Solved 2025-2026 Version.
What is a subdural hemorrhage? - Answer A type of focal head injury between the dura &
arachnoid layers. Sheering of veins so occurs much slower
What is a epidural hemorrhage? - Answer A type of focal head injury between the skull & dura
layer. Sheering of arteries so occurs rapidly, compresses brain quickly, and rapid surgical
intervention is needed to prevent herniation
What's cushing's triad? - Answer A set of 3 manifestations that indicate impending
herniation/coning:
1. Bradycardia
2. Bradypnea/irregular respirations
3. Widening pulse pressure (sBP increases. dBP decreases)
What is normal ICP in an adult lying flat? - Answer 5-15 mmHg
What are temporal brain contusions? - Answer A type of focal head injury that bruises brain
tissue. Only treatment is treating elevated ICP
What is a subarachnoid hemorrhage? - Answer A diffuse head injury that occurs between the
arachnoid & pia layer. Pia layer so thin that bleeding spreads quite quickly through brain &
causes damage fast. Manifestations similar to meningitis (sore/stiff neck, photophobia, severe
headache)
Manifestations of a subarachnoid hemorrhage are similar to meningitis. Why? - Answer The
meninges sit just below the pia layer
How do you measure mean arterial pressure (MAP)? - Answer MAP = (2xdBP + 1xsBP) / 3
What is cerebral perfusion pressure? - Answer The pressure needed to adequately perfuse
brain tissue
, If CPP drops below 60 we aren't getting enough O2 to the brain. How can we improve brain
perfusion? - Answer Either increase mean arterial pressure or decrease intracranial pressure
(fine line between increasing MAP to increase CPP, but not so high that it increases ICP)
CPP = MAP - ICP
What is the formula for CPP? - Answer CPP = MAP - ICP
What is battle's sign? - Answer Bruising behind the ear. It indicates a skull fracture in the
middle cranial fossa
What is rhinorrhea? Otorrhea? - Answer Rhinorrhea - CSF leakage from nose
Otorrhea - CSF leakage from ear
How do you know if leakage is CSF or not? - Answer CSF will be clear and will form Halo Sign
(the interior part of the stain will look bloody)
What do you do if your pt is leaking CSF? - Answer Apply a 3 sided dressing/loose 2x2. Lets
fluid out but prevents bacteria from entering
What is bilateral periorbital ecchymosis and what must you keep into consideration if someone
has this? - Answer Bilateral periorbital ecchymosis: bruising around eyes - indicates basil skull
fracture
If someone has this DO NOT insert NG/anything up nose (why? may go into brain)
What drug do you give to pts to decrease cerebral volume and lower ICP? - Answer Manitol
(osmotic diuretic) - most effective diuretic for pts with head injuries (draws out fluid from brain
tissue - fluid goes into vascular space and gets voided out)
What do you do if a pt with a brain injury starts hypoventilating? Why? - Answer Manually bag
them - then transfer pt to ICU & put on ventilator
Why? CO2 rises in hypoventilation - causes blood vessels to dilate - increased blood volume in
brain - increases ICP
When does peak swelling take place? - Answer 48-72 hr window