ATLS WRITTEN REVIEW COMPREHENSIVE
QUESTIONS AND VERIFIED ANSWERS
ACTUAL EXAMS 2026/ 2027 TEST!!
What is the primary goal of treating TBI? How is this done? - CORRECT ANSWES --
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 ANSWES -- 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:
1. anterior fossa:
2. middle fossa:
3. posterior fossa: - CORRECT ANSWES -- 1. anterior fossa: frontal lobes
2. middle fossa: temporal lobes
3. posterior fossa: lower brainstem and cerebellum
What are the 3 layers of the meninges? - CORRECT ANSWES -- dura mater, arachnoid
mater, pia mater
What does the dura mater adhere firmly to? - CORRECT ANSWES -- 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 ANSWES -- 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 ANSWES -- 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 ANSWES -- meningeal arteries.
What is the most commonly injured meningeal artery and where is it located? -
CORRECT ANSWES -- middle meningeal artery.
Located over the temporal fossa
, T/F: the arachnoid mater is fused to the dura mater? - CORRECT ANSWES -- FALSE:
not attached. This produces a potential space for a subdural hematoma
In a subdural hematoma, what is the cause? - CORRECT ANSWES -- 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 ANSWES --
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 ANSWES -- subarachnoid.
The ____ and _____ contain the reticular activating system which is responsible for
____. - CORRECT ANSWES -- midbrain and upper pons
state of alertness
What important function resides in the medulla? - CORRECT ANSWES --
cardiorespiratory centers.
What important functions are in the following brain segments:
1. left hemisphere:
2. frontal lobe:
3. parietal lobe:
4. temporal: - CORRECT ANSWES -- 1. left hemisphere: language center
2. frontal lobe: executive function, emotions, motor
3. parietal lobe: sensory function/spatial orientation
4. temporal: memory functions
What divides the brain into supratentorial and infratentorial compartments? - CORRECT
ANSWES -- tentorium cerebelli. (tent over cerebellum)
What is the physiology behind a blown pupil? - CORRECT ANSWES -- 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 ANSWES -- this is where the midbrain
passes through into the infratentorial compartment.
what part of the brain most commonly herniates through the tentorial notch? -
CORRECT ANSWES -- Uncus (medial part of temporal lobe)
does weakness occur on the same or opposite side of the uncal herniation? -
CORRECT ANSWES -- OPPOSITE. the corticospinal tract of the midbrain is
compressed and then crosses at the foramen magnum.
QUESTIONS AND VERIFIED ANSWERS
ACTUAL EXAMS 2026/ 2027 TEST!!
What is the primary goal of treating TBI? How is this done? - CORRECT ANSWES --
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 ANSWES -- 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:
1. anterior fossa:
2. middle fossa:
3. posterior fossa: - CORRECT ANSWES -- 1. anterior fossa: frontal lobes
2. middle fossa: temporal lobes
3. posterior fossa: lower brainstem and cerebellum
What are the 3 layers of the meninges? - CORRECT ANSWES -- dura mater, arachnoid
mater, pia mater
What does the dura mater adhere firmly to? - CORRECT ANSWES -- 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 ANSWES -- 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 ANSWES -- 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 ANSWES -- meningeal arteries.
What is the most commonly injured meningeal artery and where is it located? -
CORRECT ANSWES -- middle meningeal artery.
Located over the temporal fossa
, T/F: the arachnoid mater is fused to the dura mater? - CORRECT ANSWES -- FALSE:
not attached. This produces a potential space for a subdural hematoma
In a subdural hematoma, what is the cause? - CORRECT ANSWES -- 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 ANSWES --
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 ANSWES -- subarachnoid.
The ____ and _____ contain the reticular activating system which is responsible for
____. - CORRECT ANSWES -- midbrain and upper pons
state of alertness
What important function resides in the medulla? - CORRECT ANSWES --
cardiorespiratory centers.
What important functions are in the following brain segments:
1. left hemisphere:
2. frontal lobe:
3. parietal lobe:
4. temporal: - CORRECT ANSWES -- 1. left hemisphere: language center
2. frontal lobe: executive function, emotions, motor
3. parietal lobe: sensory function/spatial orientation
4. temporal: memory functions
What divides the brain into supratentorial and infratentorial compartments? - CORRECT
ANSWES -- tentorium cerebelli. (tent over cerebellum)
What is the physiology behind a blown pupil? - CORRECT ANSWES -- 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 ANSWES -- this is where the midbrain
passes through into the infratentorial compartment.
what part of the brain most commonly herniates through the tentorial notch? -
CORRECT ANSWES -- Uncus (medial part of temporal lobe)
does weakness occur on the same or opposite side of the uncal herniation? -
CORRECT ANSWES -- OPPOSITE. the corticospinal tract of the midbrain is
compressed and then crosses at the foramen magnum.
