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Field Craft 2 Study Guide Latest Updated
What are the meninges and what is their function? - ANS--Dura mater: outermost membrane and most resilient -Arachnoid: center layer -Pia mater: thin innermost membrane -Protects the cranial nerves and spinal cord What is the foramen magnum? - ANS-The primary opening through which pressure can be released; located at the base of the skull, it is a circular opening which the spinal cord passes through What are the brain hemispheres and what do they do? - ANS--Cerebrum: largest part of the brain; houses sensory functions, motor functions, and higher intellectual functions such as intelligence and memory -Cerebellum: controls primitive functions, coordination, and balance -Brain stem: controls vital body functions such as cardio-respiratory functions What is cerebrospinal fluid? - ANS-Nutrient fluid that bathes and protects the brain and spinal cord Initially, ___________ is adequate as a baseline assessment of mental status? - ANS- The MACE 2 evaluation prior to deployment should be given to obtain a base line evaluation When obtaining a Glasgow Coma Scale score, what is the highest score possible? What is the lowest score possible? - ANS--15 is the highest score possible -3 is the lowest score possible While on patrol in eastern Afghanistan the lead vehicle in your convoy hits an IED. Once the scene is secured you move to treat casualties. You begin to treat the commander. He opens his eyes when you ask him questions but his answers are confused and flustered and slaps your hand away when you pinch the back of his hand whenever he closes his eyes. What is his GCS score? - ANS--Eyes: 4; opens when you ask him questions -Verbal: 4; responses are confused and flustered -Motor: 5; moves to localized pain (purposeful movement towards painful stimuli) -GCS score of 13 Describe decorticate posturing. Where is the injury on the brain? - ANS--Abnormal flexion of the arms with the extension of the legs
-Sign of damage to the nerve pathway in the midbrain, which is between the brain and spinal cord. Describe decerebrate posturing. Where is the injury on the brain? - ANS--Abnormal body posture that involves the arms and legs being held straight out, the toes being pointed downward, and the head and neck being arched backward. -One or more lesions affecting specific parts of your brain: the lower midbrain or pons. A decrease of how many points in a GCS score is a significant finding? - ANS-A drop of two points requires immediate escalation and review. The halo test is used to determine what? How does it work? - ANS--Method for determining whether bloody discharge from the ears or nose contained cerebrospinal fluid (CSF). -To perform the test, the leaking fluid is dripped onto a 4x4 gauze or towel; positive results are indicated by blood coalescing into the center, leaving an outer ring of cerebrospinal fluid. Battle signs and raccoon eyes may indicate what kind of fracture? - ANS-Basilar skull fractures A difference greater than _____ in pupil size is consider abnormal - ANS-1.0 mm ___________ injury is probable if both pupils are dilated and do not react to light? - ANS-Brainstem injury T/F- Dilated pupils that may or may not react to light are strictly caused by brain injury - ANS--False -Dilated pupils that may or may not react to light may be caused by reasons other than a head injury Hypothermia, anoxia, lightning strike, optic nerve injury, react trauma to the eye, drug effects can also cause this condition What is Cushing's Triad? - ANS--Hypertension -Bradycardia -Agonal/irregular respirations Hypotension caused by a head injury is usually what type of event? - ANS-Terminal event What does MACE stand for and what is it designed for? What is the maximum score possible? - ANS--Military Acute Concussion Evaluation (MACE) -To evaluate a casualty in whom a concussion is suspected -Total possible score is 30 What are the red flags for a head injury? - ANS--Deteriorating level of consciousness
What is the retina? - ANS--Inner layer -Contains rods and cones (the receptors of vision allowing us to see images) The lacrimal glands are responsible for what? - ANS--Prevents infection and moistens the eye Why are contact lenses not authorized during basic training, FTXs, gas chamber exercises, deployments or combat? - ANS-Wearing of contact lenses will worsen chemical exposures of the eye and corneal injuries What is the most important step in evaluating ocular problems? - ANS-Visual acuity What is the first step in treating a casualty suffering from ocular burns? - ANS-The eyes must be flushed first If a casualty suffers an eye injury, you must assume they also suffer what else? - ANS- Head injuries What is passive protection when dealing with laser risks? - ANS--Taking cover and wearing eyepro Patients suffering from ocular injuries and who are able to swallow should be directed to do what? - ANS-To take their Combat Wound Medication Pack (CWMP) What is special about Moxifloxacin? - ANS-One of the few antibiotics that can affect the eye For how long should you irrigate a patient's eye? - ANS--For at least 20 minutes -As long as supplies will allow -Until casualty reaches MTF What is the fluid of choice for patients suffering from only burns? what if the patient is also experiencing shock? - ANS--Lactated Ringer's -If shock is present, administer Whole Blood, blood components, FDP, Hextend etc. Explain the Rule of Tens - ANS-1.Estimate the TBSA to the nearest 10%
- Percentage TBSA x 10 ml/hour 3.For every 10 kg above 80 kg, increase he initial rate by 100 ml/hour You should titrate fluids until the urine output is _______ ml/hr - ANS-30- How many vertebrae are there? - ANS-Cervical: 7 vertebrae Thoracic: 12 vertebrae Lumbar: 5 vertebrae Sacral: 5 vertebrae fused
Coccyx: 4 vertebrae fused How many bones compromise the wrist? - ANS-8 bones called carpals How many metacarpals are in each hand? - ANS-5 in each hand How many phalanges are in each hand? - ANS-14 finger bones What are the bones of the pelvis? - ANS--Ilium -Ischium -Pubis The hip joint is what type of joint/ - ANS-Ball and socket What are the 6 different types of joints and give an example of each? - ANS-1.Ball and socket (shoulder or hip joint) 2.Hinge (elbow or knee joint) 3.Pivot (atlantoaxial and proximal radio-ulnar joint) 4.Condyloid (Radius and carpal bone joint) 5.Saddle (carpal metacarpal joint) 6.Gliding (vertebrae/carpal and tarsal bones) What are the 3 categories in which musculoskeletal injuries can be placed? - ANS-- Isolated non life-threatening -Non life-threatening -Definite musculoskeletal life-threatening Loss of _______ liters of blood can be caused by a fracture of one femur? - ANS-1- liters _____________ fractures cause severe hemorrhage and can be fatal - ANS-Pelvic fractures When must you assess PMS when splinting a fracture? - ANS-Complete before and after splinting any extremity When dealing with a patient with multisystem trauma, musculoskeletal injuries should be assessed when? - ANS-Focus should be placed on maintaining vital function, limited measures should be taken to address musculoskeletal injuries of the extremities. When compartment syndrome sets in, __________ are the most vulnerable and the first to become injured - ANS-Nerves What are the 5 P's of compartment syndrome? Which are early signs and which are late? - ANS-1.Pain 2.Parasthesia
-Administer CWMP -Evaluate to consult with M.D. Embedded/Penetrating -Do not attempt to remove the object -Irrigate -If foreign body is no longer present, cover the eye -Administer CWMP -Evacuate with casualty to MO as soon as possible with glasses The treatment for eyelid lacerations consist of? - ANS--Cover the affected eye -Administer CWMP -Evacuate casualty to MO ASAP with glasses The treatment for corneal abrasions consist of? - ANS--Irrigate injured eye -Perform visual acuity -Cover the affected eye -Administer CWMP -Evacuate casualty as soon as possible with glasses The treatment for Orbital fractures consist of? - ANS--Perform visual acuity -Cover the affected eye -Administer CWMP -Evacuate casualty to a MO as soon as possible with glasses For a patient with an ocular extrusion you should never do what? - ANS-Do not attempt to force the eye back into its socket What are the functions of the skin? - ANS--Protecting underlying deeper tissues from dehydration and injury -Helps regulates body temperature -Site of many nerve endings -Temporary storage of fat, glucose, water and salts -Absorbtion In tactical field care, what is the first step in treating a casualty suffering from burn injuries? - ANS-Stop the burning process, remove the burn source You have rescued a patient from a burning building. She doesn't have any burns but you notice singed eyebrows and soot around the mouth. What do you suspect the patient is suffering from and how would you fix it? - ANS-Inhalation burns How does circumferential chest burn affect a casualty? - ANS--Constrict the chest wall to such a degree that the casualty suffocates from inability to inhale a deep breath -Increased chance of compromise to distal circulation due to swelling and edema
You should consider fluid resuscitation for casualties suffering burns covering greater than ________ of the total body surface area. - ANS-20% When attempting to establish IV access what should you avoid? What do you do if you can't gain IV access? - ANS--Avoid placement through burned tissues; placement through the burn is acceptable if no other sites are available -An IO catheter should be placed if IV access cannot be established For patients with circumferential burns to the legs or arms, what do you frequently monitor? - ANS-Frequently monitor extremity pulses What is the leading cause of death in fires? - ANS-Inhalation of toxic smoke You should always assume an ________________ in an enclosed space fire? - ANS- Always assume an inhalation injury in an enclosed fire What are first degree burns? - ANS-Minor tissue damage that reddens the epidermis only and heals in 3 to 6 days What are second degree burns? - ANS-Damage through the epidermis and into a variable depth of the dermis that appears mottled, red with weeping blisters that will heal in 2 to 4 weeks What are third degree burns? - ANS-Damage to all layers of the epidermis and dermis that appears charred, translucent pearly white with a surface that is dry with thrombosed blood vessels What are fourth degree burns? - ANS-Damage not only the skin but also involvement of underlying layers of subcutaneous tissue, muscle, bone or internal organs What does TBSA stand for? How do you determine this? - ANS--Total body surface area -The casualty's palm surface of the hand represents approximately one percent of his/her TBSA What criteria would qualify a patient to be evacuated as URGENT SURGICAL? - ANS-- Inhalation injury -Second degree burns greater than 20% TBSA -Third or fourth degree burns
- Burns of the face, hand, feet, genitalia, perineum or major joints -Electrical burns -Chemical burns -Burn casualty with preexisting medical illness that could complicate management -Any casualty with burns and trauma -Any burn to a child
What are the characteristics of the spleen? - ANS--Contains large amount of lymphatic tissue in the body -Stores RBCs and platelets; removes RBC and platelets that are worn out or defective -Carries out immune functions and has cells involved in fighting infections -Highly vascular organ What are the characteristics of the kidneys? - ANS--Excrete most of the end products of bodily metabolism through filtration of blood and formation of urine -Regulates the water, electrolytes and acid-base content of the blood What are the solid and vascular abdominal organs? - ANS--Liver -Spleen -Aorta -Vena cava A casualty's entire ___________ can be lost into the abdominal cavity? - ANS- Circulating volume What are the hollow organs of the abdomen and what can their rupture cause? - ANS-- Intestine, gallbladder, urinary bladder -Release of digestive acids, enzymes, bacteria and partially digested food into the peritoneal causes peritonitis and sepsis Penetrating trauma in the gluteal area is frequently associated with significant intraabdominal trauma up to ______ % of the cases. - ANS-50% What percentage of GSWs require surgical intervention? - ANS-85% What is the common cause of penetrating injuries in combat? - ANS-Fragmentation wounds are the most common cause of penetrating injuries in combat What is the primary factor in assessing abdominal trauma? - ANS-Determination that an abdominal injury does exist How many liters of fluid can an adult peritoneal cavity hold before the evidence of distention is apparent? - ANS-1.5 liters of fluid How do you treat an evisceration? - ANS--Clean or sterile dressing that has been moistened with saline -Attempts should not be made to replace the protruding segment back into the abdominal cavity How much blood can a pregnant casualty lose before showing signs of hypovolemia? - ANS-Pregnant women can lose 30% to 35% of total blood volume
How should you transport a pregnant casualty? - ANS-Transport the casualty on her left side, tilt the right side of the spine board, elevate the casualty's right leg or manually displace the uterus to the left to relieve supine hypotension
