ATLS Written Review Exam Questions
and Answers with complete solutions
Graded A+
What is the primary goal of treating TBI? How is this done?>>> 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?>>> 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:>>> 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?>>> dura mater, arachnoid mater, pia mater
What does the dura mater adhere firmly to?>>> 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?>>> 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?>>> 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)?>>> meningeal
arteries.
What is the most commonly injured meningeal artery and where is it located?>>> middle meningeal
artery.
, Located over the temporal fossa
T/F: the arachnoid mater is fused to the dura mater?>>> FALSE: not attached. This produces a potential
space for a subdural hematoma
In a subdural hematoma, what is the cause?>>> injury to bridging veins that extend from brain surface
to the sinuses within the dura.
_______ fills the space between the arachnoid and pia mater?>>> 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?>>> subarachnoid.
The ____ and _____ contain the reticular activating system which is responsible for ____.>>> midbrain
and upper pons
state of alertness
What important function resides in the medulla?>>> cardiorespiratory centers.
What important functions are in the following brain segments:
1. left hemisphere:
2. frontal lobe:
3. parietal lobe:
4. temporal:>>> 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?>>> tentorium cerebelli.
(tent over cerebellum)
What is the physiology behind a blown pupil?>>> 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>>> this is where the midbrain passes through into the infratentorial
compartment.
and Answers with complete solutions
Graded A+
What is the primary goal of treating TBI? How is this done?>>> 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?>>> 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:>>> 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?>>> dura mater, arachnoid mater, pia mater
What does the dura mater adhere firmly to?>>> 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?>>> 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?>>> 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)?>>> meningeal
arteries.
What is the most commonly injured meningeal artery and where is it located?>>> middle meningeal
artery.
, Located over the temporal fossa
T/F: the arachnoid mater is fused to the dura mater?>>> FALSE: not attached. This produces a potential
space for a subdural hematoma
In a subdural hematoma, what is the cause?>>> injury to bridging veins that extend from brain surface
to the sinuses within the dura.
_______ fills the space between the arachnoid and pia mater?>>> 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?>>> subarachnoid.
The ____ and _____ contain the reticular activating system which is responsible for ____.>>> midbrain
and upper pons
state of alertness
What important function resides in the medulla?>>> cardiorespiratory centers.
What important functions are in the following brain segments:
1. left hemisphere:
2. frontal lobe:
3. parietal lobe:
4. temporal:>>> 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?>>> tentorium cerebelli.
(tent over cerebellum)
What is the physiology behind a blown pupil?>>> 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>>> this is where the midbrain passes through into the infratentorial
compartment.
