EXAM 1 -Neurosensory-Brain Tumors

Question 1

How are primary tumors classified?

Answer 1

Benign, Malignant, Metastatic

Question 2

Some Post-op craniotamy interventions?

Answer 2

• Eye care -Cold compress/irrigation
• Dressing care
• Monitor Cardiac
• Monitor labs
• I/Os (restrict to 1500 ml if pituitarty involvement)
• NPO for 24 hours
• VTE prophylaxis

Question 3

Mangagement of Brain tumor?

Answer 3

• Radiation
• Chemo
• Stereotactic Radiosurgery
• Craniotamy

Question 4

A common type of tumor that originates in brain. Make up 33% of all tumors. What kind of Tumor is this and where does it originate?

Answer 4

Glioma - originates in the Glial cells.

Question 5

tumors located within cerebral hemispheres?

Answer 5

supratentorial

Question 6

How should the bed be positioned for a patient after supratentorial surgery and why?

Answer 6

elevate HOB to 30 degrees

or as tolerated to promote venous drainage

Question 7

What do acoustic neuromas tend to compress and surround?

Answer 7

• Brain tissue
• Cranial nerve V - trigeminal
• Cranial nerve Vll - Facial
• Cranial nerve IX - glossopharangeal
• Cranial nerve X - Vagus nerve

Question 8

Classification that depends on cellular or anatomic origins of tumor? Which type is this mostly used for?

Answer 8

Third Classification - mostly used for Gliomas (malignant tumors)

Question 9

Tissues are benign; cells look nearly like normal brain cells - Which grade is this?

Answer 9

Grade l

Question 10

What is the secondary classification for tumors?

Answer 10

By location: (Example: supratentorial and Infratentorial )

Question 11

What are possible signs and symptoms resulting from a infratentorial tumor?

Answer 11

• ataxia
• autonomic nervous system dysfunction
• vomiting
• drooling
• hearing loss

Question 12

Glial cell tumors developed from connective tissue cells called astrocytes. Who can these be found in? Who can develop these?

Answer 12

• Astrocytoma
• Found in Cerebrum (larger part of brain), sometimes Cerebellum (smaller inner part of brain)
• Adults and Children can develop these

Question 13

Pituitary tumor that occur in the anterior lobe and may cause endocrine dysfunction

Answer 13

Adenoma

Question 14

Tissue is malignant; cells look less like normal cells- what grade is this?

Answer 14

Grade ll

Question 15

Describe a craniotamy?

Answer 15

• Burr holes drilled into skull
• saw used to remove piece of skull to expose tumor area
• Bone flap replaced and held together by small screws

Question 16

High grade astrocytoma that are most malignant of all brain tumors? Survival rate?

Answer 16

Glioblastoma Multiforme - Poor survival rate

Question 17

Where do acoustic neuromas arise from? Which cranial nerve is this?

Answer 17

Arise from schwann cells in peripheral portion of cranial nerve Vlll - Vestibulocochlear.

Question 18

What are some things you want to assess for with brain tumors?

Answer 18

• signs and symptoms of headaches
• Neurological deficits (E.G. visual disturbances)
• ICP

Question 19

Post op complications of Craniotamy?

Answer 19

• increased ICP

* Cerebral edema

Question 20

Tumors in area of brainstem structures and cerebellum (beneath tentorium)

Answer 20

infratentorial

Question 21

What drugs are used to manage Brain tumors/Craniotmay?

Answer 21

• Analgesics - Pain
• Dexamethasone - Inflammation
• Phenytoin - prevent seizures
• Ranitidine - Stress ulcer prophylaxis

Question 22

What are 3 examples of glial cells in which Gliomas originate?

Answer 22

• Astrocytes
• Oligodendrocytes
• Ependymal cells

Question 23

complications from brain tumors?

Answer 23

• ICP
• Cerebral edema
• Pituitary dysfunction leading to F&E imbalance
• Neurologic deficits
• Hydrocephalus (csf flow obstruction)

Question 24

Tissue is malignant and Cells look very different from normal cells - what grade is this?

Answer 24

Grade lll

Question 25

Cancer cells from the lung, breast, colon, pancreas, and kidney that travel to the brain via blood and lymphatic system.

Answer 25

Metastiatic or secondary tumor

Question 26

What are possible Signs and symptoms resulting from a supratentorial tumor?

Answer 26

• paralysis
• seizures
• memory loss
• cognitive impairment
• language impairment
• vision problems

Question 27

What is the difference between primary and secondary tumors?

Answer 27

Primary originate in the CNS and secondary from metastasis in other parts of body.

Question 28

malignant tissue has cells that look most abnormal and tend to grow quickly - what grade is this?

Answer 28

Grade lV

Question 29

Most common benign tumor arise from covering of the brain (meninges); this tumor tends to reoccur

Answer 29

Meningioma

Question 30

What can also be considered malignant?

Answer 30

Carol