Neurosurgery

Question 1

Neuropraxis= _______________

Improves/ does not improve?

Answer 1

focal demyelination, improves

Question 2

Axonotmesis=_____________

Regeneration rate?

Answer 2

Loss of axon continuity (nerve and sheath intact).

Regeneration 1 mm/day

Question 3

Neurotmesis= ______

Rx?

Answer 3

Loss off nerve continuity; Surgery required for nerve recovery

Question 4

ADH produced when ____________ is sensed at __________ of the _____________.

Answer 4

high osmolarity is sensed at supraoptic nucleus of hypothalamus

Question 5

ADH causes………. to happen…….. at the………

Answer 5

causes incr free h20 absorption at the distal tubules and collecting ducts

Question 6

____ and ______ inhibit ADH release= _______ (disease)

Answer 6

alcohol and head injury; diabetes insipidus

Question 7

diabetes insipidus lab values:

UOP (high low)? specific gravity? Serum osmolarity/Na?

Answer 7

High UOP, low urine SG; high serum osmolarity/Na

Question 8

May also see SIADH with CHI= polyuria or oliguric?
High or low urine osmolarity?
High or low serum osmolarity/Na?

Answer 8

oliguric; high urine osmolarity; low serum osmo/Na (Every year)

Question 9

AVMs…..

Aneurysms……

Answer 9

AVMs- congenital, bleed age 50-60;

aneurysms- younger (age 20-59), are a/w HTN

Question 10

Most adult brain tumors are benign or malignant?

Answer 10

Malignant

Question 11

Spinal cord tumors are ___% benign

Answer 11

60% benign; (extradural likely malignant/met)

Question 12

Acoustic neuroma:

Crnaial nerve? location?

Answer 12

CN8 at the cerebello-pontine angle (cps)

Question 13

___#% of patients with head injury have a spinal injury

Answer 13

13%

Question 14

Subdural hematoma: Shape? Brain involved? Mortality?

Answer 14

Crescent shape, conforms to brain, 50% mortality

Question 15

Epidural hematoma: Shape? Brain involved? Mortality? Artery? Presentation?

Answer 15

Lens shaped, goes into brain, 10% mortality, middle meningeal artery, ‘lucid interval’

Question 16

Cerebral perfusion pressure= CPP = ____________

Answer 16

MAP- ICP, want to keep ~70 (Every Year)

Question 17

Cushing’s triad with increased ICP: ___, ____, ___.

Answer 17

HTN, bradycardia, kussmaul respirations (slow, irregular)

Question 18

GCS Motor: 6? 5? 4? 3? 2? 1?

Answer 18

6 commands, 5 localizes, 4 withdraw pain, 3 flexion pain (decorticate), 2 extension pain, 1 none

Question 19

GCS Verbal: 5? 4? 3? 2? 1?

Answer 19

5 oriented, 4 confused, 3, inappropriate, 2 incomprehensible, 1 none

Question 20

GCS Eyes: 4? 3? 2? 1?

Answer 20

4 spontaneous, 3 to command, 2 to pain, 1 none (Every year)

Question 21

GCS 8 or less: ____
GCS 10 or less: _____
GCS 5~ ___% mortality

Answer 21

ICP monitor indicated; intubation indicated; 50% mortality

Question 22

Cord injury above ___ can cause spinal shock.
Rx with ____, ____
Recognize by ____ with ______ and _______.

Answer 22

t5; fluids, may need alpha-agonist; recognize by hypotension with bradycardia, warm perfused extremities (vasodilated)

Question 23

Anterior spinal artery syndrome………..

Answer 23

lose bilateral motor, pain, and tem; keep position sense, light touch

Question 24

Brown Sequard: Injury…… syndrome….

Answer 24

spinal cord transected 1/2 way; lost ipsilateral motor, contralateral pain and temp

Question 25

Central cord syndrome….

Usually due to……….

Answer 25

bilateral loss of upper extremity motor, pain, temp; legs relatively spared….
Usually due to hyperextended c-spine injury

Question 26

Skull fx, to OR if……….

Answer 26

open fx or if depressed (to ~thickness of skull or more)