. Repetitive questioning is a common sign.
• Cerebral Contusion: A TBI in which brain tissue is bruised and damaged in a local area. This is more serious than a concussion.

Question 10

🩹 Differentiate between a spinal cord injury and a spinal column injury.

Answer 10

• A Spinal Column Injury is an injury to the vertebrae (bones).
• A Spinal Cord Injury is an injury to the spinal cord (nerves). This can occur with or without a spinal column injury.

Question 11

🩹 What are the signs and symptoms of a potential spine injury?

Answer 11

• Pain or tenderness along the spine
• Numbness, weakness, or tingling in the extremities
• Paralysis (inability to move)
• Loss of bladder or bowel control
• Deformity of the spine
• Difficulty breathing (if a cervical injury)

Question 12

🩹 What is the preferred method for opening the airway in a patient with a suspected spine injury?

Answer 12

Use the modified jaw-thrust maneuver. (If this fails, use the head tilt–chin lift maneuver, as opening the airway is the top priority).

Question 13

🩹 What is the emergency care for a possible spine injury?

Answer 13

1. Maintain manual in-line stabilization.
2. Maintain an open airway using the jaw-thrust maneuver.
3. Administer 100% oxygen.
4. Assess PMS (Pulse, Movement, Sensation) in all extremities.
5. Immobilize the patient on a long backboard with a cervical collar.

Question 14

🔑 Define: Central Nervous System (CNS) vs. Peripheral Nervous System (PNS)

Answer 14

• CNS: The brain and spinal cord.
• PNS: All nervous tissue found outside the brain and spinal cord.

Question 15

🔑 Define: Autonomic Nervous System

Answer 15

The involuntary division of the PNS. It is further divided into:
* Sympathetic: “Fight-or-flight” response.
* Parasympathetic: “Rest and digest” response.

Question 16

🔑 Define: Head Injury vs. Traumatic Brain Injury (TBI)

Answer 16

• Head Injury: A traumatic insult to the head that may result in injury to soft tissue, bony structures, and/or the brain.
• TBI: Occurs when an external force causes the brain to move within the skull or the skull to break and directly injure the brain.

Question 17

🔑 Define: Closed Head Injury vs. Open Head Injury

Answer 17

• Closed Head Injury: The skull remains intact. Risk of increased intracranial pressure (ICP).
• Open Head Injury: The skull is not intact. High risk of infection.

Question 18

🔑 Define: Paraplegia vs. Quadriplegia (Tetraplegia)

Answer 18

• Paraplegia: Loss of movement and sensation in the lower half of the body (from a thoracic or lumbar spine injury).
• Quadriplegia (Tetraplegia): Loss of movement and sensation in both arms, both legs, and parts of the body below the injury (from a cervical spine injury).