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Surgical Procedures 1 > Neurosurgery > Flashcards

Neurosurgery Flashcards

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1
Q

carpal tunnel release: definition (2)

A
  • decompression of median nerve

- achieved by incising transverse carpal ligament

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2
Q

carpal tunnel release: special equipment

A

hand positioning device (lead hand)

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3
Q

what ligament is divided for carpal tunnel release procedure?

A
  • transverse carpal ligament (flexor retinaculum)*

- divided by #15 blade #7 handle

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4
Q

ulnar nerve transposition: definition

A

relocation of ulnar nerve
-relieves symptoms:
ulnar nerve palsy/cubital tunnel syndrome

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5
Q

ulnar nerve transposition: pathophysiology (2)

A
  • ulnar nerve palsy

- cubital tunnel syndrome

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6
Q

ulnar nerve transposition: antibiotic irrigation (2)

A
  • polymyxin

- bacitracin

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7
Q

rhizotomy: definiton

A

surgical interruption of cranial or spinal root nerve to treat intractable pain when less invasive options have failed

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8
Q

rhizotomy: cordotomy

A

surgical division interruption of lateral spinothalmic tracts of spinal cord

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9
Q

rhizotomy: sympathectomy

A

excision of portion of sympathetic division of ANS

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10
Q

rhizotomy: peripheral neurectomy

A

partial or total excision of a peripheral nerve segment

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11
Q

rhizotomy: neurolysis

A

freeing or loosening of nerve from adhesions to restore nerve function or relieve pain

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12
Q

textbook indication for rhizomtomy…

A
  • trigeminal neuralgia*

- aka tic douloureux

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13
Q

magnetic resonance imaging (MRI) are used for..

A

high resolution imaging of soft tissue to detect abnormalities

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14
Q

rhizotomy: positioning (2)

A
  • wilson frame or chest rolls

- jackson table for C-arm access (intra-operative fluoroscopy)

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15
Q

rhizotomy skin preparation: what should be avoided

A
  • methylene blue*

- causes inflammatory reaction in CNS tissue

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16
Q

rhizotomy: vertebral level confirmation is achieved by?

A

placing metal (radiopaque) object suspected level and taking X-ray/fluoroscopy

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17
Q

oh shit neuro suture

A

4-0 silk

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18
Q

rhizotomy: dura mater is incised with

A 
#11 blade
#7 handle
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19
Q

laminectomy: defintion

A
  • means of exposure for other surg. procedures*

- excision of 1 or more laminae to expose spinal canal and adjacent structures

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20
Q

laminectomy: discectomy

A

removal of herniated intervertebral disk

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21
Q

laminectomy: foraminotomy:

A

enlargement of an intervertebral foramen to relieve spinal nerve compression

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22
Q

laminectomy: laminotomy

A

conservative approach to spinal canal w/ limited division of vertebral lamina

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23
Q

lumbar laminectomy: intrathecal pump

A

implantation of medication-delivery device to treat intractable pain or spastic conditions

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24
Q

cervical region of spine

A
  • 7 vertebrae, C1-C7*

- most superior

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25
thoracic region of spine
* 12 vertebrae, T1-T12* | - second most superior
26
lumbar region of spine
* largest/strongest of unfused vertebrae* * 5 vertebrae, L1-5* - third most superior
27
sacral region of spine
* 5 fused vertebrae, S1-S5* | - fourth most superior
28
5 sets of paraspinal ligaments (3)
- anterior/posterior longitudinal - interspinous/suprasinous ligaments - ligmentum flavum (yellow ligament)
29
anatomy of vertebrae
tough outer: annulus fibrosis | soft elastic inner: nucleus pulpous
30
3 membranes of spinal cord deep to superficial
- pia mater (innermost) - arachnoid mater (middle layer) - dura mater (outermost strongest layer forming fluid tight sack from foramen magnum-S2)
31
lumbar laminectomy: pathophysiology
* herniated disk* - protrusion of uncles pulpous - extruded disk fragment compresses adjacent tissue
32
90% of disk herniations occur...
- L4-L5 | - L5-S1
33
lumbar laminectomy: stenosis (3)
* excision of osteophytes relieves symptoms* - impingement of neural tissues by bony structures - bone spurs (osteophytes)
34
CT scan/X-ray study
criterion standard for evaluation of boney abnormalities
35
myelography:
antiquated study administration of radiopaque substance into the subarachnoid space of the spinal column, highlighting impingement of neural tissues
36
lumbar laminectomy: positioning
- prone (wilson frame utilized) - modified knee to chest (andrew hicks table) - lateral (not commonly used)
37
pituitary (forceps) rongeur:
* soft tissue* | * removal of herniated disk fragments*
38
kerrison rongeur:
* small bites of hard tissue* * 2mm, 3mm, 5mm* - removal of bone
39
leksell rongeur:
* removes spinous process* | * large bites of bone*
40
midas rex drill/triton system/stryker TPS
* grinding away lamina* | - bone
41
penciled dissector
* P4* - exploration of foramen - assessment of nerve decompression
42
lumbar laminectomy: nerve hook/woodson elevator
used to assess nerve root decompression
43
lumbar laminectomy: complications (4)
- SSI - hemorrhage - paralysis - blood clots/primary embolism
44
anterior cervical discectomy and fusion (ACDF): defintion
excision of intervertebral disc through anterior approach with stabilization by bone graft
45
anterior cervical discectomy and fusion (ACDF): pathophysiology (3)
- degenerative disc disease - radiculopathy (spinal nerve root compression) - myelopathy (spinal cord compression)
46
anterior cervical discectomy and fusion (ACDF): positioning (2)
- shoulder roll placed to extend neck and accentuate exposure of operative site - PTs head slightly turned away form affected side
47
anterior cervical discectomy and fusion (ACDF): incision
transverse skin incision made over confirmed cervical vertebrae level (cricoid cartilage)
48
anterior cervical discectomy and fusion (ACDF): supplies
* 3 1/2 spinal needle* | - intraoperative vertebral level confirmation
49
anterior cervical discectomy and fusion (ACDF): bone graft harvested with?
hudson brace (burr holes)
50
craniotomy:
temporary removal of section of cranial bone
51
craniectomy:
permanent removal of section of cranial bone
52
burrhole: (2)
- small hole made in cranium w/ cranial spinal perforator | - minimum exposure possible to gain brain access
53
cranioplsaty: definition
surgical repair of skull to correct traumatic injury or congenital malformation
54
ventriculoperitoneal (VP) shunt placement: definition (2)
- placement of catheter to divert flow of excess CSF from brain to body cavity - procedure of choice due to avoidance of vascular/cardiopulmonary complications
55
ventriculoperitoneal (VP) shunt placement: pathophysiology
* hydrocephalus* - increase in volume of CSF increasing ICP - communicating=external - non-communication=internal
56
what is a common indication for pediatric hydrocephalus
sunset sign (eyes)
57
ICP measured through cerebral manometry using...
manometer
58
transphenoidal hypophysectomy: definiton
partial or total excision of pituitary adenoma to treat hyposecretory endocrine disorders
59
is transphenoidal hypophysectomy a sterile procedure?
``` no class 2: clean contaminated ```
60
ventriculoscopy: definition (2)
- examination of ventricles of the brain by lighted neuroendoscope - treats PTs w/ non-communicating (internal) hydrocephalus
61
ventriculoscopy: supplies
3 french fogarty balloon catheter inserted through 2mm working port and inflated widening ventriculoscopy stoma to 5mm
62
circle of willis receives its blood supplies from... (2)
- anteriorly: two internal carotids | - posteriorly: two vertebral arteries
63
scalp clips (4)
* control scalp bleeding* - adson - leroy - michael - raney
64
powered by compressed nitrogen (3)
- craniotome - triton - anspach
65
powered by electricity
stryker drill
66
burr holes are connected by channels cut with...
gigli saw/guide
67
dural incisions are extended with...(4)
- potts smith angulated - metzenbaum - taylor - strully
68
two types of pin fixation devices
- gardner wells | - mayfield
69
retractors
stable operating field: - greenberg - budde halo retractor exposure: -leyla-yasargil
70
sponges used intracranially
-cottonoid patties/balls (soaked in antibiotic solution)
71
absorbable hemostatic agents (4)
- gelfoam - surgicel - oxycel - avitene/helistat
72
most common antibiotic solutions used as irrigants...
- lactated ringers solution | - normal saline
73
dural closure is achieved with...
4-0 silk 4-0 braided nylon 4-0 vicryl
74
what is used to increase micturition causing decrease in blood volume
mannitol
75
neurosurgical instruments are typically/surgeons like to use
bayoneted/microscope
76
aneurysms are isolated with which suture
fine silk
77
fusiform aneurysms are handled by
wrapping entirety with methacrylate impregnated gauze or muslin
78
arteriovenous malformation (AVM)
abnormal communication between arterial and venous systems
79
entire shunt system must be... (2)
- free of lint/glove powered contamination | - soaked in antibiotic/ringers lactate

Surgical Procedures 1 (12 decks)

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