21) Your patient is a 22-year-old female assault victim. She has blunt trauma to the face with swelling around the right eye and zygomatic area. Upon assessing her eye movement, you note that the right eye cannot follow your finger and does not move. Which of the following most likely explains this finding? A) She has a fracture of the orbit that has trapped the optic nerve, thereby paralyzing her gaze. B) She has direct trauma to the eyeball that has damaged the intrinsic muscles of the eye. C) She has a fracture of the orbit that has trapped the extrinsic eye muscles. D) She has direct trauma to the eyeball that has damaged the optic nerve, thereby paralyzing her gaze. 22) Which of the following groups is not among those with the highest incidence of serious head trauma? A) The elderly B) Young males C) Middle-aged males D) Infants 23) Which of the following is TRUE of the basilar skull? A) The foramen magnum is part of the basilar skull. B) It is relatively weaker than other portions of the skull. C) It provides a rough surface that may lacerate the brain in acceleration/deceleration mechanisms. D) All of the above are true. 24) When placing the patient’s head in the neutral position, the occiput should be ____ the plane made by the buttocks and the shoulder blades (or greater for an obese patient). A) Even with B) 3 to 4 inches above C) 1 to 3 inches above D) 2 to 6 inches above 25) The term head injury refers to which of the following? A) Trauma to the brain B) Soft-tissue injuries to the scalp C) Skull fractures D) All of the above 26) For the head-injury patient without signs of herniation, adjust ventilation rates to maintain an end-tidal CO2 reading of between: A) 15 and 20 mmHg B) 25 and 30 mmHg C) 45 and 50 mmHg D) 35 and 40 mmHg 27) Your patient is a 37-year-old male unrestrained driver of a vehicle. You find him with his upper body across the console and his head hanging down into the passenger’s side floorboard area. You note pooled blood from a scalp wound. After immobilizing him and loading him into the ambulance where you have more light for your examination, you note that he has a large, full-thickness avulsion of the scalp. The patient’s heart rate is 112, respirations are 20, and blood pressure is 82/50. Which of the following statements about this patient is/are TRUE? 1. The scalp wound itself cannot account for the patient’s vital signs. 2. The scalp wound itself may account for the patient’s vital signs. 3. The patient’s vital signs are consistent with increasing intracranial pressure. 4. Nothing about the vital signs indicates increased intracranial pressure. A) 1, 4 B) 2, 3 C) 1, 3 D) 2, 4 28) In cases of face and neck trauma where the region is so distorted that oral and nasal intubation are impossible, the only prehospital means to provide a life-saving airway may be performing which of the following? A) Digital intubation B) Percutaneous cricothyrotomy C) Bag-valve hyperventilation D) Surgical tracheostomy 29) When palpating the spine of a patient during your assessment, you are feeling the: A) Spinous processes B) Vertebral bodies C) Transverse vertebral processes D) Vertebral pedicles 30) A patient who has dived into a shallow pool and hit his head on the bottom is most likely to have which of the following types of injuries? A) Cervical hyperextension B) Cervical hyperflexion C) Axial distraction D) Axial loading 31) Recent research has provided evidence of which of the following regarding spinal-injury assessment? A) Only trauma patients with signs and symptoms of neurological deficit need to receive spinal immobilization. B) Paramedics cannot reliably identify patients who are likely to have spinal injuries. C) All trauma patients should be assumed to have spinal injuries. D) There are reliable criteria for determining the likelihood of spinal injury. 32) Which of the following is a common mechanism of injury associated with spinal-cord injuries? A) Penetrating injuries B) Sports-related injuries C) Auto accidents D) All of the above 33) Your patient is a 30-year-old male who was playing a backyard game of football and was tackled forcefully from the left side by his brother at the level of the shoulder. Based on this mechanism of injury, you should suspect which of the following patterns? A) Compression fractures on the left side of the cervical spine; torn ligaments on the right side of the cervical spine B) An axial distraction injury of the cervical region C) Compression fractures of the thoracic spine D) Subluxation of one or more thoracic vertebrae 34) Which of the following best describes the goals of manual cervical spine stabilization? A) Preventing movement of the head in any direction; applying a gentle lifting force of just enough to relieve some of the pressure the head exerts on the cervical spine B) Keeping the head in an “eyes forward†position; applying enough traction to cause axial unloading, which is 18 to 22 pounds in the average adult C) Preventing rotation of the head; avoiding any upward lifting or downward pressure on the cervical spine D) Preventing movement of the head in any direction; applying gentle axial pressure to