SFA MODULE 7 (NERVOUS) Flashcards by Laura Cybulski

During a postolateral approach to the hip, this nerve must be protected.
(largest nerve in the body) arises from the lumbosacral plexus. It emerges from the pelvis below the piriformis and enters the thigh between the ischial tuberosity and the greater trochanter.

Sciatic nerve

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This nerve innervates the latissimus dorsi muscle. Lateral to the long thoracic nerve. Also, if performing a latissimus dorsi flap for breast reconstruction, this structure provides its main blood supply.

Thoracodorsal nerve

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The third ventricle empties into the fourth ventricle through which of the following small ducts, which is the only exit for the third and lateral ventricles?

Aqueduct of Sylvius

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This structure is a branch of the sciatic nerve behind the knee. When placing a patient in stirrups, the SFA must ensure that the lateral head of the fibula does not rest against the stirrup. If so, this structure can be damaged.

Common peroneal nerve

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This nerve is at risk for injury when performing a thyroidectomy. If injured, could result in hoarseness, loss of voice or inability to cough.

Recurrent laryngeal

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This nerves travels along the anterior-lateral chest wall and innervates the serratus anterior muscle.

Long thoracic nerve

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This structure is largely sensory to the inguinal region and external genitalia but does supply some motor fibers to some abdominal wall muscles (internal oblique and transversus abdominis). When assisting on an inguinal hernia this structure must be identified. This sensory nerve innervates the scrotum and must be preserved.

Ilioinguinal

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This artery could be injured during an anterior cervical disectomy is the screws are placed laterally rather than straight or at a medial angle.

Vertebral Artery

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Needs to be protected during a parotidectomy.

Structure is CN VII.

Facial Nerve

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These veins drain the intracranial venous sinuses to veins on the outside of the skull.

Emissary Veins

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This nerve is frequently damaged after fractures or wounds to the elbow

Ulnar Nerve

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This structure is usually involved during an epidural hematoma

Middle meningeal artery

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This structure can be damaged whenever the patient is in the lithotomy position.

Obturator nerve

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This nerve innervates the diaphragm

phrenic nerve

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Which cranial nerve has three large divisions? Also, known as the great sensory nerve of the head and face.

Trigeminal nerve (CN V)

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The lateral ventricles with the cerebral hemisphere communicate with the third ventricle through this structure.

Foramen of Monro

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Meningiomas are begin tumors that originate in:

Dura

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Your patient presents with a fractured humerus and wrist drop. Which Nerve is affected?

Radial Nerve

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This nerve is also known as the peroneal nerve. If not careful with the unaffected leg when the patient is positioned on the fracture table, this nerve can become injured.

Common Fibular Nerve

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This structure emergences from the medulla, passes through the skull, and descends through the neck region into the thorax and abdominal region. Also, important during a vagotomy.

Vagus Nerve (CNX)

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This structure is the second layer that covers the brain and spinal cord. The fine, weblike membrane is avascular and lies beneath the dura mater.

arachnoid matter

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the 3rd ventricle empties into the 4th through this structure.

Aqueduct of Sylvius

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Structure provides motor to the posterior thigh and all muscles below the knee; sensory to the posterior thigh, posterolateral leg and ankle, and all of the foot. Terminal branches of the tibial and common peroneal nerves.

sciatic nerve

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This nerve innervates the trapezius and sternocleidomastoid muscle, and should be identified and preserved when performing a radical neck dissection.

Accessory Nerve

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A surgeon is performing a lumbar laminectomy and disectomy for an L5-S1 disc herniation that has protruded into the epidural space. Which of the following parts of the disc should be removed?

Nucleus pulposus

Structure supplies motor and sensory innervation to perineum. Also, when positioning patients if the patient's buttocks extends off the table injury may occur to this structure.

Pudendal Nerve

The point at which an impulse is transmitted from one neuron to another neuron is called the:

synapse

Which of the following is a substance that aids the transmission of nerve impulses?

Acetylcholine

The cluster of blood capillaries found in each nephron is the:

Glomerulus

The following statements concerning the abdominal part of the sympathetic trunk are not true EXCEPT for: It enters the abdomen behind the lateral arcuate ligament All of the ganglia receive white rami communicants Gray Rami Communicantes are given off to the lumbar spinal nerves The trunk passes 6 segmentally arranged ganglia

Gray Rami Communicantes are given off to the lumbar spinal nerves

The two anatomical divisions of the nervous system are:

central and peripheral

The somatic nervous system and autonomic (visceral) nervous systems comprise which functional division of the peripheral nervous system?

Efferent

The two distinct types of cells composing neural tissue are:

Neurons and neuralgia

The type of sensory neurons that monitor the position of the skeletal muscles and joints is the:

Proprioceptor

The main difference between somatic motor neurons and visceral motor neurons is the the visceral motor neuron innervates:

Peripheral effectors other than skeletal muscle

The three major nerve plexi are:

Cervical , lumbar and Brachial

Which of the following is NOT true of neurons? They all conduct nerve impulses They are most abundant cells of nervous tissue They cannot divide mitotically They all release chemical regulators

they are the most abundant cells of the nervous tissue

The neuralgia that form myelin in the CNS and guide the development of neurons in the CNS is:

oligodendrocytes

Which of the following combinations relating plexus to nerve derivation is incorrect? Brachial plexus and radial nerve Sacral plexus and the sciatic nerve Lumbar plexus and the median nerve Cervical plexus and the phrenic nerve

Lumbar plexus and the median nerve

The nerves of the brachial plexus serve the:

Shoulder girdle and arm

In the parasympathetic division of the ANS, the preganglionic (first-order) neurons are located in the:

Brain stem and sacral segments of the spinal cord

The postganglionic (second order) parasympathetic neurons are located:

In intramural ganlia or in ganglia adjacent to the target organs

Approximately 75% of all parasympathetic outflow is provided by the:

vagus nerve

Vital autonomic functions regulated by the medulla come from reflex centers known as the:

Cardiovascular and respiratory rhythmicity centers

A body structure or body region that is NOT innervated by nerves arising from the sacral plexus is the: Pelvis Lower back Perineum Abdominal wall

Abdominal wall

All of the following are components of a reflex EXCEPT: Effector Sympathetic trunk Sensory neuron Receptor

Sympathetic trunk

The nerve that we use meticulous dissection in finding during a parotidectomy is the: Facial Laryngeal Vagus Optic

facial

Which nerve might be damaged during an episiotomy? Ilionguinal Dorsal Perineal Pudendal

pudendal

Which of the following cranial nerves innervates the superior oblique muscle? Olfactory (I) Optic (II) Oculomotor (III) Trochlear (IV)

trochlear

Which of the following cranial nerves innervates the inferior, medial, superior rectus, inferior oblique, and levator palpebrae muscle of the eye? Olfactory (I) Optic (II) Oculomotor (III) Trochlear (IV)

oculomotor (III)

Which of the following cranial nerves innervates the lateral rectus muscle of the eye? Trochlear (IV) Trigeminal (V) Abducens (VI) Facial (VII)

Abducens (VI)

This structure regulates body temperature. Pons Cerebellum Midbrain Hypothalamus

Hypothalamus

this gelatinous substance is within an intervertebral disc. Spinous process Nucleus pulposus Annulus fibrosus Intervertebral foramen

Nucleus Pulposus

This structure is known as the great sensory nerve of the face and head. Trochlear Oculomotor Hypoglossal Trigeminal

Trigeminal

Which of the following cavities within the brain is filled with CSF? Aperture Medulla Pyramids Ventricles

Ventricles

this structure allows the third ventricle of the brain to empty into the fourth ventricle. Aqueduct of Sylvius Choroid plexuses Foramen venosum Foramen spinosum

Aqueduct of Sylvius

What are the significant early signs of a ruptured cerebral aneurysm?

Severe headache, nuchal rigidity, and photophobia

Do primary malignant brain tumors metastasize outside the CNS ?

rarely

What is the rationale for vomiting in a patient who has increased intracranial pressure?

Pressure on the emetic center in the medulla

Is vision lose a typical effect of advanced Parkinson’s disease?

What is the probable source of an embolus causing a cerebrovascular accident (CVA)?

Common carotid artery

The largest category of primary malignant brain tumors that arise from cells in the central nervous system (CNS) are called:

gliomas.

Creutzfeldt-Jakob disease is caused by:

infection in the brain by a prion.

Typical signs of a TIA include:

transient muscle weakness in a hand or leg.

Which conditions is marked by focal signs?

brain abcess

The rabies virus is usually transmitted by:

bites from infected animals.

How is the presence of spina bifida diagnosed?

Prenatally by ultrasound or detection of alpha-fetoprotein (AFP) in maternal blood or amniotic fluid

Through what area does the cerebrospinal fluid circulate around the brain and spinal cord?

subarachnoid space

How does a depressed skull fracture cause brain damage?

A section of skull bone is displaced below the level of the skull, causing pressure on the brain.

What does the term otorrhea mean?

CSF leaking from the ear.

Which type of cerebrovascular accident (CVA) has the poorest prognosis?

Hemorrhagic CVA

n a case of bacterial meningitis, where does swelling and purulent exudate form?

In the pia mater, arachnoid, and surface of the entire brain

How does the heart rate change as intracranial pressure increases?

Rate decreases

Which statement best describes herniation resulting from increased intracranial pressure?

Displacement of brain tissue downward toward the spinal cord

What are common early manifestations of Parkinson’s disease?

Tremors at rest in the hands and repetitive motion of the hands

What is a typical early sign of amyotrophic lateral sclerosis (ALS)?

Weakness and muscle atrophy in upper limbs

What is the typical initial effect of a herniated intervertebral disc at the L4 to L5 level?

Lower back pain radiating down the leg

Collateral circulation is most likely to be present when a CVA results from:

atherosclerosis.

In cases of Guillain-Barré syndrome, what does the pathophysiology include?

Inflammation and demyelination of peripheral nerves, leading to ascending paralysis

Herpes zoster can be identified by a typical:

unilateral rash and pain along a cranial nerve or dermatome.

With regard to meningitis, choose the correct combination of microbe and the age group commonly affected.

N. meningitides: children and youth

What are significant signs of acute bacterial meningitis?

Severe headache, nuchal rigidity, and photophobia

What causes a herniated intervertebral disc?

A protrusion of the nucleus pulposus through the annulus fibrosis

What is the pathophysiological change in Parkinson’s disease?

Degeneration of the basal nuclei with a deficit of dopamine

What characteristic is common to all individuals with cerebral palsy?

Some degree of motor disability

An epidural hematoma is located between the:

dura mater and the skull.

What is a major function of the limbic system?

Determines emotional responses

Failure of the spinous processes to fuse, but without herniation of the meninges, is called

spina bifida occulta

Vertebral fractures are classified as:

simple, compression, wedge, dislocation

The stroke scale used to rapidly diagnose a stroke includes:

capacity for speech, level of consciousness, motor skills, eye movements.

Where do you perform a lumbar puncture?

L3-L4

Which of the following characteristics indicates that the CSF is normal?

Clear and colorless fluid

what are the common early signs of multiple sclerosis?

Areas of numbness, weakness in the legs, visual problems

Where is the usual location of language centers?

left hemisphere

Which type of fracture typically occurs at the base of the skull?

basilar

Which of the following factors predispose(s) an individual to a CVA? 1. Hypertension 2. Smoking cigarettes 3. History of coronary artery disease 4. Diabetes mellitus

1234

What is the typical change in blood pressure in a patient who has increased intracranial pressure?

Increasing pulse pressure

Secondary brain tumors usually arise from:

metastasized breast or lung tumors.

What is an early indicator of increased intracranial pressure?

Decreasing responsiveness

Communicating hydrocephalus causes increased intracranial pressure because of:

failure of the subarachnoid to absorb CSF

Which type of seizure commonly occurs in children?

absence

Which of the following conditions is NOT part of the criteria for a declaration of “brain death”?

Presence of any head injury

The best description of a myelomeningocele is:

herniation of the meninges, CSF, and spinal cord or nerves through a vertebral defect.