PHTLS Traumatic Brain Injury 5

Question 1

A patient with TBI has decerebrate posturing. Compared to decorticate posturing, this suggests injury at which level?

Accepted Answer

Below the red nucleus at the level of the midbrain or upper pons

Answer

Decerebrate posturing (extension and internal rotation of all extremities) indicates injury at or below the midbrain red nucleus, a deeper and more ominous injury than decorticate.

Question 2

In the PHTLS trauma assessment, which component of the GCS is considered the MOST prognostically significant for TBI?

Accepted Answer

Motor response (M)

Answer

The motor component of the GCS has the strongest correlation with TBI outcome and neurological prognosis in trauma research.

Question 3

A patient with TBI has CSF rhinorrhea (clear fluid from the nose). This finding indicates:

Accepted Answer

Anterior fossa basilar skull fracture with dural tear

Answer

CSF rhinorrhea results from a basilar skull fracture that tears the dura in the anterior fossa, allowing CSF to drain through the cribriform plate into the nasal cavity.

Question 4

What is the PHTLS recommendation regarding spinal motion restriction in a TBI patient with a significant mechanism?

Accepted Answer

Use selective spinal motion restriction based on clinical assessment and NEXUS/Canadian C-Spine criteria

Answer

PHTLS recommends selective spinal motion restriction based on validated clinical criteria rather than universal immobilization for all trauma patients.

Question 5

A restless, agitated TBI patient is pulling at his oxygen mask. What is the MOST appropriate PHTLS response?

Accepted Answer

Reassess and manage pain/agitation while maintaining oxygenation and monitoring neuro status

Answer

Agitation in TBI may reflect hypoxia, pain, or worsening brain injury; the priority is to identify and treat the cause while maintaining oxygenation and monitoring for deterioration.

PHTLS - Prehospital Trauma Life Support Practice Test

PHTLS - Prehospital Trauma Life Support Practice Test

PHTLS Traumatic Brain Injury 5