Question 1

A 25-year-old male was in an automobile accident. At impact, his forehead struck the windshield. In this situation, the coup injury would occur in the:
A) frontal region.
B) temporal region.
C) parietal region.
D) occipital region.

Accepted Answer

The coup injury occurs at the site of impact, which in this case is the forehead striking the windshield. Therefore, the frontal region (Option A) would be the site of injury.

Question 2

A 33-year-old male is brought to the emergency department for treatment of injuries received in a motor vehicle accident. An MRI reveals an injury of the cervical cord. Cord swelling in this region may be life threatening because:
A) increased intracranial pressure may occur.
B) reflexes will be disrupted.
C) diaphragm function may be impaired.
D) bladder emptying will not occur.

Accepted Answer

Cord swelling in the cervical region may impair diaphragm function, leading to potential respiratory compromise and even death. Increased intracranial pressure may occur with brain injuries, reflexes may be disrupted with spinal cord injuries, and bladder emptying may not occur with spinal cord injuries at lower levels.

Question 3

A 15-year-old male suffered diffuse brain injury after wrecking an all-terrain vehicle. He had momentary confusion and retrograde amnesia after 5 to 10 minutes. His injury could be categorized as:
A) Grade I.
B) Grade II.
C) Grade III.
D) a mild concussion.

Accepted Answer

His momentary confusion and retrograde amnesia after 5 to 10 minutes suggest a more severe injury than a mild concussion (Grade I), but he did not suffer a prolonged loss of consciousness or post-traumatic amnesia, which would be indicative of a severe (Grade III) injury. Therefore, he would fall into the moderate category of a Grade II injury.

Question 4

Mild concussion is characterized by:
A) a brief loss of consciousness.
B) significant behavioral changes.
C) retrograde amnesia.
D) transient confusion.

Accepted Answer

The answer of Mild concussion is characterized by:
A) a brief...

Question 5

A 20-year-old female suffered from spinal cord injury that resulted from a motor vehicle accident. She had spinal shock lasting 15 days and is now experiencing an uncompensated cardiovascular response to sympathetic stimulation. This condition may accompany:
A) toxic accumulation of free radicals below the level of the injury.
B) pain stimulation above the level of the spinal cord lesion.
C) a distended bladder or rectum.
D) an abnormal vagal response.

Accepted Answer

A distended bladder or rectum is a common cause of an uncompensated cardiovascular response to sympathetic stimulation in patients with spinal cord injury. The distension stimulates the sympathetic nervous system and can cause rapid increases in heart rate and blood pressure. This can lead to life-threatening complications such as autonomic dysreflexia. Treatment involves immediate identification and resolution of the underlying cause of the stimulation.

Question 6

The main source of bleeding in extradural (epidural) hematomas is:
A) arterial.
B) venous.
C) capillary.
D) sinus.

Accepted Answer

Extradural (epidural) hematomas are caused by bleeding between the dura mater and the skull. The bleeding is usually arterial in origin, most commonly from the middle meningeal artery.

Question 7

A 69-year-old male with a history of alcohol abuse presents to the ER after a month-long episode of headaches and confusion. Based on his alcoholism, a likely cause of his neurologic symptoms is:
A) concussion.
B) chronic subdural hematoma.
C) epidural hematoma.
D) subacute subdural hematoma.

Accepted Answer

Chronic subdural hematoma is a common complication of alcohol abuse, particularly in the elderly population, and can present with chronic headaches and confusion. Concussion and acute hematomas typically present acutely, within hours to days of the injury, whereas chronic subdural hematomas can develop slowly over several weeks to months. Subacute subdural hematoma and epidural hematoma are less commonly associated with alcohol abuse.

Question 8

A 15-year-old male is brought to the emergency department for treatment of injuries received in a motor vehicle accident. An MRI reveals spinal cord injury, and his body temperature fluctuates markedly. The most accurate explanation of this phenomenon is that:
A) he developed pneumonia.
B) his sympathetic nervous system has been damaged and thermal control disturbed.
C) he has a brain injury.
D) he has septicemia from an unknown source.

Accepted Answer

The fluctuating body temperature is indicative of a disturbance in thermal control, which is regulated by the sympathetic nervous system. In this case, the spinal cord injury may have damaged the sympathetic nervous system, leading to the temperature fluctuations. The other options (pneumonia, brain injury, septicemia) do not directly explain this phenomenon.

Question 9

An initial clinical manifestation associated with acute spinal cord injury is:
A) pain below the level of the injury.
B) loss of autonomic reflexes above the injury.
C) loss of voluntary control below the injury.
D) hyperactive spinal reflexes below the injury.

Accepted Answer

Loss of voluntary control below the level of injury is an initial clinical manifestation associated with acute spinal cord injury, which is due to the interruption of descending motor pathways. Pain below the level of injury may occur but is not an initial manifestation. Loss of autonomic reflexes above the injury and hyperactive spinal reflexes below the injury are late manifestations.

Question 10

A 39-year-old male suffers a severe brain injury when he falls off a building while working. CT scan reveals that he has a basilar skull fractures. One major concern for this patient is:
A) hematoma formation.
B) meningeal infection.
C) increased intracranial pressure.
D) cognitive deficits.

Accepted Answer

Basilar skull fractures can lead to meningeal infection due to the potential for bacteria to enter the cranial cavity through fractures, especially if there is a cerebrospinal fluid leak.

Question 11

_____ are most at risk of spinal cord injury from minor trauma.
A) Infants
B) Men
C) Women
D) The elderly

Accepted Answer

Elderly people are particularly at risk from minor trauma that results in serious spinal cord injury because of preexisting degenerative vertebral disorders.
It is the elderly,not infants,who are at risk for minor trauma that results in serious spinal cord injury because of preexisting degenerative vertebral disorders.
Males are at greatest risk for major spinal cord injury.It is the elderly that are most at risk for injury with minor trauma.
Males,not females,are at greatest risk for major spinal cord injury.It is the elderly that are most at risk for injury with minor trauma.

Question 12

A 17-year-old male is brought to the emergency department for treatment of injuries received in a motor vehicle accident. A spinal cord injury is suspected. The two regions most likely to be damaged are the:
A) cervical and thoracic regions.
B) thoracic and lumbar regions.
C) lumbar and sacral regions.
D) cervical and lumbar regions.

Accepted Answer

The cervical and lumbar regions of the spinal cord are the most mobile and thus more susceptible to injury in motor vehicle accidents.

Question 13

A 65-year-old female loses her balance while walking in the woods, causing her to fall and hit her head. She loses consciousness and is in a coma for 5 days. She is diagnosed as having diffuse brain injury. Which of the following would most likely occur in this patient?
A) Complete loss of vision
B) Arrhythmia
C) Blunted affect
D) Meningitis infection

Accepted Answer

Diffuse brain injury can cause behavioral changes, including blunted affect (a reduction in the expression of emotions) due to damage to the frontal lobes of the brain. Loss of vision (A) and arrhythmia (B) are not commonly associated with diffuse brain injury. Meningitis infection (D) is a potential complication of any head injury, but it is not a direct result of diffuse brain injury.

Question 14

A 10-year-old male was climbing on a house and fell. He suffered a severe brain injury. His Glasgow Coma Scale was 5 initially and 7 after 1 day. He remained unconscious for 2 weeks, then was confused and suffered from anterograde amnesia. Which of the following is he most likely experiencing?
A) Mild diffuse brain injury
B) Moderate diffuse brain injury
C) Severe diffuse brain injury
D) Postconcussive syndrome

Accepted Answer

The answer of A 10-year-old male was climbing on a...

Question 15

A 50-year-old male presents with low back pain. He denies trauma and says he just woke up and it was hurting. An MRI reveals that the vertebra at L5 slid forward relative to those above and below it. This condition is called:
A) degenerative disk disease.
B) spondylolysis.
C) spondylolisthesis.
D) spinal stenosis.

Accepted Answer

The description given in the question suggests spondylolisthesis, which is a condition where one vertebra slips forward relative to the one below it. This can cause lower back pain and may require surgery in severe cases. Degenerative disk disease, on the other hand, is a condition where the disks between vertebrae break down over time, while spondylolysis refers to a stress fracture in the vertebrae. Spinal stenosis is a narrowing of the spinal canal that can also cause low back pain. However, the most likely diagnosis based on the scenario presented is spondylolisthesis.

Question 16

A 15-year-old male was struck by a motor vehicle and suffered a traumatic brain injury. Paramedics found him unconscious at the scene of the accident. During the ambulance ride, he regained consciousness and was able to maintain a conversation with the medical staff. Upon arrival to hospital, he was alert and oriented. Physical exam reveals confusion and impaired responsiveness. What is the probable nature of his brain injury based on this history?
A) Class IV (classic) concussion
B) Subdural hematoma
C) Extradural (epidural) hematoma
D) Diffuse axonal injury

Accepted Answer

The history of initial unconsciousness followed by a lucid interval and then deterioration is characteristic of an extradural (epidural) hematoma.

Question 17

The most severe diffuse brain injury caused by rotational acceleration is most likely to be located:
A) more peripheral to the brain stem.
B) in the central portion of the brain stem.
C) throughout the brain stem.
D) distal to the brain stem.

Accepted Answer

The answer of The most severe diffuse brain injury caused...

Question 18

Six weeks ago a female patient suffered a T6 spinal cord injury. She then developed a blood pressure of 200/120, a severe headache, blurred vision, and bradycardia. She is likely experiencing:
A) extreme spinal shock.
B) acute anxiety.
C) autonomic hyperreflexia.
D) parasympathetic areflexia.

Accepted Answer

The patient is exhibiting symptoms of autonomic hyperreflexia, which can occur after a spinal cord injury at or above the level of T6. This condition is characterized by a sudden, excessive sympathetic nervous system response, leading to elevated blood pressure, headache, blurred vision, and bradycardia. It is a medical emergency that requires prompt treatment to prevent complications such as seizures, stroke, or even death. Choice A is incorrect because spinal shock typically occurs immediately after a spinal cord injury and is characterized by a loss of reflexes and temporary paralysis. Choice B is incorrect because acute anxiety would not typically cause the symptoms described. Choice D is incorrect because parasympathetic areflexia would not cause elevated blood pressure or the other symptoms described.

Question 19

The most common type of traumatic brain injury is:
A) penetrating trauma.
B) diffuse axonal injury.
C) focal brain injury.
D) concussion.

Accepted Answer

Concussion is the most common type of traumatic brain injury. It is usually caused by a blow to the head or a sudden jolt or shaking of the head and can result in temporary loss of consciousness, confusion, and other symptoms. Penetrating trauma (A) occurs when an object penetrates the skull and damages brain tissue. Diffuse axonal injury (B) is a more severe type of brain injury that can result from shaking or rotational forces and causes widespread damage to the brain's axons. Focal brain injury (C) is a type of injury that occurs at a specific location in the brain, often due to a direct impact or contusion.

Question 20

The transient nature of spinal shock is directly related to which of the following mechanisms?
A) Incomplete transection of the spinal cord
B) Accumulation of edema within the spinal cord
C) Partial necrosis of the spinal cord
D) Free radical injury and scarring of the glial cells

Accepted Answer

Spinal shock is transient due to the temporary accumulation of edema, which disrupts normal function but can resolve as the edema subsides.

Quiz 15: Alterations of Neurologic Function

A 25-year-old male was in an automobile accident. At impact, his forehead struck the windshield. In this situation, the coup injury would occur in the:

A 33-year-old male is brought to the emergency department for treatment of injuries received in a motor vehicle accident. An MRI reveals an injury of the cervical cord. Cord swelling in this region may be life threatening because:

A 15-year-old male suffered diffuse brain injury after wrecking an all-terrain vehicle. He had momentary confusion and retrograde amnesia after 5 to 10 minutes. His injury could be categorized as:

Mild concussion is characterized by:

A 20-year-old female suffered from spinal cord injury that resulted from a motor vehicle accident. She had spinal shock lasting 15 days and is now experiencing an uncompensated cardiovascular response to sympathetic stimulation. This condition may accompany:

The main source of bleeding in extradural (epidural) hematomas is:

A 69-year-old male with a history of alcohol abuse presents to the ER after a month-long episode of headaches and confusion. Based on his alcoholism, a likely cause of his neurologic symptoms is:

A 15-year-old male is brought to the emergency department for treatment of injuries received in a motor vehicle accident. An MRI reveals spinal cord injury, and his body temperature fluctuates markedly. The most accurate explanation of this phenomenon is that:

An initial clinical manifestation associated with acute spinal cord injury is:

A 39-year-old male suffers a severe brain injury when he falls off a building while working. CT scan reveals that he has a basilar skull fractures. One major concern for this patient is:

_____ are most at risk of spinal cord injury from minor trauma.

A 17-year-old male is brought to the emergency department for treatment of injuries received in a motor vehicle accident. A spinal cord injury is suspected. The two regions most likely to be damaged are the:

A 65-year-old female loses her balance while walking in the woods, causing her to fall and hit her head. She loses consciousness and is in a coma for 5 days. She is diagnosed as having diffuse brain injury. Which of the following would most likely occur in this patient?

A 10-year-old male was climbing on a house and fell. He suffered a severe brain injury. His Glasgow Coma Scale was 5 initially and 7 after 1 day. He remained unconscious for 2 weeks, then was confused and suffered from anterograde amnesia. Which of the following is he most likely experiencing?

A 50-year-old male presents with low back pain. He denies trauma and says he just woke up and it was hurting. An MRI reveals that the vertebra at L5 slid forward relative to those above and below it. This condition is called:

The most severe diffuse brain injury caused by rotational acceleration is most likely to be located:

Six weeks ago a female patient suffered a T6 spinal cord injury. She then developed a blood pressure of 200/120, a severe headache, blurred vision, and bradycardia. She is likely experiencing:

The most common type of traumatic brain injury is:

The transient nature of spinal shock is directly related to which of the following mechanisms?