Surgery 質問

What type of intracranial hemorrhage would MOST likely be caused by a penetrating head injury?A. Subdural hematomaB. Epidural hematomaC. Intracerebral hematomaD. Subarachnoid hemorrhage

what is the most frequent for of TBI (traumatic brain injury)

Cerebrospinal fluid drainage from the ears is MOST indicative of:A. Intracerebral bleedingB. An epidural hematomaC. A skull fractureD. A nasal fracture

Death following a head injury is MOST often the result of:A. Airway compromiseB. An epidural hematomaC. Trauma to the brainD. Spinal cord transection

T/F Skull fractures do not necessarily indicate underlying brain damage

The FIRST step in any neurologic assessment involves:A. Asking the patient if he or she can feel or moveB. Assessing the pupils for size, equality, and reactivityC. Determining the patient's level of consciousnessD. Obtaining an initial Glasgow Coma Scale score

Prehospital treatment of the patient with a traumatic brain injury must focus primarily on:A. Taking measures to decrease intracranial pressureB. Maintaining cerebral perfusion pressureC. Hyperventilating the patient at 20 breaths/minD. Maintaining a systolic BP of at least 120mmHG

An epidural hematoma typically causes rapid deterioration in the head-injured patient's condition because:A. The meningeal veins are often disruptedB. Concomitant spinal cord injury is often presentC. It is associated with brisk arterial bleedingD. Numerous axons are severely damaged

Which of the following is a sign of a moderate elevation in intracranial pressure?A. Biot (ataxic) respirationsB. Widened pulse pressureC. Irregular pulse rateD. Unilaterally blown pupil

What portion of the brainstem is responsible for maintenance of consciousness?A. Reticular activating systemB. Basal gangliaC. DiencephalonD. Limbic system

What type of skull fracture is MOST common following high-energy direct trauma to a small surface area of the head with a blunt object?A. Open fractureB. Depressed fractureC. Non-displaced fractureD. Basilar fracture

The MOST disastrous consequence of a severe traumatic brain injury is:A. An increase in mean arterial pressureB. A decrease in cerebral perfusion pressureC. Severe hypertension and bradycardiaD. An increase in intracranial pressure

When an unrestrained passenger's head strikes the windshield of a motor vehicle following rapid deceleration:A. Compression injuries occur to the anterior portion of the brain, and stretching or tearing injuries occur to the posterior portion of the brainB. The anterior portion of the brain sustains stretching or tearing injuries, and the posterior portion of the brain sustains compression injuriesC. The brain initially strikes the rear of the skull, resulting in direct bruising, and then rebounds and strikes the front part of the skullD. The head falls back against the headrest or seat and the brain collides with the rear of the skull resulting in direct injury to the occipital lobe

The parietal lobe of the brain:A. Controls functions such as long-term memory, taste, and smellB. Is where the optic nerve originates and processes visionC. Controls the body's ability to perceive body limb movementD. Is important for voluntary motor action and personality traits

A scalp laceration that occurs in conjunction with a nondisplaced skull fracture:A. Should be treated with firm direct pressureB. Is considered to be an open skull fractureC. Typically causes significant hypertensionD. Often causes an infection that progresses rapidly

A 19 year old female fell from a second story window and landed on her head. She is unconscious with a blood pressure of 168/104mmHG, heart rate of 56bpm, and irregular respirations of 8 breaths/min. Further assessment reveals blood draining from her nose and bilaterally dilated pupils that are slow to react. In addition to employing full spinal precautions, the MOST appropriate treatment for this patient involves:A. Applying oxygen via nonrebreathing mask, covering her with blankets, starting an IV of normal saline set to keep the vein open, applying a cardiac monitor, initiating transport, and monitoring her pupils while en route to the hospitalB. Intubating her trachea after preoxygenating her for 2 to 3 min with a bag-mask device, transporting immediately, starting at least one large-bore IV en route, applying a cardiac monitor and performing frequent neurologic assessmentsC. Hyperventilating her with a bag-mask device at a rate of 20 breaths/min, starting two large-bore IVs, applying a cardiac monitor, administering 5 mg of Valium to prevent seizures, and transporting to a trauma centerD. Preoxygenating her with a bag-mask device and 100% oxygen for 2 to 3 min, performing nasotracheal intubation, transporting at once, starting at least one large-bore IV line en route and obtaining her Glasgow Coma Scale score

A male patient with a closed head injury opens his eyes in response to pain, makes incomprehensible sounds, and responds to pain with flexion of his arms. His Glasgow Coma Scale score is __, and the MOST appropriate treatment for him involves:A. 6, intubation hyperventilation at a rate of 20 breaths/min, two large-bore IV lines running wide open, keeping him warm, and maintaining his oxygen saturation at greater than 90%B. 7, intubation, ventilations performed at a rate of 12 breaths/min, IV fluids as needed to maintain a systolic blood pressure of at least 90mmHG, and maintaining his oxygen saturation at greater than 90%C. 9, high-flow oxygen via nonrebreathing mask, IV fluids as needed to maintain a systolic blood pressure of at least 100mmHg, monitoring his oxygen saturation, and administering 1.5 mg/kg of lidocaine to decrease intracranial pressureD. 8, ventilation assistance with a bag-mask device, a 2 L bolus of normal saline or lactated ringer solution, elevating his head 12inches, and hyperventilating him if his heart rate falls below 60 beats/min

Unlike a cerebral concussion, a cerebral contusion is:A. A type of diffuse axonal injury that often leads to permanent neurologic damageB. Typically not associated with retrograde amnesia or focal neurologic deficitsC. A diffuse brain injury that results in sever intracranial hemorrhage and pressureD. Associated with physical brain damage and more pronounced neurologic deficits

Open fractures of the cranial vault:A. Typically cause lethal atrial cardiac dysrhythmiasB. Are associated with a high risk of bacterial meningitisC. Cause death due to increased intracranial pressureD. Are uncommonly associated with multisystem trauma

Secondary brain injuries include all of the following, EXCEPT:A. Cerebral edemaB. Axonal injuryC. Intracranial hemorrhageD. Cerebral ischemia