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Anatomy
Procedure
Equipment
Cranial Nerves
Brainsss
100

The brain is divided into three main sections - what are they?

a. Cerebrum

b. Cerebellum

c. Brainstem

100
Hemostasis of the wound edge of an incision into the scalp for a craniotomy is achieved and maintained with the use of what?

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.

100

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

100

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)

100

What is the outer tissue of the cerebrum?

Cerebral cortex

200

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

200

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.

200

List two types of head stabilizers for cranial surgery.

  • Mayfield headrest

  • Gardner Wells Tongs

200

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)

200

What covers and protects the brain?

Skull

300

What are the lobes of the cerebrum?

    a.    Frontal lobe

    b.    Temporal lobe 

    c.    Parietal lobe

    d.    Occipital lobe

300

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.

300

List two types of operating room tables used for neurosurgery.

  • Andrews table

  • Jackson spinal table

300

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)

300
What are small bulges that occur throughout the surface of the cerebrum?

Gyri

400
What is each lobe responsible for controlling?

    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

400

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.

400

List a frame used for posterior lumbar laminectomy.

Wilson frame

400

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)

400

What area of the brainstem is responsible for vital functions of the circulatory system, respiration and heart rate?

Medulla

500

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)

500

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

500

What is the name of a cerebral aneurysm clip?

Yasargil

500

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)

500

What is the continuous connection between the spinal cord and the pons?

Medulla oblongata