TRAUMA FISDAP COMPREHENSIVE UPDATED EXAM
QUESTIONS AND ANSWERS GRADED A+
✔✔Frontal Lobe - ✔✔(Forehead) Important for voluntary motor action and personality
traits. Injury to the frontal lobe may result in seizures or placid reactions (flat affect).
✔✔Parietal Lobe - ✔✔Controls the somatic or voluntary sensory and motor functions for
the opposite side of the body, as well as memory and emotions.
✔✔Occipital Lobe - ✔✔(Back of the head) Responsible for processing visual
information.
✔✔Temporal Lobe - ✔✔(Side of the head) Speech area, hearing, taste and smell.
✔✔Treating a pt with Head Trauma - ✔✔Lidocaine to reduce ICP, maintain O2 sats
above 95%, administer high flow O2 if pt is breathing on their own, avoid
hyperventilation, restrict your use of IV fluids (unless hypotensive, then give fluid to
keep systolic above 110 or 120), and do not give dextrose.
✔✔Diaphragm - ✔✔Phrenic nerve (C3-C5). Injury occurring at or above C3-C4 may
cause diaphragmatic paralysis, that is seen with abdominal breathing and accessory
muscle use.
✔✔Levels of ICP - ✔✔Mild- cheyne-stokes, increased BP, decreased HR, pupils stil
reactive, AMS, vomiting. Moderate- widening pulse pressure w/ bradycardia, pupils are
non-reactive, hyperventilation, posturing. Severe- blown pupil, biot's respirations, flaccid
paralysis, irregular pulse rate, fluctuating BP (usually hypotension).
✔✔Cheyne- Stokes Respirations - ✔✔Respirations that are fast and then become slow,
with intervening periods of apnea. Common in people with head injuries/ICP.
✔✔Biots Respirations - ✔✔Characterized by irregular rate, pattern, and volume of
breathing with intermittent periods of apnea.
✔✔Babinkski Reflex - ✔✔Occurs when the toes move upward in response to
stimulation of the sole of the foot. Under normal circumstances, the toes move
downward.
✔✔Coup Contrecoup - ✔✔Front and rear injury. Brain slams into the front of the skull,
and then slams into the back end of the skull.
✔✔Autoregulation - ✔✔The body responds to a decrease in CPP by increasing the
MAP. Resulting in cerebral vasodilation and increased cerebral blood flow. However,
this is a vicious cycle cause it actually increases ICP.
, ✔✔Decorticate - ✔✔Flexor posturing. Pt's limbs will be facing toward their core,
involving flexion of the arms and legs.
✔✔Decerebrate - ✔✔Extensor posturing. Pt's limbs will be extending away from the
body.
✔✔Intracerebral Hematoma - ✔✔Involves bleeding within the brain tissue itself. Can
follow a penetrating injury to the head. Have a high mortality rate.
✔✔Hyperpyrexia - ✔✔Patients with a head injury can develop a high body temperature,
which can worsen the condition of the brain.
✔✔Signs and symptoms of a Pneumothorax - ✔✔Pt may only report mild dyspnea, and
pleuritic chest pain on one side. Diminished or unequal breath sounds may be heard on
auscultation. Pt's with larger pneumo's present with severe respiratory compromise and
hypoxia- tachycardia, tachypnea, AMS.
✔✔How to treat a Pneumothorax - ✔✔If there is an open wound, cover it with an
occlusive dressing. Provide high flow O2. *Positive pressure will aggravate this
condition, resulting in a tension pneumo.
✔✔Open Pneumothorax - ✔✔When a defect in the chest wall allows air to enter the
pleural space. GSW, stabbing, or other impaled objects. Aka "sucking chest wound", if
blood is involved it might be "bubbling". Occlusive dressing!
✔✔Sternal Injuries - ✔✔If the thorax received enough pressure to cause damage to the
sternal bone then assume the heart, and great vessels also received damage.
✔✔JVD - ✔✔Suggest increased intravenous pressure, can be caused by a tension
pneumothorax, volume overload, right sided heart failure, or cardiac tamponade.
✔✔Flail Chest - ✔✔A major injury to the chest wall, may result from blunt trauma, like
MVC, falls, and assaults. In this injury, two or more ribs are fractured in two or more
places. When the Pt breathes, their chest will rise and fall paradoxically. You can also
feel crepitus when assessing your Pt. *Positive pressure ventilation is important with this
kind of pt!
✔✔Pulmonary Contusion - ✔✔An injury to the underlying lung tissue that inhibits normal
diffusion of O2 & CO2.
✔✔Pericardial Tamponade - ✔✔Causes compression of the heart, and decreased
cardiac output. You will see increased HR, muffled heart sounds, hypotension, and
JVD.
QUESTIONS AND ANSWERS GRADED A+
✔✔Frontal Lobe - ✔✔(Forehead) Important for voluntary motor action and personality
traits. Injury to the frontal lobe may result in seizures or placid reactions (flat affect).
✔✔Parietal Lobe - ✔✔Controls the somatic or voluntary sensory and motor functions for
the opposite side of the body, as well as memory and emotions.
✔✔Occipital Lobe - ✔✔(Back of the head) Responsible for processing visual
information.
✔✔Temporal Lobe - ✔✔(Side of the head) Speech area, hearing, taste and smell.
✔✔Treating a pt with Head Trauma - ✔✔Lidocaine to reduce ICP, maintain O2 sats
above 95%, administer high flow O2 if pt is breathing on their own, avoid
hyperventilation, restrict your use of IV fluids (unless hypotensive, then give fluid to
keep systolic above 110 or 120), and do not give dextrose.
✔✔Diaphragm - ✔✔Phrenic nerve (C3-C5). Injury occurring at or above C3-C4 may
cause diaphragmatic paralysis, that is seen with abdominal breathing and accessory
muscle use.
✔✔Levels of ICP - ✔✔Mild- cheyne-stokes, increased BP, decreased HR, pupils stil
reactive, AMS, vomiting. Moderate- widening pulse pressure w/ bradycardia, pupils are
non-reactive, hyperventilation, posturing. Severe- blown pupil, biot's respirations, flaccid
paralysis, irregular pulse rate, fluctuating BP (usually hypotension).
✔✔Cheyne- Stokes Respirations - ✔✔Respirations that are fast and then become slow,
with intervening periods of apnea. Common in people with head injuries/ICP.
✔✔Biots Respirations - ✔✔Characterized by irregular rate, pattern, and volume of
breathing with intermittent periods of apnea.
✔✔Babinkski Reflex - ✔✔Occurs when the toes move upward in response to
stimulation of the sole of the foot. Under normal circumstances, the toes move
downward.
✔✔Coup Contrecoup - ✔✔Front and rear injury. Brain slams into the front of the skull,
and then slams into the back end of the skull.
✔✔Autoregulation - ✔✔The body responds to a decrease in CPP by increasing the
MAP. Resulting in cerebral vasodilation and increased cerebral blood flow. However,
this is a vicious cycle cause it actually increases ICP.
, ✔✔Decorticate - ✔✔Flexor posturing. Pt's limbs will be facing toward their core,
involving flexion of the arms and legs.
✔✔Decerebrate - ✔✔Extensor posturing. Pt's limbs will be extending away from the
body.
✔✔Intracerebral Hematoma - ✔✔Involves bleeding within the brain tissue itself. Can
follow a penetrating injury to the head. Have a high mortality rate.
✔✔Hyperpyrexia - ✔✔Patients with a head injury can develop a high body temperature,
which can worsen the condition of the brain.
✔✔Signs and symptoms of a Pneumothorax - ✔✔Pt may only report mild dyspnea, and
pleuritic chest pain on one side. Diminished or unequal breath sounds may be heard on
auscultation. Pt's with larger pneumo's present with severe respiratory compromise and
hypoxia- tachycardia, tachypnea, AMS.
✔✔How to treat a Pneumothorax - ✔✔If there is an open wound, cover it with an
occlusive dressing. Provide high flow O2. *Positive pressure will aggravate this
condition, resulting in a tension pneumo.
✔✔Open Pneumothorax - ✔✔When a defect in the chest wall allows air to enter the
pleural space. GSW, stabbing, or other impaled objects. Aka "sucking chest wound", if
blood is involved it might be "bubbling". Occlusive dressing!
✔✔Sternal Injuries - ✔✔If the thorax received enough pressure to cause damage to the
sternal bone then assume the heart, and great vessels also received damage.
✔✔JVD - ✔✔Suggest increased intravenous pressure, can be caused by a tension
pneumothorax, volume overload, right sided heart failure, or cardiac tamponade.
✔✔Flail Chest - ✔✔A major injury to the chest wall, may result from blunt trauma, like
MVC, falls, and assaults. In this injury, two or more ribs are fractured in two or more
places. When the Pt breathes, their chest will rise and fall paradoxically. You can also
feel crepitus when assessing your Pt. *Positive pressure ventilation is important with this
kind of pt!
✔✔Pulmonary Contusion - ✔✔An injury to the underlying lung tissue that inhibits normal
diffusion of O2 & CO2.
✔✔Pericardial Tamponade - ✔✔Causes compression of the heart, and decreased
cardiac output. You will see increased HR, muffled heart sounds, hypotension, and
JVD.
