Week 12 - Neurosurgery Flashcards
Acoustic neuroma
benign tumor of the 8th cranial nerve; schwannoma
Aneurysm
dilation or ballooning of an artery wall as a result of injury, disease, or congential condition
Arteriovenous malformation (AVM)
collection of blood vessels with abnormal communication between arteries and veins
Astrocytes
cells that support the nerve cells (neurons)
Bone flap
section of bone removed from skull during craniotomy procedures
Embolization
technique used to occlude a blood vessel; variety or material are injected in to the vessel under fluoroscopy to stop active bleeding or prevent bleeding
Intracranial pressure (ICP)
pressure within the skull exerted by the brain tissue, blood, and cerebral spinal fluid
Stereotactic
computerized method of locating a point in space or in tissue, using coordinates in 3 dimension
Skull (cranium)
bony plates connected by suture; covers and protects the brain; frontal, parietal (x2), temporal (x2), and occipital bone
Cerebellum
hindbrain; 2nd largest are of the brain; helps control coordination, movement, and equilibrium
Cerebrum
forebrain; controls all motor activity and sensory impulses; divided into right and left hemispheres; largest part of the brain
Spinal cord
located within the vertebral canal; continuous with the medulla oblongata; originates at magnum foramen terminates in the cauda equina at L1-L2; surrounded by meninges
Brain stem
medulla oblongata, midbrain (thalmus, hypothalmus, pituitary gland, pineal gland), and pons; controls circulatory system, respiration, and heart rate
Cranial nerves
12 pairs of nerves that originate in the brain; responsible for sensory and motor functions
I Olfactory
sense of smell
II Optic
conveys impulses for sight
III Oculomotor
controls muscles that move the eye and iris
IV Trochlear
controls the oblique muscle of the eye
V Trigeminal
sensory nerve; controls sensations of the face, forehead, mouth, nose, and top of head
VI Abducens
controls lateral movement of the eye
VII Facial
motor nerve; controls muscles in face and scalp, tears and salivation
VIII Vestibulocochlear (acoustic)
controls hearing and equilibrium
IX Glossopharyngeal
controls sense of taste and pharyneal movement, parotid gland, and salivation
X Vagus
innervates the pharyngeal and laryngeal muscles, heart, pancreas, lungs and digestive systems; control sensory pathways of abdominal viscera, pleura, and thoracic viscera
XI Accessory
cranial and spinal portions; cranial-joins the vagus nerve to help control pharyneal and larygeal muscles; spinal-controls trapezius and sternomastoid muscles
XII Hypoglossal
innervates muscles of the tounge
Vertebral column
provides structure and protects spinal cord; 24 vertebrae (7 cervical, 12 thoracic, 5 lumbar, 5 sacral, 1 coccygeal)
History and Physical
determine past and present symptoms, trauma, neurological illness and pathological abnormalities
Computed tomography
gold standard for evaluating cranial vascular disorders
Magnetic resonance imaging
used to diagnose tumors, abscesses, ligament damages, and disc herniation
Stereotactic magnetic resonance
combines MRI with a head frame (magnetic markers=fiducials) to pinpoint a particular location of the brain to provide precise coordinates for surgery
Functional magnetic resonance imaging
used for pre op brain mapping; alloy neurosurgeon to localize areas of the brain responsible for certain motor skills, language and sensory functions
Magnetic resonance angiography
produces very detailed images of vascular structures; useful for visualizing cerebral circulation
Angiography (arteriography)
used to diagnosis cerebral aneurysms and arteriovenous malformations; contrast medium is injected into pts arterial system to outline the structure of the vessels
Digital subtraction angiography
imaging technique used with standard angiography to isolate vascular structures; precontrast image is “subtracted” from the data to reveal vascular structure
Three-dimensional CT angiography
contrast medium used to provide images of intracranial vasculature
Myelography
contrast medium injected into subarachnoid space of cervical or lumbar spine, xrays taken to record images
Discography
imaging technique with contrast used to evaluate pathology of an intravertebral disc
Ultrasound
used to assess blood flow in cerebral blood vessels; used intraop for real-time imaging of cysts, tumor, and other structures in brain and spinal cord
Electroencephalogram (EEG)
measures the electrical activity of the brain; used to evaluate seizure disorders, head injuries, dementia, metabolic conditions affecting the brain
Electromyography (EMG)
measures conduction rate of motor nerves; used to evaluate loss of nerve conduction due to herniated disc, spondylosis, and other impingement disorders
Somatosensory evoked potentials (SSEP)
measures sensory impulses from the body to the brain, used to access nerve damage
Burr hole
holes are drilled in the cranium with a neurosurgical drill (craniotome); used to relieve pressure on brain caused by an accumulation of fluid beneath the dura mater
Craniotomy (tumor removal)
incision into the cranium, bone replaced
Craniectomy
removal of cranial bone; bone removed
Anterior cervical discectomy and fusion
ACD-excise one or more herniated cervical intervertebral discs; F-restores continuity to spine after disc is removed
Posterior cervical laminectomy
performed to access the cervical spinal cord and remove a portion of the cervical lamina
Lumbar laminectomy and disectomy
LL-performed to access lumbar spinal cord and remove a portion of the lumbar lamina; D-to excise and remove a portion of the intervertebral disc
Lumbar fusion
performed to stabilize the spine using bone graft or metal implant
Cordotomy
chordotomy; disable pain-conducting tracts in the spinal cord
