FINALS NEUROSURGERY

Overview of neurosurgery

Focuses on the surgical treatment of the brain, spinal cord, and peripheral nerves

Special considerations for neurosurgery

• precise positioning (e.g., mayfield headrest for cranial stability)

• Microsurgical instruments

• Multiple setup tables ( especially in skull base and pituitary procedures)

• Delicate handling of neural tissues and structures

What are the 12 cranial nerves and there functions

What is the cerebrum

Largest brain structure; responsible for thinking, memory, and voluntary movement

What is the occipital lobe

Houses the visual cortex

What is the medulla oblongata

Lowest part of the brainstem, continuous with the spinal cord

What are fissures

Deep grooves in the cerebrum that separate loves

What is the subarachnoid space

The area where cerebrospinal fluid (CSF) circulates

What is pia mater

The innermost meningeal layer in intimate contact with the brain

How many total vertebrae are there

33

How many cervical vertebrae are there

7

How many thoracic vertebrae are there

12

How many lumbar vertebrae are there

5

How many sacrum vertebrae are there

5 fused

How many coccyx vertebrae are there

1, 4 fused

What is spinous process

Bony projection from the vertebra, often palpable

What are osteophytes

Bone spurs, often seen in degenerative disc disease

What are penfield #1-5 used for

Dissectors used for brain and nerve tissue

What are Cottonoids/patties used for

Countable neurosurgical sponges used to protect neural tissue

what are kerrison rongeur used for

Used to remove lamina in spinal procedures

What are pituitary rongeurs used for

Removes disc material during discectomy

What is a craniotome with dural guard used for

Used to connect burr holes while protecting dura during craniotomy

What is a mayfield headrest used for

Pin fixation system for cranial stabilization

What is a Wilson frame used for

Used for prone positioning during lumbar laminectomy

What is a craniotomy

• involves removal of part of the skull

• Skull flap is reattached using titanium plates/screws or stainless steel wire

• Always protect underlying tissue with dural guard attachments when using powered tools

What is a transsphenoidal hypophysectomy

• removes pituitary tumors via the sphenoid sinus

• Often involves three setups: nasal access, tumor resection, and graft placement

What is a ventriculoperitoneal (V-P) shunt

• treats hydrocephalus by draining excess CSF from the brain to the peritoneal cavity

What is an epidural hematoma

• a life threatening condition from trauma causing blood to collect between skull and dura

• May require emergency craniotomy

What is a craniosynostosis

• a congenital condition involving premature closure of cranial sutures

• Requires surgical intervention to allow normal brain growth

What is a discectomy and fusion

• common for herniated discs, especially cervical

• Anterior cervical approach retracts the trachea, esophagus, and carotid artery to access the disc space

• Often followed by intervertebral fusion using bone grafts or cages

What is carpal tunnel release

• treats compression of the median nerve under the transverse carpal ligament

What is the atlas (c1)

First cervical vertebra; supports the skull

What is the coccyx

Tailbone; lowest portion of spinal column

What is the sacrum

Five fused vertebrae in the pelvis

What is the subarachnoid space

Where CSF flows around brain and spinal cord

What device is used to stabilize the skull during a craniotomy

Mayfield headrest

How many cranial nerves are there, and what is there function

12, control senses/ motor functions

Name the largest part of the human brain

Cerebrum

Which menigeal layer is in closest contact with the brain

Pia mater

What is the function of cottonwood patties in neurosurgery

To protect neural tissue

What is the anatomical term for a deep groove that separates brain lobes

Fissure

What procedure uses the sphenoid sinus to access a pituitary tumor

Transhpenoidal hypophyscectomy

What is the name of the frame used to position patients for lumbar laminectomy

Wilson frame

What type of surgical approach is used for cervical disc herniation

Discectomy and fusion

What is a common result of blunt trauma to the skull

Epidural hematoma

How is the skull flap typically reattached after a craniotomy

Titanium plates/ screws, stainless steel wire

What congenital defect involves early closure of cranial sutures

Craniosynostosis

What vertebra is also known as the atlas

C1

What condition is treated by releasing the transverse carpal ligament

Carpal tunnel/ compression of median nerve

Which brainstem structure connects directly to the spinal cord

Medulla oblongata

What is the function of the pituitary gland, and why might it be removed

Regulates body functions, might be removed if tumor is present

What is a bony spur on the spine called

Osteophytes

Which instrument removes bone in spinal procedures

Kerrison rongeurs

Where is the distal catheter placed in a V-P shunt

Peritoneal cavity

Which vertebral section contains five fused bones and supports the pelvis

Sacrum

What are the three meningeal layers from outermost to innermost?

• Dura

• Arachnoid

• Pia

What procedure place a catheter to drain CSF into the peritoneal cavity

Ventriculoperitoneal shunt (VP shunt)

What instrument is used to remove bone during a laminectomy?

kerrison rongeur

What is the function of Penfield dissectors

Delicate tissue separation

What spinal frame is often used for positioning in laminectomy

Wilson frame

What type of hematoma often results from a skull fracture?

Epidural hematoma

What is a Mayfield headrest/fixation Device for

holds Skull steady for a craniotomy

What is a kerrison rongeur for

Removes laminas/bone during laminectomy

What is a leksell rongeur for

Larger bone Removal

What is a Penfield Dissectors 1-5 for

Used for delicate tissue separation

What are raney clips for?

Control scalp bleeding during craniotomy

What are Cottonoid’s/patties for?

protect neural tissue, absorb irrigation

What is a craniotomy?

Opening school for tumor removal, aneurysm, repair, or trauma

What is a ventriculoperitoneal shunt? (VP shunt)

Divert CSF from ventricles to peritoneal cavity

What is a carotid endarterectomy?

Often performed with neurosurgical involvement

What is a laminectomy?

Removal of vertebral lamina to decompress spinal cord/nerve roots

What is a discectomy

Removal of herniated intervertebral disc

What is a spinal fusion?

Stabilization of spine with grafts, rods, or screws

what is a microdiscectomy?

Minimally invasive discectomy using microscope

what is a transphenoidal hypophysectomy?

Removal of pituitary tumor via nasal/sphenoid approach

What is an aneurysm clipping?

Microsurgical clipping of cerebral aneurysm

What is evacuation of hematoma?

Subdural or epidural clot removal

What is the CSF Flow

Produced in ventricles→ Circulates around brain/spine→ Reabsorbed by arachnoid villi

What is spinal stenosis?

Narrowing of spinal canal compresses cord/nerve roots

What is the central nervous system

• composed of the brain and spinal cord

• Acts as the command center that interprets sensory information and issues instructions

What is the peripheral nervous system

• includes nerves and ganglia outside the CNS

• Divides into:

  • somatic nervous system (SNS): controls voluntary movement

  • Autonomic (ANS): regulates involuntary activities

  • Sympathetic division: activates “flight/flight”

  • Parasympathetic division: supports “rest/digest” activities like digestion and elimination

Explain how a nerve impulse is transmitted across a synapse, including the role of neurotransmitters

When the nerve reaches the axon, it triggers the release of neurotransmitters (chemical messengers) across the synapse

Indemnify the 3 layers of the meninges and describe their individual functions in protecting the central nervous system

1. Dura mater (outermost):

2. Arachnoid mater (middle):

3. Pia mater (innermost):

What are the major functions of the cerebrum and how are the different lobes specialized

• largest Brian region, divided into 2 hemispheres with outer folds called gyri, and inner folds called sulci

• Lobes:

  • frontal: Reasoning, planning, movement

  • parietal: sensory perception

  • Temporal: hearing and memory

  • Occipital: vision

what is the significance of cerebrospinal fluid and where is it found

• cushions the CNS and removes waste

• Found in the subarachnoid space, ventricles, and central canal

Describe the structure of a typical neuron and explain how its part contribute to nerve signaling

• structures: cell body, dendrites (receive signals) and axons (sends signals)

• Specialized cells that carry electrochemical signals

List the 12 cranial nerves and a brief description of their functions

1. Olfactory: controls smell

2. Optic: controls vision

3. Oculomotor: adjust/ coordinate eye position during movement

4. Trochlear: controls eye movement to look up or down

5. Trigeminal: controls chewing movement

6. Abducens: controls eye movement (side to side)

7. Facial: controls facial muscles

8. vestibularcochlear: equilibrium and hearing

9. Glossopharyngeal: controls swallowing/ senses taste

10. Vagus: regulation of internal organ functions

11. Accessory: controls swallowing/ nerve

12. Hypoglossal- controls tongue movement/ swallowing muscles

How do the sensory organs of the ear contribute to both hearing and balance?

• external ear: collects sound

• Middle ear: contains auditory ossicles (tiny bones

• Inner ear: processes sound + maintains balance

What is the role of the iris in vision, and how does it respond to changes in lighting

It regulates the pupil size to control light entry

Describe the structure of the retina and the function of the photoreceptor cells found there

Retina is the innermost layer containing photo receptor cells

• rods: function in low light, detect black and white

• Cones: detects color, needs bright light

what is vitreous humor

A jelly like fluid that maintains eye shape, located between eye lens and retina

What is aqueous humor

A clear fluid in the front part of the eye. Keeps eye inflated and provides nourishment

How does a cerebrovascular accident (stroke) impair nervous system function, and what are some potential causes

• sudden weakness, facial droop, slurred speech, loss of balance

• Possible causes: interruption of blood flow to the brain due to a clot (ischemic) or a burst vessel (hemorrhagic stroke)

How do the lacrimal glands protect and maintain the health of the eye

Produce tears to lubricate/ clean the eye

Functions of the nervous system

• primary communication/ control network

• Collects sensory input

• Processes information

• Initiates responses to maintain homeostasis

What do neurolgia (glial cells) do

Supportive cells that protect and nourish neurons

What is a nerve

A bundle of axons (fibers) located outside the CNS

What is a tract

A similar bundle to a nerve, located within the CNS

What is the brainstem

Connects brain th spinal cord, regulates vital functions

What are the functions of the brainstem

• serves as a passage way for nerve tracts traveling between the brain and spinal cord

• Contains nuclei that control basic life sustaining processes

• Houses the origin of several cranial nerves responsible for motor and sensory functions of the head and neck