Neurosurgery Self Study packet, part I

The largest division of the brain is

the cerebrum

The cerebrum controls

muscular contraction

Functions of CSF include (three)

shock absorption, fills ventricles, provides some nutrients for CNS

The medulla oblongata

a) contains the centers which control the heart, respirations, and blood pressure

b) is the lowest part of the brain

c) is the area where nerve fibers pass from one side of the brain to the other

d) all of the above

d) all of the above: contains the centers which control the heart, respirations, and blood pressure; is the lowest part of the brain; and is the area where nerve fibers pass from one side of the brain to the other

The spinal cord is covered with

meninges

The spinal cord is

the conduction pathway to and from the higher centers in the brain

Name the three layers of the meninges.

Dura mater, arachnoid, pia mater

The foramen magnum of the skull refers to the opening in the skull where

the brainstem passes through to the spinal cord

How many vertebrae are in the adult spine?

33

Extra equipment needed for a craniotomy includes

a craniotome and electric drill

A myelogram would be described as

x-rays of dye injected through a spinal puncture to outline the cord

Name some hemostatic substances used during neurosurgery.

Bone wax, gelfoam, topical thrombin, scalp clips, epinephrine

When positioning the neurosurgical patient, it is important to remember (three)

to protect the eyes, to pad pressure areas, and to allow room for adequate respiratory expansion (prone position)

Pre-anesthesia medications are given to neurosurgical patients to

depress secretions and increase the stability of the heart

Anesthesia for neurosurgery is generally dependent on

the positioning of the patient and type of procedure

Diagnostic procedures done for a patient with a suspected herniated disc may include (three)

A-P and lateral spine x-rays, myelogram, discogram

Diagnostic procedures done for a patient with a suspected brain tumor may include (three)

pneumoencephalogram, visual field examination, MRI scan

Brain scans are done to diagnose (three)

cerebral thrombosis, subdural hematoma, or tumor

Fractures of the skull require surgical treatment if

they are compound or depressed

Indications for a cranioplasty include (three)

cosmetic effect, fear of injury, local discomfort

Intracranial hemorrhage may be due to

a ruptured aneurysm or injury

An intracranial hemorrhage may be

epidural or subdural

Treatment of intracranial hemorrhage may include

immediate craniotomy, or burr holes for evacuation of clot with possible craniotomy

The location of the incision and bone flap for a craniotomy is (three)

usually within the hairline, dependent on the location of the pathology, will determine the patient’s position

Examples of types of brain tumors

neuroma, astrocytoma, glioblastoma (GBM), chordoma, CNS lymphoma, glioma, medulloblastoma, meningioma, metastatic brain tumors, pituitary tumors, cystic, abscesses

Atherosclerosis, aneurysms, and cerebral embolisms are all

vascular disorders of the brain that are treatable by surgery

A sympathectomy may be done to treat

vascular disorders

Special equipment generally used during a sympathectomy includes

silver clips, McKensie clips, or hemoclips

The most common donor site of bone for a spinal fusion is the

iliac crest

During a spinal fusion, the bone graft is

impacted in with a bone tamp

The surgical procedure done to relieve carpal tunnel syndrome is called

median nerve decompression

Clips used on an aneurysm of the Circle of Willis include

olivercrona clips (“oliver clips”)

Vomiting, drowsiness, and headache are all symptoms of

increased ICP

The respiratory center of the brain is located in the

medulla oblongata

Which portion of the brain controls the ability to make precise movements?

The cerebellum

What are the “vital centers” that the medulla oblongata controls?

Cardiac, vasomotor, and respiratory

A collection of excessive CSF in the cranium increasing the size of the head causes what condition?

Hydrocephalus

The cranial nerve responsible for slowing of the heartbeat is the

vagus nerve

Repair of an intervertebral disc, treatment of a vertebral compression fracture, and repair of an encephalocele are all reasons for doing what procedure?

A laminectomy

Another name for the “soft spots” in an infant’s skull is

fontanels

The sella turcica cavity is the structure that protects which gland?

The pituitary gland

The structural unit of the nervous system is

the neuron

The function of the lining of the ventricles (choroid plexus) is to

manufacture CSF

The unit of the autonomic system that increases activity during periods of stress is known as the

sympathetic nervous system

Pneumoencephalography and a ventriculogram are two diagnostic procedures that may require

burr holes

What is the position for a carotid angiogram?

Supine with bilateral shoulders elevated, and head turned to nonoperative side

Equilibrium is regulated from the

cerebellum (specifically the flocculonodular lobe)

Which cranial nerve is involved in correcting the condition of tic douloureux?

The trigeminal nerve, or cranial nerve V

Hemorrhage control in neurosurgery is accomplished by

cautery, gelfoam, topical thrombin, bone wax, epinephrine

The special clips used for hemorrhage control near the skin area in craniotomy incisions are called

Rainey clips, or scalp clips

Dense, fibrous tissue which is the outer layer covering the brain is the

dura mater

The hypothalamus regulates

temperature

The coverings of the brain which also extend over the spinal cord are the

meninges

The master gland located in the cerebrum is the

pituitary gland

The artery that supplies blood for the scalp is called the

external carotid

Where is CSF located?

The ventricles and subarachnoid space

The layer of the meninges which directly covers the brain is called the

pia mater

What is the function of the pons?

To be a conduction pathway between the cerebral cortex and the cerebellum

The Circle of Willis is located in the brain and is a communication between which two arteries?

The internal carotid artery and the vertebral artery

The removal of one or more vertebral laminae to expose the spinal cord or intervertebral disc is called a

laminectomy

A neurosurgical procedure performed specifically to treat intractable pain is called a

rhizotomy

A congenital malformation where there is incomplete fusion of the archaea of one or more vertebrae with herniation of the cord structures is

spina bifida

A meningocele is the herniation of

the meninges due to failure of the vertebrae to fuse

The name of the surgical procedure which is sometimes done to treat hypertension or vascular disturbances of the extremities is called a

sympathectomy

A herniated intervertebral disc is a condition of the spine in which

the cushion between the vertebrae breaks down and moves into a place it isn’t supposed to be (usually up against a spinal nerve)

The functioning unit of the nervous system is the

neuron

The parasympathetic and sympathetic nervous systems are concerned with control of

autonomic functions

The respiratory center is found in the

medulla oblongata

The structure which conducts impulses away from a nerve cell body is called the

axon

Many vital reflexes have their center in the

medulla oblongata

The part of the brain that serves as a reflex center for muscle coordination and equilibrium is the

cerebellum

CSF is produced from materials supplied by the

circulatory system

Messages of touch or smell are carried to the brain by the nerves classified as

sensory nerves

The function of CSF that would be described as protective is the one that provides for

cushioning of the brain and spinal cord against injury

When a lumbar puncture is performed for the purpose of obtaining a specimen of spinal fluid, the neede is usually inserted between L3 and L4 because

the spinal cord ends above the second lumbar vertebrae

An important function of the myelin sheath is to

provide insulation and speed up impulse conduction

The CNS is made up of the

brain and spinal cord

The point of contact between the axon of a neuron and the dendrites of another neuron is called a

synapse

Efferent nerves are those which carry impulses

from the CNS to muscles and glands

The cerebrum is the

largest part of the brain

A function of the hypothalamus is to control (four)

body temperature, sleep, some emotions, and both divisions of the autonomic nervous system

Thinking and making decisions are done in the part of the brain called the

cerebrum

The end of a nerve cell that receives messages is called the

dendrite

Afferent nerves transmit messages

toward the CNS

Efferent refers to what kind of neuron?

A motor neuron

The meninges are

three layers of tissue which cover the brain and spinal cord

Which division of the nervous system is composed of the spinal and cranial nerves?

The peripheral nervous system

Efferent nerves are those which

transmit messages from the CNS

How many dermatomes do the spinal nerves supply each?

Each spinal nerve supplies one dermatome

The pons is

part of the conduction pathway between the spinal cord and the brain

One function of the spinal cord is to

conduct impulses from various nerves to the brain

The CSF fills a space between the middle and inner membranes of the spinal column known as the

subarachnoid space

The function of the neurilemma is

regeneration

The substance which gives the nerve fibers their white, shining appearance and acts as insulation is the

myelin sheath

The division of the autonomic nervous system which regulates the body when it’s under stress and prepares it for “fight or flight” is the

sympathetic nervous system

The basic physiological unit of the nervous system is composed of

a cell body, an axon, and several dendrites

What is the function of an axon?

To conduct impulses away from the cell body

A ganglion may be defined as a

group of nerve cells outside the brain and spinal cord

Neuroglia is

connective tissue of the nervous system

The membrane which lies proximal to the cranium is the

dura mater