ATLS Written Review questions with correct
answers
What is the primary goal of treating TBI? How is this done? - correct answerspreventing
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
answersmass 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 answers1. 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 answersdura mater, arachnoid mater, pia
mater
What does the dura mater adhere firmly to? - correct answersthe 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 answersdura 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 answersThe 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
answersmeningeal arteries.
What is the most commonly injured meningeal artery and where is it located? - correct
answersmiddle meningeal artery.
Located over the temporal fossa
T/F: the arachnoid mater is fused to the dura mater? - correct answersFALSE: not attached.
This produces a potential space for a subdural hematoma
In a subdural hematoma, what is the cause? - correct answersinjury to bridging veins that
extend from brain surface to the sinuses within the dura.
_______ fills the space between the arachnoid and pia mater? - correct answersCSF. 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 answerssubarachnoid.
The ____ and _____ contain the reticular activating system which is responsible for ____. -
correct answersmidbrain and upper pons
state of alertness
, What important function resides in the medulla? - correct answerscardiorespiratory centers.
What important functions are in the following brain segments:
1. left hemisphere:
2. frontal lobe:
3. parietal lobe:
4. temporal: - correct answers1. 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
answerstentorium cerebelli. (tent over cerebellum)
What is the physiology behind a blown pupil? - correct answersblown 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 answersthis is where the midbrain passes through
into the infratentorial compartment.
what part of the brain most commonly herniates through the tentorial notch? - correct
answersUncus (medial part of temporal lobe)
does weakness occur on the same or opposite side of the uncal herniation? - correct
answersOPPOSITE. the corticospinal tract of the midbrain is compressed and then crosses at
the foramen magnum.
answers
What is the primary goal of treating TBI? How is this done? - correct answerspreventing
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
answersmass 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 answers1. 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 answersdura mater, arachnoid mater, pia
mater
What does the dura mater adhere firmly to? - correct answersthe 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 answersdura 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 answersThe 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
answersmeningeal arteries.
What is the most commonly injured meningeal artery and where is it located? - correct
answersmiddle meningeal artery.
Located over the temporal fossa
T/F: the arachnoid mater is fused to the dura mater? - correct answersFALSE: not attached.
This produces a potential space for a subdural hematoma
In a subdural hematoma, what is the cause? - correct answersinjury to bridging veins that
extend from brain surface to the sinuses within the dura.
_______ fills the space between the arachnoid and pia mater? - correct answersCSF. 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 answerssubarachnoid.
The ____ and _____ contain the reticular activating system which is responsible for ____. -
correct answersmidbrain and upper pons
state of alertness
, What important function resides in the medulla? - correct answerscardiorespiratory centers.
What important functions are in the following brain segments:
1. left hemisphere:
2. frontal lobe:
3. parietal lobe:
4. temporal: - correct answers1. 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
answerstentorium cerebelli. (tent over cerebellum)
What is the physiology behind a blown pupil? - correct answersblown 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 answersthis is where the midbrain passes through
into the infratentorial compartment.
what part of the brain most commonly herniates through the tentorial notch? - correct
answersUncus (medial part of temporal lobe)
does weakness occur on the same or opposite side of the uncal herniation? - correct
answersOPPOSITE. the corticospinal tract of the midbrain is compressed and then crosses at
the foramen magnum.
