ATLS Written Review Exam Questions With Solutions

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