NEURO test Flashcards
1
Q
what is included in the central nervous system?
A
brain, spinal cord
2
Q
what are the three layers of the meninges from outside to inside?
A
dura mater, arachnoid, pia mater
3
Q
what part of the brain controls equilibrium?
A
cerebellum
4
Q
what part of the brain is responsible for vital function control?
A
medulla oblongata
5
Q
what arteries supply blood to the brain?
A
carotid, vertebral
6
Q
what might the neurosurgeon use to attach the drapes to the skin of the patient?
A
staples, towel clips
7
Q
how many pairs of crainal nerve are there? spinal nerves?
A
12,31
8
Q
list three special precautions taken with the neurosurgical patient
A
foley, scd’s, bipolar cautery
9
Q
what are the sponges used in neurosurgery called?
A
raytec, cottonoids, cotton balls
10
Q
list three types of diagnostics used by the neurosurgeon?
A
xray, MRI, CT
11
Q
what should you do if you are assisting the surgeon with a craniotomy incision?
A
hold pressure on the skin
12
Q
what is done with the bone that is removed during a craniotomy?
A
placed in moist raytec
13
Q
what approaches can be used for a hypophysectomy?
A
transphenoidal and frontal craniotomy-larger
14
Q
in the st role what do you need to do when the surgeon is working through the microscope on a neuro case?
A
hand how they will use it, keep them clean
15
Q
why is intracranial revascularization doen?
A
AV malformation, trauma, restore blood flow
16
Q
3 advantages of sterotaxis?
A
less anesthesia time, accurate, smaller opening
17
Q
what is the procedure called when a subfreezing temp substance is used to create a lesion and treat diease?
A
cryosurgery
18
Q
which shunt is longer VA or VP?
A
ventriculoperitoneal
19
Q
what is the big table called that goes over the body of the neuro patient?
A
mayfield
20
Q
why is the microscope preferred over loupes?
A
gives more light
21
Q
what is the purpose of taking a lateral xray prior to beginning spinal procedures?
A
assure correct level
22
Q
symptoms of a patient with bony changes of the spinal column that require a laminectomy would include?
A
pain, loss of mobility
23
Q
when a patient has a herniated disc, symptoms will be?
A
numbess, tingling, on the side
24
Q
spondylosis
A
age related wear and tear of the spinal disks
25
lumbar discoscopy involves?
thoracic or general surgeon
26
what do you need to add to your set up if the dura is opened to remove a spinal cord tumor? SUTURE
prolene, duralone
27
corpectomy
removing all or part of the vertebral body, bone graft to fill in
28
what must the ST keep track of during spinal fixation?
implanted hardware and whether it is left in or taken out
29
where is the info during a spinal fixation placed?
implant record
30
suture for a periopheral nerve repair would be what type and size?
fine nylon 8-0,9-0, 10-0
31
what is the penfield 1-4?
dissector
32
primary benign tumor that arises from the protective covering of brain
meningioma
33
facial sinus used for surgical approach to pituitary adenoma
sphenoid
34
results most often from skull trauma over the middle meningeal artery
epidural hematoma
35
circle of willis is?
network of major arteries in the brain
36
how many vertebrae are there in the normal adult spine?
33
37
approach most desirable for treatment of herniated cervical disk with interbody fusion
anterior medial
38
which anatomical structure is the tough band that encases the intervertebral disc material?
annulus fibrosis
39
what is a kerrison?
rongeur
40
which surgical procedure treats compression of the median nerve by transverse ligament?
carpal tunnel release
41
which portion of the spinal column consists of five fused vertebrae?
sacrum
42
another name for C1?
atlas
43
name of the structure that the pituitary gland sits on?
sella turcica
44
what is the name of the structure that produces CSF?
choroid plexus
45
which instrument could be used for burr hole cranial perforation in no power is available?
hudson brace
46
used for scalp hemostasis and resembles a crile or kelly except curved to the side
dandy
47
what is the distal most area of the spinal cord or spinal nerves called?
filum terminale
48
largest part of the human brain?
cerebrum
49
countable surgical sponges used in neuro procedures to protect delicate tissue
patties
50
what test would detect an aneurysm next to the circle of willis?
cerebral angiogram
51
anatomical area where CSF circulates over all parts of the CNS
subarachnoid space
52
anatomical structure that the distal end of VP shunt catheter is inserted into?
peritoneal cavity
53
what si the name of the pin fixation device for neurosurgical cranial positioning?
mayfield
54
craniosynostosis is a congenital defect involving?
premature cranial suture closure
55
fiducials placed on bony landmarks assist in what?
sterotactic guided imagery
56
posterior fossa craniectomy is performed for pathology involving?
cerebellum
57
diagnostic study that demonstrates a herniated disc and filling defect
myelogram
58
part of the vertebra that projects posteriorly and is palpable through the skin
spinous process
59
soft, gelatinous part of intervertebral disc, sent as specimen after diskectomy
nucleus pulposus
60
what are osteophytes?
bony spurs
61
result of torn bridging veins between the cerebral cortex and venous sinuses
subdural hematoma
62
lowest part of the brain stem and contiguous with the spinal cord
medulla oblongata
63
what is not a congenital anomaly?
HNP
64
deep groove of the cerebrum that separates the brain into 2 lobes
fissure
65
portion of the spinal column with 5 vertebrae
lumbar
66
instrument used to extract pieces of the nucleus pulposus ina diskectomy
pituitary rongeur
67
dural fold that separates the right and left hemispheres for the cerebrum
falx cerebri
68
wilson, andrews and hall frames are positioning devices are used for?
lumbar laminectomy
69
position usually used for micro decompression endoscopic diskectomy
lateral
70
esophagus, carotid artery, and trachea are retracted medially?
ACDF
71
area where autologous bone graft is usually procedure for ACDF?
iliac crest
72
measuring device used to assess intraventricular pressure
manometer
73
part of the body is prepped for ulnar nerve decompression or transposition?
upper extremity down
74
visual cortex of the brain is located in which region?
occipital
75
neurosurgical retractor that has attachments for malleable brain spatulas and spoons
leyla yasargil
76
papaverine is used in craniotomy for aneurysm clipping to prevent?
vasospasm
77
name of the out folding convolutions of the brain
gyri
78
which layer has the closest and most intimate contact with the brain?
pia
79
instrument used to strip and separate the galea and pericranium from the skull
langenbeck elevator
80
what attachment to craniotome is needed to protect the dura and underlying tissues?
dural guard
81
where do most intracranial aneurysms occur?
arterial bifurcations
82
group of spinal nerves that continue from the distal spinal cord at about L2?
cauda equina
83
largest pair of bilateral nerves and innervate the buttocks and lower extremities?
sciatic
84
retractor with proximal hook for wound and distal hook for attachment of weight or sandbag
taylor
85
disease of the spinal nerve roots that results in pain, numbness, tingling or weakness
radiculopathy
86
skull flap can be reattached to the cranium by?
titanium plates and screws
87
mode of electrosurgical energy most used in neuro surgery around delicate tissue?
bipolar
88
uses variable ultrasonic energy to remove tumor tissue
CUSA
89
inability to move the lower part of the body
paraplegia
90
method of 3 dimensional plotting for guidance and biopsy?
sterotaxis
91
mechanism of supplying oxygen to an area of an organ when normal perfusion is interrupted?
collateral flow
92
infection of CNS tissue via direct injury or circulatory transfer?
brain abcess
93
most primitive part of the CNS, responsible for basic life functions
brain stem
94
cannulated instrument designed to provide passage for a catheter
tunneler
95
generation of heat during a chemical reaction
exothermic
96
what are cranial and spinal nerves?
peripheral nervous system
97
functional system of the nervous system are?
voluntary and involuntary
98
2 parts of a neuron?
cell body and axon
99
parasympathetic increases heart rate and is known as fight or flight?
false
100
nervous system depends on?
circulatory system for glucose and O2
101
cranium has how many bone?
8
102
anterior fontanelle closes at?
18 months
103
neuroglial cell create an environment neurons can efficiently perform in?
true
104
skull has 8 cranial bones and 14 facial bones?
true
105
galea of the scalp
connects muscles front to back
106
involuntary nervous system divisions
sympathetic and parasympathetic
107
where does the spinal cord begin and end?
foramen magnum
| level of L1 and L2
108
where does the spinal cord run?
in the vertebral canal and is continuation of brain stem
109
ventral nerve root arises from spinal cord to form spinal nerve and?
brain to body, controls motor function, is anterior
110
there are 3 ventricles in the brain
false
111
all ventricles are filled with CSF and most CSF is formed in the 4th ventricle?
false
112
what does the gray matter of the cerebral cortex contain?
neuron cell bodies
113
what does the gray matter of the cerebral cortex do?
conducts higher mental function like movement and behavior
114
white matter in comparison to gray matter location
white below gray
115
cerebrum divided into 2 hemispheres and connected by nerve fibers that allow communication
corpus callosum
116
fissure are landmarks on the brain. the later fissure?
divides temporal from frontal and parietal lobes
117
hindbrain consists of?
cerebellum, pons, medulla oblongata
118
cerebellum helps control coordination and equilibrium?
true
119
cranial remodeling is not done to treat craniosynostosis
false
120
CSF flows in the?
subarachnoid
121
fissure of roland?
divides frontal from parietal lobe, is an indentation, central fissure
122
circle of willis location
cerebellum
123
main blood supply to brain is anterior, internal carotid art. and posterior, vertebral art.
true
124
brain oxygen
requires 20% more than any other organ
125
dorsal nerve root is posterior and handles sensory stimuli and?
handles stimuli body to brain
126
medulla oblongata
vital to sustaining life, controls RR and HR, impulses located here
127
neural arch is formed by pedicles and lamina and is posterior part of vertebral foramen
true
128
part of brain that relays info between forebrain and hindbrain
cerebral peduncles and midbrain
129
most frequent site of cerebral aneurysm
circle of willis
130
what is the forebrain?
cerebrum
131
cerebrum governs all motor activites and sensory impulses and is the center for?
memory, intelligence and reason
132
gyri of the cerebrum are?
convolutions in the surface
133
greenberg
self retaining cranial retractor
134
scoville malleable brain spoon
cranial retractor to depress or elevate brain tissue
135
craniotome and perforator
create burr holes- stops automatically
136
astrocytoma
malignant cranial tumor that cant be excised
137
most common reasons for neurosurgery?
cancer, trauma
138
what is the most common brain tumor?
glioma
139
what symptoms are associated with acoustic neuroma?
headache, loss of hearing
140
what does acoustic neuroma affect?
8th cranial nerve
141
position for occipital surgery
sitting, prone
142
instrument to create burr holes
midas rex, craniotome
143
done to counteract friction
irrigate with saline
144
used to enlarge holes? what should be done with bone chips?
kerrison
| save bone chips
145
how is bleeding controlled during craniotomy?
bone wax
146
how is the dura separated from the bone flap?
#3 penfield
147
how is the dura lifted free? what is used to protect?
durahook
| cottonoids
148
what is used to provide visualization during craniotomy?
brain spoons
149
ideal temp of irrigation within cranium?
body temp
150
describe CUSA
emits energy that emulsifies abnormal tissue
151
ICP, procedure to place ICP monitor
intracranial pressure
| burr hole or craniectomy
152
causes of hydrocephalus
obstruction
| malformation
153
incision for pituitary tumor
upper gum
154
what is used to remove pituitary tumor? what is used to replace tissue?
ronguer
| fascia from thigh
155
laminectomy
remove lamina, doesn't damage veins when you incise
156
discetomy
removal of a disk between vertebrae
157
spinal fusion, how is it done?
fixation of unstable segment of spine
| done after discectomy rods, screws
158
ACDF
supine, lamina no removed
159
PCDF
prone, 3 pins, mayfield
160
why is thoracotomy approach more popular for thoracic vertebral surgery?
small diameter of thoracic spinal canal
161
rhizotomy and why?
severed nerve roots in spinal cord, relieve back pain
162
procedure to relieve pressure on median nerve
carpal tunnel release
163
purpose of SCD's
prevent DVT and PE
164
why do neurosurgeons drape?
its complex
165
marking incision
marking pencil, back of scalpel
| NEVER METHYENE BLUE-inflammatory
166
purpose of Raney clips
compression, hemostasis
167
bipolar electrosurgery
current is isolated so less is required
168
what can be used to control bleeding when usual forms can't be?
patients own fat
169
hemostatics
thrombin oxycel
170
diuretics
mannitol, lasix
171
antibiotics
vancomycin, bacitracin
172
antinflammatory
dexamethasone
173
lumbar puncture
gain access to CSF
174
angiography
injected into arteries, study vessels of the brain
175
myelography
uses fluoro to see where dye is flowing
176
EEG
brain activity, place electrodes
177
neuron
most important cell
178
cell body
receives input
179
axon
send messages
180
neuron and neuroglial cells
make up neurons system
181
glial cells
support neurons
182
where do spinal nerves emerge from?
spinal cord
183
nervous system functions
sensory, motor, integrative
184
subq tissue
vascular
185
fontanelles
baby's soft spots, present at birth
186
dura mater
outermost
187
arachnoid
middle
188
pia mater
vascular inner membrane
189
subarachnoid space
filled with cerebrospinal fluid
190
how many parts of the brain?
forebrain, midbrain, hindbrain
191
sulci
furrows
192
what is the cerebral cortex known as?
gray matter
193
midbrain location
between the 2 cerebral hemispheres
194
midbrain
visual and auditory sense
195
pons
white matter, relay between the peduncles and medulla
196
medulla oblongata location
between spinal cord and pons
197
CSF
support and cushion brain and spinal cord, filter out waste
| 3x per day
198
what is the spinal cord protected by?
same coverings as the brain
199
what are the cranial nerves responsible for?
sensory and motor
200
position for cranial procedures
sitting or supine
201
position for spinal procedures
supine or prone
202
why is the incision site injected?
to control bleed
203
when is raytec used?
before the skull or spinal cord are opened
204
craniectomy
removing more bone than burr holes does
205
craniotomy
making a flap- will put back on later
206
why is the bone flap left intact on part of the skin?
for blood blood to scalp
207
why must CSF rhinorrhea be corrected?
dura is compromised
208
transsphenoidal hypophysectomy
removing pituitary tumor through nose
209
why doesn't the catheter flow up?
valve, hemorrhage if pumped too much after surgery
210
reasons for shunt replacement
failure, growth not for the valve!!
211
encephalitis
inflammation involves spinal cord and brain
212
myasthenia gravis
weakness of skeletal muscles of the body
213
anterior cervial fusion
relieve pain in neck, no laminectomy required, iliac crest
