ATLS WRITTEN REVIEW 2025.
ATLS Written Exam Review 2025/2026 With
Accurate Questions and Correct Answer.
What is the primary goal of treating TBI? How is this done? -CORRECT ->>preventing
secondary brain injury. This is done by maintaining blood pressure and providing
adequate profusion.
After managing ABCDEs of TBI what MUST be identified if present? How is this done? -
CORRECT ->>mass lesion that requires surgical evacuation is critical! this is done with
CT. NOTE: obtaining a CT should not delay patient transfer to trauma center.
Which brain lobes do the following hold:
anterior fossa:
middle fossa:
posterior fossa: -CORRECT ->>1. anterior fossa: frontal lobes
middle fossa: temporal lobes
posterior fossa: lower brainstem and cerebellum
What are the 3 layers of the meninges? -CORRECT ->>dura mater, arachnoid mater,
pia mater
What does the dura mater adhere firmly to? -CORRECT ->>the skull. it is tough and
fibrous
What layer of the meninges splits into two leaves as specific sites to enclose large
venous sinuses? What do these sinuses do? -CORRECT ->>dura mater.
these sinuses provide major venous drainage from the brain.
What is the midline sinus of of the brain that splits into two sinuses: bilateral transverse
and sigmoid sinus? What side are these bigger on? -CORRECT ->>The main sinus
enclosed by the dura major is the midline superior sagital sinus. This splits into the
sigmoid and bilateral transverse sinuses which are larger on the right side.
What are the arteries that lie between the skull and the dura mater (epidural space)? -
CORRECT ->>meningeal arteries.
,ATLS WRITTEN REVIEW 2025.
What is the most commonly injured meningeal artery and where is it located? -
CORRECT ->>middle meningeal artery.
Located over the temporal fossa
T/F: the arachnoid mater is fused to the dura mater? -CORRECT ->>FALSE: not
attached. This produces a potential space for a subdural hematoma
In a subdural hematoma, what is the cause? -CORRECT ->>injury to bridging veins that
extend from brain surface to the sinuses within the dura.
fills the space between the arachnoid and pia mater? -CORRECT ->>CSF. this
cushions the brain and spinal cord.
What location of brain hemorrhage is frequently seen in brain contusion or injury to
major blood vessels at base of brain? -CORRECT ->>subarachnoid.
The and contain the reticular activating system which is responsible for .
-CORRECT ->>midbrain and upper pons state of alertness
What important function resides in the medulla? -CORRECT ->>cardiorespiratory
centers.
What important functions are in the following brain segments:
left hemisphere:
frontal lobe:
parietal lobe:
temporal: -CORRECT ->>1. left hemisphere: language center
frontal lobe: executive function, emotions, motor
parietal lobe: sensory function/spatial orientation
temporal: memory functions
, ATLS WRITTEN REVIEW 2025.
What divides the brain into supratentorial and infratentorial compartments? -CORRECT
->>tentorium cerebelli. (tent over cerebellum)
What is the physiology behind a blown pupil? -CORRECT ->>blown pupil: dilation of
pupil
-CN III runs along the tentorium cerebelli. parasympathetic fibers that constrict the pupil
run along CN III (oculomotor). When temporal lobe is herniated, it can compress these
fibers. Unapposed sympathetic activity causes pupillary dilation.
What is the tentorial notch/hiatus -CORRECT ->>this is where the midbrain passes
through into the infratentorial compartment.
what part of the brain most commonly herniates through the tentorial notch? -
CORRECT ->>Uncus (medial part of temporal lobe)
does weakness occur on the same or opposite side of the uncal herniation? -CORRECT
->>OPPOSITE. the corticospinal tract of the midbrain is compressed and then crosses
at the foramen magnum.
state: Ipsilateral/contralateral
pupillary dilation associated with hemiparesis is the classic sign of uncial
herniation. -CORRECT ->>ipsi
contra
average ICP is mmHg. -CORRECT ->>10
The monro-kellie doctrine states that the total volume of intracranial contents must
remain constant, because the cranium is correct answer a rigid, non expandable
container.
ATLS Written Exam Review 2025/2026 With
Accurate Questions and Correct Answer.
What is the primary goal of treating TBI? How is this done? -CORRECT ->>preventing
secondary brain injury. This is done by maintaining blood pressure and providing
adequate profusion.
After managing ABCDEs of TBI what MUST be identified if present? How is this done? -
CORRECT ->>mass lesion that requires surgical evacuation is critical! this is done with
CT. NOTE: obtaining a CT should not delay patient transfer to trauma center.
Which brain lobes do the following hold:
anterior fossa:
middle fossa:
posterior fossa: -CORRECT ->>1. anterior fossa: frontal lobes
middle fossa: temporal lobes
posterior fossa: lower brainstem and cerebellum
What are the 3 layers of the meninges? -CORRECT ->>dura mater, arachnoid mater,
pia mater
What does the dura mater adhere firmly to? -CORRECT ->>the skull. it is tough and
fibrous
What layer of the meninges splits into two leaves as specific sites to enclose large
venous sinuses? What do these sinuses do? -CORRECT ->>dura mater.
these sinuses provide major venous drainage from the brain.
What is the midline sinus of of the brain that splits into two sinuses: bilateral transverse
and sigmoid sinus? What side are these bigger on? -CORRECT ->>The main sinus
enclosed by the dura major is the midline superior sagital sinus. This splits into the
sigmoid and bilateral transverse sinuses which are larger on the right side.
What are the arteries that lie between the skull and the dura mater (epidural space)? -
CORRECT ->>meningeal arteries.
,ATLS WRITTEN REVIEW 2025.
What is the most commonly injured meningeal artery and where is it located? -
CORRECT ->>middle meningeal artery.
Located over the temporal fossa
T/F: the arachnoid mater is fused to the dura mater? -CORRECT ->>FALSE: not
attached. This produces a potential space for a subdural hematoma
In a subdural hematoma, what is the cause? -CORRECT ->>injury to bridging veins that
extend from brain surface to the sinuses within the dura.
fills the space between the arachnoid and pia mater? -CORRECT ->>CSF. this
cushions the brain and spinal cord.
What location of brain hemorrhage is frequently seen in brain contusion or injury to
major blood vessels at base of brain? -CORRECT ->>subarachnoid.
The and contain the reticular activating system which is responsible for .
-CORRECT ->>midbrain and upper pons state of alertness
What important function resides in the medulla? -CORRECT ->>cardiorespiratory
centers.
What important functions are in the following brain segments:
left hemisphere:
frontal lobe:
parietal lobe:
temporal: -CORRECT ->>1. left hemisphere: language center
frontal lobe: executive function, emotions, motor
parietal lobe: sensory function/spatial orientation
temporal: memory functions
, ATLS WRITTEN REVIEW 2025.
What divides the brain into supratentorial and infratentorial compartments? -CORRECT
->>tentorium cerebelli. (tent over cerebellum)
What is the physiology behind a blown pupil? -CORRECT ->>blown pupil: dilation of
pupil
-CN III runs along the tentorium cerebelli. parasympathetic fibers that constrict the pupil
run along CN III (oculomotor). When temporal lobe is herniated, it can compress these
fibers. Unapposed sympathetic activity causes pupillary dilation.
What is the tentorial notch/hiatus -CORRECT ->>this is where the midbrain passes
through into the infratentorial compartment.
what part of the brain most commonly herniates through the tentorial notch? -
CORRECT ->>Uncus (medial part of temporal lobe)
does weakness occur on the same or opposite side of the uncal herniation? -CORRECT
->>OPPOSITE. the corticospinal tract of the midbrain is compressed and then crosses
at the foramen magnum.
state: Ipsilateral/contralateral
pupillary dilation associated with hemiparesis is the classic sign of uncial
herniation. -CORRECT ->>ipsi
contra
average ICP is mmHg. -CORRECT ->>10
The monro-kellie doctrine states that the total volume of intracranial contents must
remain constant, because the cranium is correct answer a rigid, non expandable
container.
