COMBAT MEDIC 68W FIELDCRAFT 2 EXAM C168W144 QUESTIONS AND ANSWERS

Cranium Medical name for the skull encases and protects brain tissue Function of the cranium Parietal, Temporal, Sphenoid, cribform plate, frontal, occipital, Bones that fuse together to form the cranium foramen magnum The primary opening through which pressure can be released, located at the base of the skull, where the spinal cord passes through controls all bodily functions and processes Function of the brain Mandible Medical name for lower jaw bone Maxillae Medical name for fused bones of the upper jaw zygomatic bones Medical name for cheekbones Nasal bone Provides some of the structure of the nose Meninges Name of the three membranes that cover the brain Dura mater The outermost brain membrane and most resilient Arachnoid Center layer membrane of the brain Pia mater The thin most inner layer brain membrane Cerebrum The largest part of the brain, houses sensory functions, motor functions, and higher intellectual functions such as intelligence and memory Cerebellum Part of the brain that controls primitive functions, coordination, and balance Brain stem Part of the brain that controls body functions such as cardio-respiratory functions In the ventricles of the brain Where is cerebrospinal fluid produced? Linear skull fractures Skull fractures that transverse the the full thickness of the skull Linear skull fracture Type of fractures that account for 80% of skull fractures Depressed skull fractures Type of skull fracture in which fragments of the bone are driven toward underlying tissue Closed Which type of depressed skull fracture increases the risk for intracranial hematoma? Basilar skull fracture Fracture on the floor of the cranium Basilar skull fracture What type of fracture should be suspected if casualty has CSF draining from nostrils and ears, Periorbital ecchymosis (raccoon eyes), and ecchymosis behind the ears (battle's sign)? Nasal fracture Type of fracture if the casualty has epistaxis, edema, ecchymosis, nasal deformity, and crepitus? Mandible fracture Type of fracture in which the casualty complains of teeth "not fitting together" Mid-face fractures Type of fracture in which the casualty presents asymmetrical or flattened face Evidence of head injury Contraindication for nasopharyngeal airway? Hyperventilation What should be avoided when managing breathing for casualties with suspected head injuries? 20 breaths per minute What is the ventilation rate of a casualty with suspected increased intracranial pressure? Can contribute to ischemia through vasoconstriction What can hyperventilation do to casualties with a TBI? Yes, if they can vocalize pain then the TBI is not severe enough to be further damaged by pain meds If the patient can vocalize their head pain should the medic give pain medication? Morphine Pain medication that should be avoided with TBI casualties Fentanyl and Ketamine Two pain medications that can make a moderate to severe TBI worse but can be used for mild TBI? A kerlix "Donut" Type of bandage that can be used to keep pressure off of a depressed or open skull fracture Basilar "Raccoon eyes" indicates what kind of skull fracture? Greater than 1 mm Difference in pupil size that is considered abnormal? Supine position and tilt the casualty towards the side of injury to allow for drainage Position to transport a casualty with suspected TBI? Urgent Surgical What type of classification should a casualty be if they have suspected TBI? An injury to the brain resulting from an external force and/or acceleration/deceleration mechanism from an event Definition of a traumatic brain injury No Is loss of consciousness required to diagnose a concussion CT or MRI scan What is required to make a definitive diagnosis of a TBI level? Physical, cognitive, emotional, and social What type of problems can a TBI cause in a casualty? Confused and disoriented state for less than 24 hours, loss of consciousness for up to 30 minutes, memory loss lasting less than 24 hours Components of a Mild TBI Confused and disoriented state for more than 24 hours, loss of consciousness for more than 30 minutes but less than 24 hours, memory loss lasting more than 24 hours but less than 7 days Components of a Moderate TBI Closed or Open injuries, Confused and disoriented state for more than 24 hours, loss of consciousness lasting more than 7 days Components of a Severe TBI Traumatic brain injuries Intracranial hematoma, epidural hematoma, subdural hematoma, cerebral contusions, and subarachnoid hemorrhage are considered what? Military Acute Concussion Evaluation What is MACE? 25 points MACE score below _______ is shown to be the best indicator for a true cognitive impairment Any soldier in a vehicle associated with a blast or rollover, any soldier within 50 meters of a blast, any soldier that sustains a blow to the head Conditions that mandate prompt concussion evaluation and a 24 hour rest period Witnessed loss of consciousness, two or more blast exposures within 72 hours, unusual behavior, unequal pupils, seizures, repeated vomiting, double vision, worsening headache, weakness on one side of the body Red flags for immediate referral to MO and/or transport