ITLS Head and Spinal Trauma 3

Question 1

What is neurogenic shock, and how does it differ from hypovolemic shock in its presentation?

Accepted Answer

Neurogenic shock presents with hypotension and bradycardia due to loss of sympathetic tone, while hypovolemic shock presents with hypotension and tachycardia

Answer

They are the same condition with different names

Answer

Neurogenic shock causes hypertension, while hypovolemic shock causes hypotension

Answer

Neurogenic shock only occurs in brain injuries, not spinal injuries

Question 2

A patient dove into shallow water and has quadriplegia with loss of sensation below the clavicles. At what spinal level is the injury most likely?

Accepted Answer

C3-C4

Answer

C5-C6

Answer

T1-T2

Answer

L1-L2

Question 3

What are the signs of a basilar skull fracture that ITLS providers should recognize?

Accepted Answer

Battle's sign (mastoid ecchymosis), raccoon eyes (periorbital ecchymosis), CSF rhinorrhea/otorrhea, and hemotympanum

Answer

Visible skull deformity at the vertex

Answer

Bleeding from the scalp only

Answer

Depressed palpable fracture at the forehead

Question 4

Why is hyperventilation no longer recommended as routine management for traumatic brain injury?

Accepted Answer

Hyperventilation causes cerebral vasoconstriction that reduces ICP but also reduces cerebral blood flow, potentially worsening ischemia in the already injured brain

Answer

Hyperventilation has no effect on intracranial pressure

Answer

Hyperventilation causes cerebral vasodilation and increases ICP

Answer

It was never used in TBI management

Question 5

A patient has a penetrating object (knife) embedded in the skull. What is the correct prehospital management?

Accepted Answer

Stabilize the object in place, control bleeding around it, and transport for surgical removal

Answer

Remove the object to allow wound assessment

Answer

Push the object deeper for better stabilization

Answer

Apply a cervical collar directly over the wound

Question 6

What is spinal shock, and how does it affect the neurological assessment of a spinal cord injury patient?

Accepted Answer

It is a temporary loss of all spinal cord function below the injury level, making it impossible to determine the true extent of permanent injury during the acute phase

Answer

It is the same as neurogenic shock and causes hypotension

Answer

It only affects sensory function, not motor function

Answer

It lasts only a few seconds after the injury