PHTLS 10TH EDITION POST TEST 2026
PRACTICE EXAM WITH SOLUTIONS
◉ CPP- Cerebral Perfusion Pressure Answer: The amount of
pressure it takes to push blood through the cerebral circulation.
CPP=Mean Arterial pressure (MAP) - Intercranial pressure (ICP)
◉ CPP- is normally below ? mmHg Answer: CPP is normally 15
mmHg or below
◉ Autoregulation Answer: The brain changes the cerebral blood
vessel resistance (CVR) to compensate for changes in the cerebral
pulse pressure (CPP)
◉ For neurological injured PT's the systolic blood pressure is best if
maintained at or above Answer: 90 mmHg
◉ Hyperventilation and TBI Answer: Hyperventilation can reduced
CBF by causing vasoconstriction due to hypocapnia, PaCO2 >35
increases risk of cerebral ischemia
◉ Primary Brain injury Answer: The direct trauma or mechanical
injury, includes contusions, hemorrhages and lacerations
,◉ Secondary brain injury Answer: pathologic mechanisms that
related to intercranial mass effect, elevated ICP, and herniation,
hemotoma, hypoxia and hypotension
◉ Mass effect Answer: The effect of a growing mass or tumor
◉ Uncal Herniation Answer: temporal lobe epidural hematoma
forces pressure on the medial portion of the temporal lobe (uncus)
which in turn puts pressure on the 3rd cranial nerve causing dilation
or blown pupil on the side of the herniation. May also cause loss of
function of the motor track on the same side.
◉ Final stage of uncal herniation Answer: The RAS is affected
patient lapses into coma
◉ decorticate posturing Answer: flexion of the upper extremities
with rigidity and extension of the lower extremities.
◉ decerebrate posturing Answer: all extrem become flaccid and
motor activity is absent
◉ Cheyne strokes ventilation Answer: repeating cycle of slow hallow
breaths that become deeper and more rapid and then return to slow
,◉ Central neurogenic hyperventilation Answer: rapid deep breaths
◉ Ataxic breathing Answer: erratic ventilatory efforts that lack any
discernible pattern
◉ Cushings phenomenon Answer: greatly increased arterial blood
pressure and the resultant bradycardia (increase BP + decreased
HR) may occur with severely increasing ICP
◉ Hypercapnia (high CO2) Answer: causes vasodilation
◉ Hypocapnia (low CO2) Answer: causes vasoconstriction
◉ When people have 20 mmHg CO2 in their blood (half of the
official norm), Answer: they have about 40% less blood supply to the
brain in comparison with normal conditions
◉ Indication of TBI
Hemiparesis Answer: One sided weakness
◉ Indication of TBI
Hemiplegia Answer: One sided paralysis
, ◉ Indications for a nose fracture Answer: ecchymosis, edema, nasal
deformity, swelling, epistaxis
◉ Epidural Hematoma
1-brief Loss of consciousness
2-Lucid Interval
3-Rapid decline in level of consciousness Answer: The period of time
after a brief loss of consciousness where the PT may be oriented,
lethargic or confused followed by a rapid decline of consciousness
◉ Subdural Hematoma Answer: Account for 30% of TBI-Generally
results from venous blood from bridging viens that are torn during a
violent blow to the head.
◉ Epidural Hematoma Answer: Account for 2% of TBI-Arterial
blood starts to dissect or peal the dura off of the inner table of the
skull creating an epidural space filled with blood
◉ Epidural Hematoma Signs Answer: Altered LOC, dilated and
sluggish non reactive pupil on the side of herniation, hemiparesis or
hemiplegia on opposite side of injury.
◉ Subdural Hematoma Answer: Can be chronic or acute. Pt on
coumadin are at high risk of un identified subdural hematomas that
PRACTICE EXAM WITH SOLUTIONS
◉ CPP- Cerebral Perfusion Pressure Answer: The amount of
pressure it takes to push blood through the cerebral circulation.
CPP=Mean Arterial pressure (MAP) - Intercranial pressure (ICP)
◉ CPP- is normally below ? mmHg Answer: CPP is normally 15
mmHg or below
◉ Autoregulation Answer: The brain changes the cerebral blood
vessel resistance (CVR) to compensate for changes in the cerebral
pulse pressure (CPP)
◉ For neurological injured PT's the systolic blood pressure is best if
maintained at or above Answer: 90 mmHg
◉ Hyperventilation and TBI Answer: Hyperventilation can reduced
CBF by causing vasoconstriction due to hypocapnia, PaCO2 >35
increases risk of cerebral ischemia
◉ Primary Brain injury Answer: The direct trauma or mechanical
injury, includes contusions, hemorrhages and lacerations
,◉ Secondary brain injury Answer: pathologic mechanisms that
related to intercranial mass effect, elevated ICP, and herniation,
hemotoma, hypoxia and hypotension
◉ Mass effect Answer: The effect of a growing mass or tumor
◉ Uncal Herniation Answer: temporal lobe epidural hematoma
forces pressure on the medial portion of the temporal lobe (uncus)
which in turn puts pressure on the 3rd cranial nerve causing dilation
or blown pupil on the side of the herniation. May also cause loss of
function of the motor track on the same side.
◉ Final stage of uncal herniation Answer: The RAS is affected
patient lapses into coma
◉ decorticate posturing Answer: flexion of the upper extremities
with rigidity and extension of the lower extremities.
◉ decerebrate posturing Answer: all extrem become flaccid and
motor activity is absent
◉ Cheyne strokes ventilation Answer: repeating cycle of slow hallow
breaths that become deeper and more rapid and then return to slow
,◉ Central neurogenic hyperventilation Answer: rapid deep breaths
◉ Ataxic breathing Answer: erratic ventilatory efforts that lack any
discernible pattern
◉ Cushings phenomenon Answer: greatly increased arterial blood
pressure and the resultant bradycardia (increase BP + decreased
HR) may occur with severely increasing ICP
◉ Hypercapnia (high CO2) Answer: causes vasodilation
◉ Hypocapnia (low CO2) Answer: causes vasoconstriction
◉ When people have 20 mmHg CO2 in their blood (half of the
official norm), Answer: they have about 40% less blood supply to the
brain in comparison with normal conditions
◉ Indication of TBI
Hemiparesis Answer: One sided weakness
◉ Indication of TBI
Hemiplegia Answer: One sided paralysis
, ◉ Indications for a nose fracture Answer: ecchymosis, edema, nasal
deformity, swelling, epistaxis
◉ Epidural Hematoma
1-brief Loss of consciousness
2-Lucid Interval
3-Rapid decline in level of consciousness Answer: The period of time
after a brief loss of consciousness where the PT may be oriented,
lethargic or confused followed by a rapid decline of consciousness
◉ Subdural Hematoma Answer: Account for 30% of TBI-Generally
results from venous blood from bridging viens that are torn during a
violent blow to the head.
◉ Epidural Hematoma Answer: Account for 2% of TBI-Arterial
blood starts to dissect or peal the dura off of the inner table of the
skull creating an epidural space filled with blood
◉ Epidural Hematoma Signs Answer: Altered LOC, dilated and
sluggish non reactive pupil on the side of herniation, hemiparesis or
hemiplegia on opposite side of injury.
◉ Subdural Hematoma Answer: Can be chronic or acute. Pt on
coumadin are at high risk of un identified subdural hematomas that
