TCRN TCRN Head and Neck Trauma 4

Question 1

A patient with a subdural hematoma has a lucid interval followed by rapid neurological deterioration. This presentation is more classic for which type of hematoma?

Accepted Answer

Epidural hematoma

Answer

Epidural hematomas classically present with a lucid interval followed by rapid deterioration due to arterial bleeding (typically middle meningeal artery) expanding between the dura and skull.

Question 2

The cerebral perfusion pressure (CPP) is calculated as:

Accepted Answer

MAP – ICP

Answer

CPP = MAP – ICP; maintaining CPP between 60–70 mmHg is the target in severe TBI management to prevent secondary ischemic injury.

Question 3

Which type of facial fracture involves the orbital floor and can cause entrapment of the inferior rectus muscle?

Accepted Answer

Orbital blowout fracture

Answer

Orbital blowout fractures fracture the orbital floor, potentially trapping the inferior rectus muscle and causing diplopia and restricted upward gaze.

Question 4

When assessing a trauma patient using the AVPU scale, a patient who responds only to painful stimuli is classified as:

Accepted Answer

Pain

Answer

On the AVPU scale, 'P' (Pain) indicates the patient responds only to painful stimulation, roughly correlating with a GCS of 8 or below.

Question 5

A trauma patient with a scalp laceration is found to have a depressed skull fracture on CT. Which finding would most clearly indicate the need for urgent surgical intervention?

Accepted Answer

Fracture depression greater than the thickness of the skull with dural tear

Answer

A depressed skull fracture with depression greater than skull thickness and an associated dural tear typically warrants surgical elevation to prevent infection and neurological deficit.

TCRN Exam Practice Test

TCRN Exam Practice Test

TCRN TCRN Head and Neck Trauma 4