TCRN Review - Head and Neck (Neurological
Trauma and Maxillofacial and Neck Trauma)
QUESTIONS AND ANSWERS 100% RATED
CORRECT WITH 100% SURE PASS|GRADED
A+
What are the three main constituents in the brain? - CORRECT ANSWERS CSF, Brain Tissue
(mostly water), Blood
The brain makes up approximately _____% of the volume of the skull and is _____% water. - CORRECT
ANSWERS 80%
75%
CSF makes up about _____% of the volume of the skull. - CORRECT ANSWERS 10%
There is approximately _____ mL of CSF. - CORRECT ANSWERS 125-150 mL
Blood makes up about _____% of the volume of the skull and _____% of the blood is venous. - CORRECT
ANSWERS 10%
80%
The pressure of water, CSF and blood against the skull is known as _____. - CORRECT ANSWERS
ICP - Intracranial pressure
What are the normal ICPs for children and adults? - CORRECT ANSWERS Child - 0-5 mmHg
Adult - 5-12 mmHg
,ICP pressures above _____ mmHg in any age group is considered elevated. - CORRECT ANSWERS
20 mmHg
ICP pressures above 20 mmHg do what? - CORRECT ANSWERS Compromise blood flow into
the skull and contribute to cerebral hypoxia and hypoglycemia.
What can happen if ICP pressures climb too high? - CORRECT ANSWERS The brain may be
forced out of the skull through any opening (such as skull fractures, tentorial plate or foramen magnum).
ICP above _____ mmHg is severe and life-threatening. - CORRECT ANSWERS 40 mmHg
ICP between _____ and _____ mmHg is termed "moderate intracranial hypertension". - CORRECT
ANSWERS 20 and 40 mmHg
ICP above 20 mmHg is abnormally high and is known as _____. - CORRECT ANSWERS Early
increased ICP
What should resting ICP be? - CORRECT ANSWERS Less than 10 mmHg
When ICP increases, pressure is exerted downwards on brain tissue, affecting the cerebral cortices
_____ and _____. - CORRECT ANSWERS Reticular Activating System (RAS) and Cranial Nerves
List 6 things caused by pressure on the RAS (Reticular Activating System). - CORRECT ANSWERS
1. Progressive restlessness
2. Confusion
3. Disorientation
4. Lethargy or combativeness
5. Changes in speech
,6. Loss of judgement
List 4 motor functions caused by increased ICP. - CORRECT ANSWERS 1. Monoplegia
2. Hemiplegia
3. Over-pronation or supination of the wrists
4. Pronator drift
List 5 eye changes caused by increased ICP. - CORRECT ANSWERS Diplopia
Blurred Vision
Visual field defects (loss of sight in part of one visual field)
Conjugate deviation of eyes or gaze palsies
Oval pupils with hippus
Increased ICP causes _____ losses. - CORRECT ANSWERS Sensory
List 3 things caused by pressure on the hypothalamus. - CORRECT ANSWERS Nuchal rigidity
Temperature changes
Vomiting (usually without nausea)
Describe how to test for pronator drift. - CORRECT ANSWERS Ask the patient to hold both
arms straight forward with the palms up for at least 30 seconds. Have the patient close his or her eyes.
Monitor for unilateral downward drift of one hand (known as pronator drift).
Describe "conjugate deviation of the eyes". - CORRECT ANSWERS Both eyes move in the
same direction.
What is a gaze palsy? - CORRECT ANSWERS Inability to move both eyes in one direction.
, What is a hippus? - CORRECT ANSWERS Pupil rapidly dilates and constricts when stimulated
with light so it looks as though it is jiggling up and down.
List 6 late signs of increased ICP. - CORRECT ANSWERS 1. Further reduction in LOC and
responsiveness
2. Wide fluctuations in core body temperature
3. Seizures
4. Pressure on the brainstem
5. Pupillary changes
6. Flexor/extensor posturing
What two things are caused by pressure on the brainstem? - CORRECT ANSWERS Cushing's
Triad
Decreased or absent brainstem reflexes
What is Cushing's Triad? - CORRECT ANSWERS Systolic hypertension with a widened pulse
pressure
Bradypnea or irregular respirations
Bradycardia
What are some examples of absent brainstem reflexes? - CORRECT ANSWERS Cough, gag,
corneal, Doll's eye, cold calorics
What 2 types of pupillary changes are caused by pressure on the brainstem? - CORRECT ANSWERS
Unilateral or bilateral dilation
Decreased reactivity to light
Trauma and Maxillofacial and Neck Trauma)
QUESTIONS AND ANSWERS 100% RATED
CORRECT WITH 100% SURE PASS|GRADED
A+
What are the three main constituents in the brain? - CORRECT ANSWERS CSF, Brain Tissue
(mostly water), Blood
The brain makes up approximately _____% of the volume of the skull and is _____% water. - CORRECT
ANSWERS 80%
75%
CSF makes up about _____% of the volume of the skull. - CORRECT ANSWERS 10%
There is approximately _____ mL of CSF. - CORRECT ANSWERS 125-150 mL
Blood makes up about _____% of the volume of the skull and _____% of the blood is venous. - CORRECT
ANSWERS 10%
80%
The pressure of water, CSF and blood against the skull is known as _____. - CORRECT ANSWERS
ICP - Intracranial pressure
What are the normal ICPs for children and adults? - CORRECT ANSWERS Child - 0-5 mmHg
Adult - 5-12 mmHg
,ICP pressures above _____ mmHg in any age group is considered elevated. - CORRECT ANSWERS
20 mmHg
ICP pressures above 20 mmHg do what? - CORRECT ANSWERS Compromise blood flow into
the skull and contribute to cerebral hypoxia and hypoglycemia.
What can happen if ICP pressures climb too high? - CORRECT ANSWERS The brain may be
forced out of the skull through any opening (such as skull fractures, tentorial plate or foramen magnum).
ICP above _____ mmHg is severe and life-threatening. - CORRECT ANSWERS 40 mmHg
ICP between _____ and _____ mmHg is termed "moderate intracranial hypertension". - CORRECT
ANSWERS 20 and 40 mmHg
ICP above 20 mmHg is abnormally high and is known as _____. - CORRECT ANSWERS Early
increased ICP
What should resting ICP be? - CORRECT ANSWERS Less than 10 mmHg
When ICP increases, pressure is exerted downwards on brain tissue, affecting the cerebral cortices
_____ and _____. - CORRECT ANSWERS Reticular Activating System (RAS) and Cranial Nerves
List 6 things caused by pressure on the RAS (Reticular Activating System). - CORRECT ANSWERS
1. Progressive restlessness
2. Confusion
3. Disorientation
4. Lethargy or combativeness
5. Changes in speech
,6. Loss of judgement
List 4 motor functions caused by increased ICP. - CORRECT ANSWERS 1. Monoplegia
2. Hemiplegia
3. Over-pronation or supination of the wrists
4. Pronator drift
List 5 eye changes caused by increased ICP. - CORRECT ANSWERS Diplopia
Blurred Vision
Visual field defects (loss of sight in part of one visual field)
Conjugate deviation of eyes or gaze palsies
Oval pupils with hippus
Increased ICP causes _____ losses. - CORRECT ANSWERS Sensory
List 3 things caused by pressure on the hypothalamus. - CORRECT ANSWERS Nuchal rigidity
Temperature changes
Vomiting (usually without nausea)
Describe how to test for pronator drift. - CORRECT ANSWERS Ask the patient to hold both
arms straight forward with the palms up for at least 30 seconds. Have the patient close his or her eyes.
Monitor for unilateral downward drift of one hand (known as pronator drift).
Describe "conjugate deviation of the eyes". - CORRECT ANSWERS Both eyes move in the
same direction.
What is a gaze palsy? - CORRECT ANSWERS Inability to move both eyes in one direction.
, What is a hippus? - CORRECT ANSWERS Pupil rapidly dilates and constricts when stimulated
with light so it looks as though it is jiggling up and down.
List 6 late signs of increased ICP. - CORRECT ANSWERS 1. Further reduction in LOC and
responsiveness
2. Wide fluctuations in core body temperature
3. Seizures
4. Pressure on the brainstem
5. Pupillary changes
6. Flexor/extensor posturing
What two things are caused by pressure on the brainstem? - CORRECT ANSWERS Cushing's
Triad
Decreased or absent brainstem reflexes
What is Cushing's Triad? - CORRECT ANSWERS Systolic hypertension with a widened pulse
pressure
Bradypnea or irregular respirations
Bradycardia
What are some examples of absent brainstem reflexes? - CORRECT ANSWERS Cough, gag,
corneal, Doll's eye, cold calorics
What 2 types of pupillary changes are caused by pressure on the brainstem? - CORRECT ANSWERS
Unilateral or bilateral dilation
Decreased reactivity to light
