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WorksheetsEmergency Med - Head and Neck Trauma
Total questions: 41
Worksheet time: 23mins
Upon primary survey of a traumatic head injury, which of the following would indicate endotracheal intubation?
loss of gag reflex
GCS < 8
loss of consciousness
incontinence
Blunt force to the chest is a cervical spine injury until proven otherwise.
True
False
Which of the following would help indicate that one's airway is NOT patent?
crepitus
flail chest
tracheal deviation
breath sounds
What is the main concern when evaluating circulation on your primary survey?
Cyanosis
HoTN
HTN
Syncope
Which of the following is an easily reversible cause of altered mental status?
hypoglycemia
hypoxemia
overdose
hypophosphatemia
_______ posture results from damage to the upper brain stem. In this posture, the arms are adducted and extended, with wrists pronated and fingers flexed. Legs are stiffly extended with plantar flexion of the feet.
Decortisone
Decerebrate
Decorticate
Decelerate
A pt should be completely undressed and ENTIRE body should be examined upon primary survey
True
False
Which of the following would concern you for possible brain herniation?
hypertension
hypotension
bradycardia
respiratory depression
Head lacerations can be closed up to _____ hours after initial injury
8
12
24
48
Lacerations to the _______ should be repaired with absorbable sutures to prevent a subgleal hematoma and subsequent infxn
Loose connective tissue
Galea Aponeurotica
Skin
Periosteum
When should you strongly consider a CT to evaluate a more serious intracranial injury?
Scalp Hematoma
Scalp laceration
Scalp abrasion
Which of the following would indicate a fracture at the base/floor of the skull
Battle sign
Raccoon eyes
CSF leak
hemotypanum
Clear drainage of the ears and nose that is exacerbated by Valsalva should concern you for what?
Risk of Meningitis
CSF leak
Otitis Media
TM rupture
Basillar skull fractures can be missed on CT, so if clinical signs, consult neurosurgery and consider sending home
True
False
A pt presents with a history of initial brief LOC that progressed to a transient "lucid interval". Upon CT of the head you find a bioconvex shaped collection of blood between the dura mater and bones of skull, what is the most likely diagnosis?
Epidural hematoma
Subdural hematoma
Subarachnoid hematoma
What is the most likely source of bleeding for an elderly, alcohlic pt presenting with a crescent shaped, bioconcave bleed between the dura mater and arachnoid mater?
Veins
Arteries
Aneurysm
A pt presents to the ED with a chief complaint severe headache. She has a history of vomiting, vision changes and loss of consciousness since the onset of headache. She reports that this is the worst headache of her life that came on like a thunder clap. What would you suspect to find on CT of this female's head?
blood between her eye balls
blood between arachnoid and pia mater
blood between arachnoid and dura mater
blood between skull and dura mater
A concussion is a _______ mild traumatic brain injury with temporary loss of brain function.
irreversible
reversible
Multiple concussions over a lifetime can lead to an increased cognitive function.
True
False
This is the diagnosis given to a pt that have persistent concussion sx despite adequate rest period.
Concussive cognitive impairment
Postconcussion syndrome
Epidural hematoma
Persistent concussion defect
What is the name of the guideline recommendations for when to CT pediatric head trauma?
EMTALA
PECARN
PCOM
PCOS
What should you be concerned of that can cause esophageal or airway injury upon blunt trauma to the neck?
pneumothorax
Pneumomediastinum
Pericardial effusion
Pleural effusion
Any Neck Injury to ______ should be explored by a SURGEON.
Sternocleidomastoid
Platysma
Platypus
Platelet rich plasma
A pt who had recent neck trauma presents with hoarseness, stridor, painful phonation and pneumothorax. What is the best option to identify the underlying cause?
CT chest
Bronchoscopy
Esophagoscopy
CXR
You receive a pt with CC of Neck pain by MVA. CT results show an intimal flap of internal carotid. Which of the following steps should you consider?
Consult Cardiothoracic Surgery
Consult Trauma Surgery
Consult General Surgery
Consult Neurosurgery
_______ is most common form of injury to the face.
Blunt Trauma
Penetration Trauma
Emotional Trauma
Childhood Trauma
What should you be concerned of when dealing with a Parotid injury?
Carotid impingement
Laceration of Stensen Duct
Fracture of the mandible
Acquired hypothyroidism
What Ophthalmologic Emergency should you be concerned of in a pt presenting with proptosis, decreased extraocular movements, elevated IOP and vision changes?
Corneal abrasion
Orbital compartment syndrome
Ruptured Globe
Glaucoma
A pt complains of light sensitivity and 8/10 eye pain. Pt is unable to keep eye open and complains of severe pain upon blinking. Which of the following would be the best next step in managing this pt?
Instill 1 drop of artificial tears for relief
Instill fluorescein and use Wood's lamp to observe
Forcefully Blow in the pt's eye
Instill 3 drops of Ofloxacin
What should you suspect upon visualizing this in a pt with no ocular complaints, and how should you treat the pt?
Subconjunctival Hemorrhage
Orbital Blowout Fracture
Send home, will resolve on its own
Send to Ophtho, will need surgery
What should you be concerned of in a pt in the ED after a baseball hit his face experiencing double vision with inability to look upward along with decreased EOMs?
Glaucoma
Orbital Floor Blowout Fracture
Orbital compartment syndrome
Subconjunctival Hemorrhage
What should you do for a pt who's TM is ruptured upon your otoscopic exam due to getting slapped by his little sister?
Rx Amox/Clav PO
Send home, will resolve on its own
Rx Ofloxacin otic drops
Send to Ophthalmology
A wrestler comes into the ER complaining of ear pain. Upon exam you note that there is swelling between the perichondrium and auricular cartilage. What is the next best step in managing this pt?
Tell him to rub some dirt in it
Drain fluid
Slap it
start abx
What classification would be given to a frx that includes the maxilla and bony nasal skeleton?
LeFort I
LeFort II
LeFort III
Which of the following could be treated with analgesics and sent home with a follow up appointment?
LeFort I
LeFort II
LeFort III
A pt comes in to the ED after being punched in the face by his dog. You suspect a nasal fracture. What should you inspect for to prevent necrosis and saddle nose deformity?
septal herniation
Septal hematoma
epidural hematoma
septal deviation
Which of the following is is the most appropriate first step in caring for a pt presenting with an ear laceration?
Local infiltration of lidocaine without epinephrine
check for signs of AMS in basilar skull frx
Irrigation of wound with normal saline
Local infiltration of lidocaine with epinephrine
A 17 yo high school football star comes into office with neck pain. He reports it started after being tackled and was followed by tingling in both arms. What is the next best step in management?
Neurosurgical referral
Neck Slap
C spine immobilization
Analgesia and observation
Displacement of tooth out of socket is known as what?
tooth decay
tooth subluxation
tooth dislocation
tooth avulsion
The most common tooth fracture involving the enamel and yellow dentin is considered what type of fracture?
Ellis Grey
Ellis II
Elvis I
Ellis III
A 13 yo was hit in the right eye with a billiard ball. The area is ecchymotic and swollen. His pain level is a 6/10. Which of the following exam findings is most supportive of the likely diagnosis?
subcutaneous emphysema
Restricted ROM
Proptosis
loss of accomodation
