Neurosurgery Flashcards Preview

Senior Rotations > Neurosurgery > Flashcards

Flashcards in Neurosurgery Deck (88)
Loading flashcards...
1

2 structural divisions of nervous system

CNS: brain/spinal cord

PNS: sensory/motor neurons

2

2 functional divisions of nervous system

somatic/voluntary: sensory and motor

autonomic: involuntary, viscera + smooth muscle

3

2 divisions of autonomic nervous system

sympathetic: fight or flight

parasympathetic: calming

4

8 bones of cranium

2 parietal

2 temporal

frontal

occipital

sphenoid

ethmoid

5

foramen magnum

opening in occipital bone where spinal cord passes through

6

3 cranial fossae

anterior: circle of willis

middle: temporal lobes, pituitary, inner + middle ear structures

posterior: occipital lobes, cerebellum, brainstem

7

3 meningeal membranes

dura: superficial, tough, white

arachnoid: middle, thin, avascular

pia: inner, transparent, adhered to surface of cord and brain

8

subarachnoid space

CSF between arachnoid and pia maters

9

principal lobes of cerebrum

frontal

parietal

temporal

occipital

10

3 structures of brainstem

midbrain

pons

medulla oblongata

11

ventricular flow

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

12

where is CSF formed

choroid plexus (ependymal cells)

most in lateral ventricles

13

where is CSF absorbed

arachnoid villi in dural venous sinuses

into venous circulation

14

CSF volume in an adult

80-150ml

15

CSF pressure

10-20mmHg

70-200 mmH2O

16

vertebrae in spinal column

33

17

spinal nerves in column

31

18

what level does spinal cord terminate

L1-L3

19

cauda equina

near vertical continuation of spinal nerves from end of cord

20

5 paraspinal ligaments

anterior + posterior longitudinal

interspinal

supraspinal

ligamentum flavum

21

intervertebral disk

outer annulus fibrosis

inner nucleus pulposis

shock absorber

22

ruptured intervertebral disk

annulus fibrosis ruptures, nucleus pulposis protrudes through

disk fragment compresses nerves

23

how does a ruptured disk produce symptoms

nerve compression

24

1-6 cranial nerves

1 olfactory

2 optic

3 oculomotor

4 trochlear

5 trigeminal

6 abducens

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