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Senior Rotations > Neurosurgery > Flashcards

Neurosurgery Flashcards

1
Q

2 structural divisions of nervous system

A

CNS: brain/spinal cord

PNS: sensory/motor neurons

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2
Q

2 functional divisions of nervous system

A

somatic/voluntary: sensory and motor

autonomic: involuntary, viscera + smooth muscle

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3
Q

2 divisions of autonomic nervous system

A

sympathetic: fight or flight
parasympathetic: calming

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4
Q

8 bones of cranium

A

2 parietal

2 temporal

frontal

occipital

sphenoid

ethmoid

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5
Q

foramen magnum

A

opening in occipital bone where spinal cord passes through

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6
Q

3 cranial fossae

A

anterior: circle of willis
middle: temporal lobes, pituitary, inner + middle ear structures
posterior: occipital lobes, cerebellum, brainstem

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7
Q

3 meningeal membranes

A

dura: superficial, tough, white
arachnoid: middle, thin, avascular
pia: inner, transparent, adhered to surface of cord and brain

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8
Q

subarachnoid space

A

CSF between arachnoid and pia maters

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9
Q

principal lobes of cerebrum

A

frontal

parietal

temporal

occipital

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10
Q

3 structures of brainstem

A

midbrain

pons

medulla oblongata

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11
Q

ventricular flow

A

lateral –> monroe –> 3rd ventricles –> cerebral aqueduct –> 4th ventricle –> lushka, magendie –> basal cisterns (arachnoid villi)

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12
Q

where is CSF formed

A

choroid plexus (ependymal cells)

most in lateral ventricles

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13
Q

where is CSF absorbed

A

arachnoid villi in dural venous sinuses

into venous circulation

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14
Q

CSF volume in an adult

A

80-150ml

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15
Q

CSF pressure

A

10-20mmHg

70-200 mmH2O

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16
Q

vertebrae in spinal column

A

33

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17
Q

spinal nerves in column

A

31

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18
Q

what level does spinal cord terminate

A

L1-L3

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19
Q

cauda equina

A

near vertical continuation of spinal nerves from end of cord

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20
Q

5 paraspinal ligaments

A

anterior + posterior longitudinal

interspinal

supraspinal

ligamentum flavum

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21
Q

intervertebral disk

A

outer annulus fibrosis

inner nucleus pulposis

shock absorber

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22
Q

ruptured intervertebral disk

A

annulus fibrosis ruptures, nucleus pulposis protrudes through

disk fragment compresses nerves

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23
Q

how does a ruptured disk produce symptoms

A

nerve compression

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24
Q

1-6 cranial nerves

A

1 olfactory

2 optic

3 oculomotor

4 trochlear

5 trigeminal

6 abducens

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25
7-12 cranial nerves
7 facial 8 vestibulocochlear/acoustic/auditory 9 glossopharyngeal 10 vagus 11 spinal accessory 12 hypoglossal
26
cranial nerve for sight
2 optic
27
cranial nerve for hearing/balance
7 vestibulocochlear/auditory/acoustic
28
3 cranial nerves for eye movement
3 oculomotor 4 trochlear 6 abducens
29
cranial nerve for smell
1 olfactory
30
5 arteries that form circle of willis
anterior, posterior, middle cerebrals anterior, posterior communicating
31
function of the circle of willis
blood through cerebral/cerebellar hemispheres equalize BP intracranial circulation
32
arteries that supply circle of willis
r+l internal carotids anteriorly r+l vertebrals posteriorly
33
5 common sites of intracranial aneurysm formation
anterior, posterior communicating anterior, middle, posterior cerebrals
34
3 most common surgical approaches to circle of willis
frontal pterional bifrontal
35
first sign of ruptured intracranial aneurysm
sudden, severe headache
36
Bell's palsy
facial lower motor nerve paralysis 7. facial
37
Meniere's disease
dizziness, sensation of fullness or pressure in ears 8. vestibulocochlear/auditory/acoustic
38
trigeminal neuralgia
severe pain in the face 5. trigeminal
39
treat tic douloureux
glycerol rhizotomy radiofrequency balloon compression microvascular decompression
40
carpal tunnel syndrome
compression of the median nerve
41
how to treat carpal tunnel syndrome
decompression of the median nerve at the wrist
42
neurectomy
division of the vestibular portion of 8th cranial nerve treats Meniere's disease/vertigo
43
rhizotomy
dissection of a nerve root
44
sympathectomy
excision of a portion of the autonomic nervous system
45
neurolysis
freeing a nerve from adhesion
46
most frequently encountered neurosurgical problem
herniated lumbar disk laminectomy
47
meningocele
failure of the union of vertebral areas in fetal development
48
myelomeningocele
meningocele with neural elements
49
cerebrospinal rhinorrhea
CSF leak of the nose
50
cerebrospinal otorrhea
CSF leak of the ear
51
craniotomy
incision into the skull to expose the brain (flap replaced)
52
craniectomy
opening into the skull where the bone flap isn't replaced
53
craniotomy vs. craniectomy
in craniectomy the bone flap isn't replaced
54
why do a craniotomy
intracranial hematoma control bleeding debulk/resect a tumor excise/clip vascular lesions aspirate abscesses decompress cranial nerves
55
why do a craniectomy
remove tumors hematoma bone infection
56
cranioplasty
repair of a skull defect
57
burr hole
small incision from scalp to brain minimum exposure
58
why do a burr hole
remove localized fluid access ventricles biopsy electrode placement
59
epidural vs subdural hematoma
epidural: arterial bleeding, increased ICP, more common subdural: slow collection of venous blood
60
epidural hematoma tear/laceration of what artery
middle meningeal
61
vessels commonly responsible for subdural hemorrhage
basalar CHECK
62
lumbar laminectomy
excision of one or more lumbar lamina
63
why do a lumbar laminectomy
decompress neural tissue
64
positions for lumbar laminectomy
prone: most common modified knee-chest lateral
65
frames in lumbar laminectomy
Wilson: prone lateral: bean bag Andrews: knee chest
66
spinal cord stimulator unit
implantable, non destructive device CHECK
67
spinal cord stimulator use
chronic intractable pain in trunk/limbs electrical impulse in epidural space (tingling masks pain)
68
arteriovenous malformation
abnormal communication between arterial and venous systems; blood vessel tumor
69
treat AVM
excision/ligation endovascular embolization
70
cervical tongs for neck injury
Crutchfield Garner Wells Vinke
71
x-ray of choice for acute head injury
CT scan
72
methylene blue
marking ink inflammatory response in CNS tissue
73
myelography
contract in subarachnoid space (spine) view cord, roots, column
74
WADA's test
before brain surgery to lateralize: language memory dominant hemisphere seizure/lesion
75
hydrocephalus
excessive CSF causes dilation of ventricles
76
external vs internal hydrocephalus
external (communicating): abnormal absorption internal (non-communicating): obstruction of pathways
77
2 surgical shunts for hydrocephalus
ventriculoperitoneal ventriculoatrial
78
common disposable hemostatic scalp clips
Raney LeRoy mechanical hemostasis of galea/skin
79
3 ways to treat intracranial aneurysms
ligation of feeding vessels with clips fine silk suture wrap with muslin PMMA
80
mechanical hemostasis
physical barrier patties clips gelfoam surgicel bone wax
81
chemical hemostasis
clotting cascade surgicel topical thrombin absorbable collagen/fibrillar
82
hand-controlled pneumatic driver for burr holes
craniotome
83
hand-controlled manually-powered driver for burr holes
Hudson Brace
84
hi-powered foot-controlled pneumatic instrument for turning bone flaps or removing laminae
Midas Rex Triton Saber
85
instrument to remove nucleus pulposis (soft tissue)
pituitary rongeur
86
instrument to remove bone spurs from intervertebral laminae
kerrison rongeur
87
CUSA
cavitron ultrasonic surgical aspirator hi frequency sound waves
88
CUSA in neuro
debulk/emulsify a tumor hemostasis and spares other tissue

Senior Rotations (8 decks)

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