Neurosurgery

Question 1

Which of the following diagnostic procedures utilizes a contrast medium, a computer, and x-ray technology to show differences between normal and abnormal tissue?
(a) echoencephalography
(b) evoked potential
(c) pneumoencephalography
(d) CT scan

Answer 1

(d) CT scan

Question 2

A herniation of the brain and its coverings through a defect in the skill is:
(a) meningoencephalocele
(b) myelomeningocele
(c) encephaloma
(d) aneurysm

Answer 2

(a) meningoencephalocele

Question 3

Bleeding that has occurred between the skill and the outer covering of the brain is a(n):
(a) epidural hematoma
(b) subdural hematoma
(c) intracerebral hemorrhage
(d) arteriovenous malformation

Answer 3

(a) epidural hematoma

Question 4

Venous air embolism would be a surgical complication more likely to occur in patients having a(n):
(a) lumbar laminectomy for a ruptured disk
(b) repair of a meningocele with the patient in the prone position
(c) anterior cervical discectomy in the supine position
(d) posterior fossa craniotomy in the sitting position

Answer 4

(d) posterior fossa craniotomy in the sitting position

Question 5

Which of the following positions would be most likely used for performing a lumbar laminectomy?
(a) fowler
(b) modified prone
(c) modified supine
(d) left lateral

Answer 5

(b) modified prone

Question 6

Which of the following instruments would be considered contaminated during a craniotomy?
(a) craniotome used for burr holes in skull
(b) penfield dissector used to separate dura from the skull
(c) cushing forceps used in placement of traction sutures in the dura
(d) needle holder used when securing drape towels

Answer 6

(d) needle holder used when securing drape towels

Question 7

During a craniotomy, the brain is protected with:
(a) cottonoid pledgets/patties
(b) 4x4 sponges
(c) laparotomy tapes
(d) telfa

Answer 7

(a) cottonoid pledgets/patties

Question 8

All of the following procedures would usually require a craniotomy incision EXCEPT:
(a) intracranial clipping of an aneurysm
(b) transspenoidal hypophysectomy
(c) anteriovenous malformation repair
(d) excision of an acoustic neuroma

Answer 8

(b) transspenoidal hypophysectomy

Question 9

Equipment used to emulsify and remove a benign tumor is a(n):
(a) cryosurgical unit
(b) ultrasonic aspirator
(c) midas rex/anspache with attachments
(d) craniotome

Answer 9

(b) ultrasonic aspirator

Question 10

Hydrocephalus is treated by which surgical procedure?
(a) craniectomy
(b) laminectomy
(c) ventriculoperitoneal shunt placement
(d) cranioplasty

Answer 10

(c) ventriculoperitoneal shunt placement

Question 11

A herniated nucleus pulposus is treated with which surgical procedure?
(a) craniectomy
(b) laminectomy
(c) ventriculoperitoneal shunt placement
(d) cordotomy

Answer 11

(b) laminectomy

Question 12

Craniosynostosis is treated with which surgical procedure?
(a) craniectomy
(b) cordotomy
(c) ventriculoperitoneal shunt placement
(d) cranioplasty

Answer 12

(d) cranioplasty
craniosynostosis is a birth defect when one or more fissures close before brain is totally formed.

Question 13

Stereotaxis provides:
(a) the location of a fixed point in space using geometric coordinates
(b) images of the vascular structures of the brain
(c) images of the outlines of the ventricles to assess for obstruction
(d) a sample of cerebrospinal fluid for analysis

Answer 13

(a) the location of a fixed point in space using geometric coordinates

Question 14

The meningeal layer located proximal to the brain tissue is the:
(a) pia mater
(b) subarachnoid
(c) dura mater
(d) arachnoid mater

Answer 14

(a) pia mater
Dura, arachnoid, subarachnoid, pia

Question 15

Cranial Nerve X is the:
(a) trochlear
(b) olfactory
(c) vagus
(d) trigeminal

Answer 15

(c) vagus

Question 16

What is the position of choice for supratentoral craniotomy?
(a) “beach chair”
(b) prone
(c) lateral
(d) dorsal recumbent

Answer 16

(d) dorsal recumbent

Question 17

The hemostatic clips applied on the scalp following the skin incision are called ___ clips.
(a) Rolando
(b) Raney
(c) Penfield
(d) Mayfield

Answer 17

(b) Raney

Question 18

The tissue encountered under the skin of the scalp is the:
(a) dura mater
(b) arachnoid space
(c) galea/aponeurosis
(d) periosteum

Answer 18

(c) galea/aponeurosis

Question 19

A congenital defect in the vertebral canal without herniation of the meningeal tissues is referred to as a(n):
(a) meningocele
(b) spina bifida
(c) hydrocephalus
(d) arteriovenous malformation

Answer 19

(b) spina bifida

Question 20

Shunts placed for the treatment of the hydrocephalus commonly drain into the:
(a) peritoneum and left atrium
(b) peritoneum and right atrium
(c) right or left atrium
(d) peritoneum or portal vein

Answer 20

(b) peritoneum and right atrium- goes into heart to be deoxygenated by lung

Question 21

The procedure for the treatment of chronic pain which involves surgery on the nerve root is referred to as:
(a) rhizotomy
(b) cingulotomy
(c) kyphoplasty- glue, used on back
(d) neurolysis

Answer 21

(a) rhizotomy- nerve division to break up nerve impulse to brain.

Question 22

Which of the following is a dye that should not be used to mark the skin prior to neurosurgical procedures?
(a) gentian violet- skin marker
(b) indigo carmine
(c) methylene blue
(d) brilliant green

Answer 22

(c) methylene blue- Should never be in the Neuro Room

Question 23

The area of cerebral circulation where the basilar arteries feed into is referred to as the:
(a) circle of magendie
(b) circle of sylvius
(c) circle of willis
(d) circle of raney

Answer 23

(c) circle of willis

Question 24

Dural traction sutures are secured with:;
(a) bulldogs
(b) allises
(c) oschners
(d) kellys/peans

Answer 24

(a) bulldogs

Question 25

The medication used during transspenoidal hypophysectomy (up your nose with a rubber hose) to aid incisional hemostasis would be:
(a) lidocaine hydrochloride with ephedrine (ephedrine is pain reliever)
(b) dexamethasone
(c) lidocaine hydrochloride without epinephrine-
(d) cocaine hydrochloride

Answer 25

(d) cocaine hydrochloride

Question 26

The tissue responsible for the secretion of cerebrospinal fluid is the:
(a) cerebellum
(b) pia mater
(c) choroid bodies/plexus
(d) subarachnoid space

Answer 26

(c) choroid bodies/plexus

Question 27

The tissue/structure found in the sella turcica is the:
(a) corpus callosum
(b) fourth ventricle
(c) pituitary gland
(d) pineal gland

Answer 27

(c) pituitary gland

Question 28

The meningeal layer space where bleeding most commonly occurs following trauma is the:
(a) epipial space
(b) subpial space
(c) subarachnoid space
(d) subdural space

Answer 28

(d) subdural space- arachnoids are very delicate

Question 29

Identify F

Answer 29

cerebral aqueduct of sylvius

Question 30

Identify

Answer 30

cerebrum

Question 31

Identify

Answer 31

cerebellum

Question 32

Identify

Answer 32

central sulcus

Question 33

Identify

Answer 33

circle of willis

Question 34

Identify

Answer 34

subarachnoid space

Question 35

After CSF is formed in the lateral ventricles it flows into the third ventricle through the ______________________ into the fourth ventricle

Answer 35

aqueduct of sylvius

Question 36

Tic douloureaux is a condition of unknown origin caused by the dysfunctional of the _____________ or ____________

Answer 36

5th cranial nerve
trigeminal facial nerve

Question 37

Most neurological procedures are classified as a _____________: clean procedure

Answer 37

Class I

Question 38

What is the Glasgow coma scale (GCS)?

Answer 38

GCS is an objective assessment of the level of consciousness after trauma

Question 39

Which artery is associated with epidural hematomas?

Answer 39

Middle meningeal artery

Question 40

What is the most common primary brain tumor in adults?

Answer 40

Glioblastoma multiforme (GBM)
(Think: GBM Greatest Brain Malignancy)

Question 41

What is a berry aneurysm

Answer 41

Saccular outpouching of vessels in the circle of Willis, usually at bifurcations