Anatomy
The brain is divided into three main sections - what are they?
a. Cerebrum
b. Cerebellum
c. Brainstem
Raney Scalp clips – the scalp is highly vascular for hemostasis of the wound edges raney scalp clips are applied over the full thickness of the flap.
List the instruments associated with neurosurgery.
Assorted bone rongeurs (Kerrison, Leksell)
Assorted pituitary rongeurs
Penfield dissectors
Self-retaining retractors (e.g., Weitlaner, Janson, Adson-Beckman, Gelpi, Cloward, Scoville)
Cranial self-retaining retractor systems
Handheld retractors (e.g., Meyerding, Taylor, )
Toothed and untoothed forceps (e.g., bayonet, Cushing, Adson, Gerald, dural)
Periosteal elevators (Cobb)
Osteotomes and gouges
Dural hooks, nerve hooks
Scalp clip appliers or clip applier gun
Bone curettes (straight and angled)
Bipolar forceps
Frazier suction tips (assorted sizes)
Microsurgical instruments as requested
Hall perforator drill
Midax Rex drill and guards
What cranial nerve conveys impulses for sight?
I (olfactory) II (Optics) III (Oculomotor) IV (Trochlear) V (Trigeminal) VI (Abducens) VII (Facial) VIII (Vestibulocochlear) IX (Glossopharyngeal) X (Vagus) XI (Accessory) XII (Hypoglossal)
II (Optic)
What is the outer tissue of the cerebrum?
Cerebral cortex
What are the three protective layers of membranes, known as the meninges, that protect the brain and spinal cord?
a. Dura mater
b. Arachnoid mater
c. Subarachnoid space
If it is necessary for a patient's hair to be removed for a cranial procedure, what is the protocol?
The patient’s hair may be saved and returned to the patient as personal property.
List two types of head stabilizers for cranial surgery.
Mayfield headrest
Gardner Wells Tongs
What cranial nerve controls sense of smell?
I (olfactory) II (Optics) III (Oculomotor) IV (Trochlear) V (Trigeminal) VI (Abducens) VII (Facial) VIII (Vestibulocochlear) IX (Glossopharyngeal) X (Vagus) XI (Accessory) XII (Hypoglossal)
I (Olfactory)
What covers and protects the brain?
Skull
What are the lobes of the cerebrum?
a. Frontal lobe
b. Temporal lobe
c. Parietal lobe
d. Occipital lobe
Why would your patient undergo a rhizotomy?
Rhizotomy is performed to relieve pain originating in the facet joints. Degenerative disease and bone spurs, which impinge on the nerves, may develop in the joints. During the procedure the nerves are detached on both sides by bipolar ESU.
List two types of operating room tables used for neurosurgery.
Andrews table
Jackson spinal table
What cranial nerve controls the muscle of the tongue?
I (olfactory) II (Optics) III (Oculomotor) IV (Trochlear) V (Trigeminal) VI (Abducens) VII (Facial) VIII (Vestibulocochlear) IX (Glossopharyngeal) X (Vagus) XI (Accessory) XII (Hypoglossal)
XII (Hypoglossal)
Gyri
a. Frontal lobe – responsible for thought and behavior
b. Temporal lobe – controls memory, the senses, language and emotions
c. Parietal lobe – primarily controls language
d. Occipital lobe – controls vision
What is a disc herniation and what procedure is done to fix it?
Discectomy is used to treat a herniation of the intervertebral disc. Disc herniation refers to a tear in the outer ring (annulus fibrosis) that allows the softer middle portion of the disc (nucleus pulposus) to bulge out.Disc herniation occurs most frequently between the fourth and fifth lumbar vertebrae or between the fifth lumbar vertebra and the sacrum. Disc herniation may be the result of degenerative disc disease, general wear and tear or of a traumatic event, such as lifting while bent at the waist.
List a frame used for posterior lumbar laminectomy.
Wilson frame
What cranial nerve controls hearing and equilibrium?
I (olfactory) II (Optics) III (Oculomotor) IV (Trochlear) V (Trigeminal) VI (Abducens) VII (Facial) VIII (Vestibulocochlear) IX (Glossopharyngeal) X (Vagus) XI (Accessory) XII (Hypoglossal)
VIII (Vestibulocochlear)
What area of the brainstem is responsible for vital functions of the circulatory system, respiration and heart rate?
Medulla
List the vertebrae and how many are in each section?
a. 7 cervical
b. 12 thoracic
c. 5 lumbar
d. 5 sacral (fused together as one)
e. 1 coccygeal (containing one to three fused together)
What are common diagnostic procedures that might be erformed during the perioperative phase?
Computed tomography (CT)
Magnetic resonance imaging (MRI)
Functional MRI (fMRI)
Stereotactic magnetic resonance imaging
Magnetic resonance angiography
Angiography (arteriography)
Three-dimensional CT angiography
Digital subtraction angiography (DSA)
Myelography
Discography
Ultrasound
Electroencephalogram
Electromyography
What is the name of a cerebral aneurysm clip?
Yasargil
What cranial nerve controls sensations of the face, forehead, mouth, nose, and top of the head?
I (olfactory) II (Optics) III (Oculomotor) IV (Trochlear) V (Trigeminal) VI (Abducens) VII (Facial) VIII (Vestibulocochlear) IX (Glossopharyngeal) X (Vagus) XI (Accessory) XII (Hypoglossal)
V (Trigeminal)
What is the continuous connection between the spinal cord and the pons?
Medulla oblongata