Question 1

Which one of the following signs or symptoms best indicates the patient has suffered an injury to the thoracic spine?

Accepted Answer

Tingling in the legs can indicate nerve damage or spinal cord injury in the thoracic region, as this area of the spine affects the lower part of the body including the legs.

Question 2

A patient injured in a motor vehicle collision is suffering from the separation of the rib and its associated spinal vertebrae. Based on the anatomy of the spine, where has this injury occurred?

Accepted Answer

The thoracic spine is the portion of the spine that contains the ribs, and is located between the cervical and lumbar spine. Therefore, a separation of a rib and its associated vertebrae would occur in the thoracic spine.

Question 3

For a person to make a fist, which one of the following must occur?

Accepted Answer

To make a fist, the brain sends a message through the central nervous system to stimulate the muscles in the hand and fingers. This message travels down the spinal cord and out through the peripheral nerves, causing the muscles to contract and create a fist. Therefore, option A is the correct choice.

Question 4

You have been called for a patient with severe back pain. When obtaining a medical history, he tells you that he has a history of damaged disks in his vertebrae. As a knowledgeable EMT, you should recognize that the:

Accepted Answer

The fluid-filled structures between the vertebrae are known as intervertebral disks which act as shock absorbers and help with movement of the spine. Damage to these disks can cause severe back pain, making D the correct choice. A is incorrect as overstretched ligaments would not cause damaged disks. B is incorrect as fractured vertebrae is a different condition. C is incorrect as damage to the spinal cord is a more serious condition that would present with neurological deficits beyond just severe back pain.

Question 5

You arrive on the scene of a two-car motor vehicle collision. The patient was the unrestrained driver of a car that struck another from behind at 25 mph. In the course of the collision, the patient flew forward and struck the windshield with his head. No air bags were deployed. The patient extricated himself and denies head, neck, or back pain; however, you do note a small cut on his hand, which occurred as he was getting out of the car. When asked about preexisting medical problems he tells you that he did have herniated disks in his lumbar spine that were surgically repaired several years ago. Based on this, your strongest reason to fully immobilize this patient would be:

Accepted Answer

The mechanism of injury, which involves a high-impact collision and the patient striking the windshield with his head, suggests a high risk of spinal injury despite the absence of immediate pain or symptoms. This warrants full immobilization as a precautionary measure.

Question 6

A young female driver, involved in a motor vehicle collision, complains of cervical pain resulting from a lateral-type mechanism of neck injury. Based on this information, what type of collision most likely took place?

Accepted Answer

A lateral-type mechanism of neck injury suggests that the patient's car was struck from the side.

Question 7

As you approach a motorcyclist who was thrown from his bike, you hear him saying that he cannot feel or move his legs. You note obvious deformity to both femurs as well as his left wrist and forearm. Emergency Medical Responders are holding manual in-line spinal stabilization. Of the following, which should be done first?

Accepted Answer

Checking the rate and effort of breathing is a critical primary assessment step that should be done first to ensure the airway is clear and the patient is able to breathe. This should be a priority over checking motor function and sensation or looking for bleeding, as airway and breathing are essential for life. Placing a cervical collar and administering oxygen should also be done, but these are secondary assessment steps that can wait until after the airway and breathing are assessed.

Question 8

You have arrived on a shooting where a middle-aged male has suffered a single gunshot wound to the abdomen. As you approach the patient, you note that he is sitting up and talking with the police officer holding a blood-soaked towel over the left upper quadrant of his abdomen. Your initial action in caring for this patient is to:

Accepted Answer

The answer of You have arrived on a shooting where...

Question 9

A 42-year-old man has called 911 because of severe back pain. He informs you that his back pain is related to a recent fracture of his coccyx. Based on this information, where should the EMT expect the patient to be complaining of pain?

Accepted Answer

The coccyx, also known as the tailbone, is located at the base of the spine in the pelvic area. Therefore, pain related to a fracture of the coccyx would be expected in the pelvic area.

Question 10

Assessment of a young girl who was hit while riding her bike reveals her to be responsive to painful stimuli with flexion of the extremities and in respiratory distress. There is marked deformity to her thoracic spine and bruising noted to her anterior chest and abdomen. She does not move her legs when a noxious stimulus is applied to the lower extremities. Manual in-line spinal stabilization is being held and a cervical collar has been applied. Given the critical nature of this patient, which one of the following is most appropriate for her care?

Accepted Answer

The most appropriate course of action for a critical patient with suspected spinal injuries is to completely immobilize them to the long board on scene prior to rapid transport to the hospital. While time is of the essence, it is important to take the time to properly immobilize the patient to prevent further injury to the spine. The cervical collar and manual in-line spinal stabilization should be maintained during the immobilization process. Rapid transfer to the stretcher with immobilization to the long board done en route to the hospital could result in further injury to the patient. Waiting for family members to arrive and give consent for treatment is not appropriate in a critical situation as it can delay necessary medical interventions. Transfer to the long board already placed on the stretcher and secure with straps en route to the hospital may lead to inadequate immobilization and further injury to the patient.

Question 11

An Emergency Medical Responder reports that a male patient, injured while playing football, has bruising to the lumbar area of the back. Based on this statement, the EMT should expect to find bruising in which area?

Accepted Answer

The lumbar area is located in the lower back, so the EMT should expect to find bruising in that area.

Question 12

A young intoxicated male patient cannot move his left arm and leg after diving into the shallow end of a pool and hitting the bottom head first. The EMT would recognize which of the following mechanisms as most likely responsible for this injury?

Accepted Answer

Compression occurs when a force is applied to the body that causes it to be crushed, compressed, or shortened. Diving headfirst into the shallow end of a pool would likely result in the head and neck being compressed, which could cause injury to the spinal cord and paralysis of the limbs below the point of injury. Rotation, distraction, and penetration are less likely to be responsible for these specific symptoms in this type of injury.

Question 13

While performing the primary assessment on a patient with an isolated spinal cord injury, you note that he is in severe respiratory distress and struggling to breathe. Where should you suspect the spinal cord injury has occurred?

Accepted Answer

Severe respiratory distress is a common symptom of a cervical spine injury, as the nerves controlling the diaphragm (which is the primary muscle involved in breathing) originate from the cervical spine.

Question 14

Which one of the following shows that the EMT is correctly assessing motor function in the arms of a patient with potential spine injuries?

Accepted Answer

Flexing both arms across the chest is a test of motor function and strength in the upper extremities. This allows the EMT to assess for any weakness or inability to perform the movement, which may suggest a spine injury. Choice A tests for sensory function, choice C tests for pain sensation, and choice D tests for circulation.

Question 15

An elderly patient has fallen down a flight of stairs and is complaining of neck and back pain as well as weakness to both legs. The primary assessment reveals no life threats to the airway, breathing, or circulation. Manual in-line spinal stabilization is being maintained. Which of the following would the EMT do next?

Accepted Answer

The answer of An elderly patient has fallen down a...

Question 16

Which injury is possible based on the anatomy of the spine?

Accepted Answer

The human spine consists of 7 cervical, 12 thoracic, and 5 lumbar vertebrae, followed by the sacrum and coccyx. There is no ninth cervical vertebra or sixth lumbar vertebra, making options A and B anatomically impossible. Disk injuries can occur between any vertebrae, making option C possible. Option D is incorrect because there are only 5 lumbar vertebrae, not 12.

Question 17

The EMT is caring for a patient who has a problem with the autonomic component of his nervous system. Which sign or symptom would most likely be caused by this condition?

Accepted Answer

The autonomic nervous system controls involuntary functions such as heart rate, blood pressure, and breathing. An issue with this system can lead to an elevated heart rate, making option B the most likely symptom. Difficulty walking (A) may be caused by a problem with the motor component of the nervous system, while an inability to move facial muscles (C) could be a sign of a neurological disorder such as Bell's palsy. Trouble remembering his name (D) is a cognitive symptom and is not directly related to the autonomic nervous system.

Question 18

What area of the spinal cord is most commonly injured?

Accepted Answer

The cervical spine, which includes the first seven vertebrae in the neck, is the most commonly injured area of the spinal cord, accounting for up to 60% of all spinal cord injuries. This is because it is the most mobile and flexible part of the spine, making it more vulnerable to traumatic injuries such as fractures and dislocations. Injuries to the cervical spine can result in paralysis or numbness in the arms, legs, and torso, and can also affect breathing and other bodily functions.

Question 19

Based on the structure of the nervous system, which of the following is true?

Accepted Answer

The peripheral nervous system consists of nerves that extend from the brain and spinal cord to the rest of the body. Therefore, a deep laceration to the arm can sever peripheral nerves. A stroke, on the other hand, represents an injury to the central nervous system. A gunshot wound to the spinal cord will directly damage the spinal cord, which is part of the central nervous system. Finally, numbness in a fractured leg indicates damage to the somatic nervous system, which controls voluntary movements, rather than the autonomic nervous system.

Question 20

You arrive on the scene of a motor vehicle collision. Walking toward you is the unrestrained driver of the vehicle that sustained moderate front-end damage. The patient complains of some back pain, but is walking around after the crash and does not appear to be suffering from any neurological deficits. What is your initial action in caring for this patient?

Accepted Answer

The initial action should be to take manual in-line spinal stabilization to prevent any potential spinal injury from worsening, especially given the mechanism of injury and the patient's complaint of back pain.

Quiz 32: Spinal Column and Spinal Cord Trauma