NEURO test Flashcards
what is included in the central nervous system?
brain, spinal cord
what are the three layers of the meninges from outside to inside?
dura mater, arachnoid, pia mater
what part of the brain controls equilibrium?
cerebellum
what part of the brain is responsible for vital function control?
medulla oblongata
what arteries supply blood to the brain?
carotid, vertebral
what might the neurosurgeon use to attach the drapes to the skin of the patient?
staples, towel clips
how many pairs of crainal nerve are there? spinal nerves?
12,31
list three special precautions taken with the neurosurgical patient
foley, scd’s, bipolar cautery
what are the sponges used in neurosurgery called?
raytec, cottonoids, cotton balls
list three types of diagnostics used by the neurosurgeon?
xray, MRI, CT
what should you do if you are assisting the surgeon with a craniotomy incision?
hold pressure on the skin
what is done with the bone that is removed during a craniotomy?
placed in moist raytec
what approaches can be used for a hypophysectomy?
transphenoidal and frontal craniotomy-larger
in the st role what do you need to do when the surgeon is working through the microscope on a neuro case?
hand how they will use it, keep them clean
why is intracranial revascularization doen?
AV malformation, trauma, restore blood flow
3 advantages of sterotaxis?
less anesthesia time, accurate, smaller opening
what is the procedure called when a subfreezing temp substance is used to create a lesion and treat diease?
cryosurgery
which shunt is longer VA or VP?
ventriculoperitoneal
what is the big table called that goes over the body of the neuro patient?
mayfield
why is the microscope preferred over loupes?
gives more light
what is the purpose of taking a lateral xray prior to beginning spinal procedures?
assure correct level
symptoms of a patient with bony changes of the spinal column that require a laminectomy would include?
pain, loss of mobility
when a patient has a herniated disc, symptoms will be?
numbess, tingling, on the side
spondylosis
age related wear and tear of the spinal disks
lumbar discoscopy involves?
thoracic or general surgeon
what do you need to add to your set up if the dura is opened to remove a spinal cord tumor? SUTURE
prolene, duralone
corpectomy
removing all or part of the vertebral body, bone graft to fill in
what must the ST keep track of during spinal fixation?
implanted hardware and whether it is left in or taken out
where is the info during a spinal fixation placed?
implant record
suture for a periopheral nerve repair would be what type and size?
fine nylon 8-0,9-0, 10-0
what is the penfield 1-4?
dissector
primary benign tumor that arises from the protective covering of brain
meningioma
facial sinus used for surgical approach to pituitary adenoma
sphenoid
results most often from skull trauma over the middle meningeal artery
epidural hematoma
circle of willis is?
network of major arteries in the brain
how many vertebrae are there in the normal adult spine?
33
approach most desirable for treatment of herniated cervical disk with interbody fusion
anterior medial
which anatomical structure is the tough band that encases the intervertebral disc material?
annulus fibrosis
what is a kerrison?
rongeur
which surgical procedure treats compression of the median nerve by transverse ligament?
carpal tunnel release
which portion of the spinal column consists of five fused vertebrae?
sacrum
another name for C1?
atlas
name of the structure that the pituitary gland sits on?
sella turcica
what is the name of the structure that produces CSF?
choroid plexus
which instrument could be used for burr hole cranial perforation in no power is available?
hudson brace
used for scalp hemostasis and resembles a crile or kelly except curved to the side
dandy
what is the distal most area of the spinal cord or spinal nerves called?
filum terminale
largest part of the human brain?
cerebrum
countable surgical sponges used in neuro procedures to protect delicate tissue
patties
what test would detect an aneurysm next to the circle of willis?
cerebral angiogram
anatomical area where CSF circulates over all parts of the CNS
subarachnoid space
anatomical structure that the distal end of VP shunt catheter is inserted into?
peritoneal cavity
what si the name of the pin fixation device for neurosurgical cranial positioning?
mayfield
craniosynostosis is a congenital defect involving?
premature cranial suture closure
fiducials placed on bony landmarks assist in what?
sterotactic guided imagery
posterior fossa craniectomy is performed for pathology involving?
cerebellum
diagnostic study that demonstrates a herniated disc and filling defect
myelogram
part of the vertebra that projects posteriorly and is palpable through the skin
spinous process
soft, gelatinous part of intervertebral disc, sent as specimen after diskectomy
nucleus pulposus
what are osteophytes?
bony spurs
result of torn bridging veins between the cerebral cortex and venous sinuses
subdural hematoma
lowest part of the brain stem and contiguous with the spinal cord
medulla oblongata
what is not a congenital anomaly?
HNP
deep groove of the cerebrum that separates the brain into 2 lobes
fissure
portion of the spinal column with 5 vertebrae
lumbar
instrument used to extract pieces of the nucleus pulposus ina diskectomy
pituitary rongeur
dural fold that separates the right and left hemispheres for the cerebrum
falx cerebri
wilson, andrews and hall frames are positioning devices are used for?
lumbar laminectomy
position usually used for micro decompression endoscopic diskectomy
lateral
esophagus, carotid artery, and trachea are retracted medially?
ACDF
area where autologous bone graft is usually procedure for ACDF?
iliac crest
measuring device used to assess intraventricular pressure
manometer
part of the body is prepped for ulnar nerve decompression or transposition?
upper extremity down
visual cortex of the brain is located in which region?
occipital
neurosurgical retractor that has attachments for malleable brain spatulas and spoons
leyla yasargil
papaverine is used in craniotomy for aneurysm clipping to prevent?
vasospasm
name of the out folding convolutions of the brain
gyri
which layer has the closest and most intimate contact with the brain?
pia
instrument used to strip and separate the galea and pericranium from the skull
langenbeck elevator
what attachment to craniotome is needed to protect the dura and underlying tissues?
dural guard
where do most intracranial aneurysms occur?
arterial bifurcations
group of spinal nerves that continue from the distal spinal cord at about L2?
cauda equina
largest pair of bilateral nerves and innervate the buttocks and lower extremities?
sciatic
retractor with proximal hook for wound and distal hook for attachment of weight or sandbag
taylor
disease of the spinal nerve roots that results in pain, numbness, tingling or weakness
radiculopathy
skull flap can be reattached to the cranium by?
titanium plates and screws
mode of electrosurgical energy most used in neuro surgery around delicate tissue?
bipolar
uses variable ultrasonic energy to remove tumor tissue
CUSA
inability to move the lower part of the body
paraplegia
method of 3 dimensional plotting for guidance and biopsy?
sterotaxis
mechanism of supplying oxygen to an area of an organ when normal perfusion is interrupted?
collateral flow
infection of CNS tissue via direct injury or circulatory transfer?
brain abcess
most primitive part of the CNS, responsible for basic life functions
brain stem
cannulated instrument designed to provide passage for a catheter
tunneler
generation of heat during a chemical reaction
exothermic
what are cranial and spinal nerves?
peripheral nervous system
functional system of the nervous system are?
voluntary and involuntary
2 parts of a neuron?
cell body and axon
parasympathetic increases heart rate and is known as fight or flight?
false
nervous system depends on?
circulatory system for glucose and O2
cranium has how many bone?
8
anterior fontanelle closes at?
18 months
neuroglial cell create an environment neurons can efficiently perform in?
true
skull has 8 cranial bones and 14 facial bones?
true
galea of the scalp
connects muscles front to back
involuntary nervous system divisions
sympathetic and parasympathetic
where does the spinal cord begin and end?
foramen magnum
level of L1 and L2
where does the spinal cord run?
in the vertebral canal and is continuation of brain stem
ventral nerve root arises from spinal cord to form spinal nerve and?
brain to body, controls motor function, is anterior
there are 3 ventricles in the brain
false
all ventricles are filled with CSF and most CSF is formed in the 4th ventricle?
false
what does the gray matter of the cerebral cortex contain?
neuron cell bodies
what does the gray matter of the cerebral cortex do?
conducts higher mental function like movement and behavior
white matter in comparison to gray matter location
white below gray
cerebrum divided into 2 hemispheres and connected by nerve fibers that allow communication
corpus callosum
fissure are landmarks on the brain. the later fissure?
divides temporal from frontal and parietal lobes
hindbrain consists of?
cerebellum, pons, medulla oblongata
cerebellum helps control coordination and equilibrium?
true
cranial remodeling is not done to treat craniosynostosis
false
CSF flows in the?
subarachnoid
fissure of roland?
divides frontal from parietal lobe, is an indentation, central fissure
circle of willis location
cerebellum
main blood supply to brain is anterior, internal carotid art. and posterior, vertebral art.
true
brain oxygen
requires 20% more than any other organ
dorsal nerve root is posterior and handles sensory stimuli and?
handles stimuli body to brain
medulla oblongata
vital to sustaining life, controls RR and HR, impulses located here
neural arch is formed by pedicles and lamina and is posterior part of vertebral foramen
true
part of brain that relays info between forebrain and hindbrain
cerebral peduncles and midbrain
most frequent site of cerebral aneurysm
circle of willis
what is the forebrain?
cerebrum
cerebrum governs all motor activites and sensory impulses and is the center for?
memory, intelligence and reason
gyri of the cerebrum are?
convolutions in the surface
greenberg
self retaining cranial retractor
scoville malleable brain spoon
cranial retractor to depress or elevate brain tissue
craniotome and perforator
create burr holes- stops automatically
astrocytoma
malignant cranial tumor that cant be excised
most common reasons for neurosurgery?
cancer, trauma
what is the most common brain tumor?
glioma
what symptoms are associated with acoustic neuroma?
headache, loss of hearing
what does acoustic neuroma affect?
8th cranial nerve
position for occipital surgery
sitting, prone
instrument to create burr holes
midas rex, craniotome
done to counteract friction
irrigate with saline
used to enlarge holes? what should be done with bone chips?
kerrison
save bone chips
how is bleeding controlled during craniotomy?
bone wax
how is the dura separated from the bone flap?
3 penfield
how is the dura lifted free? what is used to protect?
durahook
cottonoids
what is used to provide visualization during craniotomy?
brain spoons
ideal temp of irrigation within cranium?
body temp
describe CUSA
emits energy that emulsifies abnormal tissue
ICP, procedure to place ICP monitor
intracranial pressure
burr hole or craniectomy
causes of hydrocephalus
obstruction
malformation
incision for pituitary tumor
upper gum
what is used to remove pituitary tumor? what is used to replace tissue?
ronguer
fascia from thigh
laminectomy
remove lamina, doesn’t damage veins when you incise
discetomy
removal of a disk between vertebrae
spinal fusion, how is it done?
fixation of unstable segment of spine
done after discectomy rods, screws
ACDF
supine, lamina no removed
PCDF
prone, 3 pins, mayfield
why is thoracotomy approach more popular for thoracic vertebral surgery?
small diameter of thoracic spinal canal
rhizotomy and why?
severed nerve roots in spinal cord, relieve back pain
procedure to relieve pressure on median nerve
carpal tunnel release
purpose of SCD’s
prevent DVT and PE
why do neurosurgeons drape?
its complex
marking incision
marking pencil, back of scalpel
NEVER METHYENE BLUE-inflammatory
purpose of Raney clips
compression, hemostasis
bipolar electrosurgery
current is isolated so less is required
what can be used to control bleeding when usual forms can’t be?
patients own fat
hemostatics
thrombin oxycel
diuretics
mannitol, lasix
antibiotics
vancomycin, bacitracin
antinflammatory
dexamethasone
lumbar puncture
gain access to CSF
angiography
injected into arteries, study vessels of the brain
myelography
uses fluoro to see where dye is flowing
EEG
brain activity, place electrodes
neuron
most important cell
cell body
receives input
axon
send messages
neuron and neuroglial cells
make up neurons system
glial cells
support neurons
where do spinal nerves emerge from?
spinal cord
nervous system functions
sensory, motor, integrative
subq tissue
vascular
fontanelles
baby’s soft spots, present at birth
dura mater
outermost
arachnoid
middle
pia mater
vascular inner membrane
subarachnoid space
filled with cerebrospinal fluid
how many parts of the brain?
forebrain, midbrain, hindbrain
sulci
furrows
what is the cerebral cortex known as?
gray matter
midbrain location
between the 2 cerebral hemispheres
midbrain
visual and auditory sense
pons
white matter, relay between the peduncles and medulla
medulla oblongata location
between spinal cord and pons
CSF
support and cushion brain and spinal cord, filter out waste
3x per day
what is the spinal cord protected by?
same coverings as the brain
what are the cranial nerves responsible for?
sensory and motor
position for cranial procedures
sitting or supine
position for spinal procedures
supine or prone
why is the incision site injected?
to control bleed
when is raytec used?
before the skull or spinal cord are opened
craniectomy
removing more bone than burr holes does
craniotomy
making a flap- will put back on later
why is the bone flap left intact on part of the skin?
for blood blood to scalp
why must CSF rhinorrhea be corrected?
dura is compromised
transsphenoidal hypophysectomy
removing pituitary tumor through nose
why doesn’t the catheter flow up?
valve, hemorrhage if pumped too much after surgery
reasons for shunt replacement
failure, growth not for the valve!!
encephalitis
inflammation involves spinal cord and brain
myasthenia gravis
weakness of skeletal muscles of the body
anterior cervial fusion
relieve pain in neck, no laminectomy required, iliac crest
