Head and Spinal Trauma Flashcards
6 cards from real ITLS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Head and Spinal Trauma flashcards as text
A patient struck in the head with a baseball bat initially loses consciousness, then regains awareness and appears lucid for 30 minutes before rapidly deteriorating. What type of intracranial hemorrhage is most likely?
Answer: Epidural hematoma
An epidural hematoma, typically from tearing of the middle meningeal artery by a temporal bone fracture, classically presents with a 'lucid interval' followed by rapid neurological decline as the arterial bleed expands.
What clinical signs indicate Cushing's triad, and what does it signify?
Answer: Hypertension, bradycardia, and irregular respirations indicating critically elevated intracranial pressure
Cushing's triad (hypertension, bradycardia, irregular respirations) is a late and ominous sign of critically elevated ICP with impending brainstem herniation, requiring immediate intervention.
A trauma patient has unequal pupils—the right pupil is fixed and dilated while the left is reactive. What does this finding most likely indicate?
Answer: Right-sided uncal herniation compressing the right oculomotor nerve
A unilateral fixed, dilated pupil in a trauma patient indicates ipsilateral uncal herniation, where the medial temporal lobe herniates through the tentorial notch and compresses the ipsilateral CN III (oculomotor nerve).
A motorcycle crash victim has weakness and loss of pain/temperature sensation in both arms but relatively preserved leg function. What spinal cord injury pattern is this?
Answer: Central cord syndrome
Central cord syndrome involves greater motor impairment in the upper extremities than the lower, with variable sensory loss. It occurs from cervical hyperextension that damages the central portion of the spinal cord where upper extremity fibers are located.
What is the appropriate blood pressure target when managing a trauma patient with both a severe traumatic brain injury (GCS 6) and hemorrhagic shock?
Answer: Maintain systolic BP above 90 mmHg to protect cerebral perfusion, even though this conflicts with permissive hypotension strategy
TBI patients require adequate cerebral perfusion pressure, making hypotension particularly dangerous. When TBI coexists with hemorrhagic shock, maintaining systolic BP above 90 mmHg takes priority over permissive hypotension to prevent secondary brain injury.
A patient with a suspected cervical spine injury is vomiting while secured to a backboard. What is the immediate management?
Answer: Tilt the entire backboard to the side as a unit while suctioning
Tilting the entire backboard with the patient as a unit (log-roll on the board) allows drainage of vomitus while maintaining spinal alignment. Aspiration is immediately life-threatening and takes priority.