Chapter 24 Neurosurgery completed 2022

Typically found at the bifurcation of the circle of Willis: Aneurysm Through the sella turcica for pituitary tumor removal: Transsphenoidal Premature closure of the cranial structures of an infant: Craniostenosis Abnormal accumulation of CSF in the subarachnoid space due to obstruction, congenital malformation, or excessive formation: Hydrocephalus Layer of tissue covering periosteum of cranial bones: Galea aponeurotica Congenital defect with abnormal communication between arteries and veins: AVM Layer containing cerebrospinal fluid: Subanrachnoid space Tumor of the meninges? Meningioma Protrusion of the nucleus p pulposus: Herniated disc Occurs when veins in the cerebral cortex or bridging the cerebral cortex are torn: Subdural hematoma Tumor of the eighth cranial nerve: Acoustic neuroma Results from torn vessels in the Dura matter: Epidural hematoma Formation of osteophytes, causing compression within the spinal canal: Spondylosis Malignant cranial tumor that usually cannot be excised, grated between one and four: Astrocytoma Inflammation and infection of the three layers surrounding the brain and spinal cord: Meningitis What are The most common reasons for neurosurgery? Compression of cranial nerves, destruction of brain tissue, irritation of cerebral cortex, increased intracranial pressure What is the most common type of brain tumor? Glioma What is the Mayfield pin fixational device used to accomplish? Complete immobilization of the head for cranial procedures Access to the occipital lobe of the brain may be accomplished with the patient in either of two positions. Name the two possible positions. Sitting position, prone What can be used to create the burr holes for the Craniotomy or provide relief for for intracranial pressure if you are doing a craniotomy how is the bone flap created? Hudson brace with attachments What is done to counteract friction, remove bone dust, and eliminate heat during the process of drilling bone? Irrigate drill bit with saline When enlarging the holes drilled or removing bone what is used to accomplish the process? What should the ST do as the pieces are removed? Double-action rongeur or Kerrison rongeur. How is bleeding controlled during the craniotomy? Bone wax and neurosurgical sponge What is done with the bone flap during the craniotomy procedure? Place in the basin on back table to soak in Betadine solution or normal saline and antibiotic How is the dura separated from the craniotomy? #3 Penfield dissector What is used for hemostasis during the procedure? warm saline irrigation, Surgicel, thrombin-impregnated Gelfoam, and bipolar cautery How is the dura lifted free from the brain tissue? This is achieved with 4-0 braided nylon or dural hook What is used to protect brain tissue during the procedure? Cottonoid patties are placed under the dura with bayonet forceps What is used to retract or provide visualization during the procedure? 4-0 dural traction sutures are placed along the dural edges and tagged with mosquito hemostats for retraction Describe how the bone flap is closed: Airtight fashion with a running 4-0 braided nylon or silk suture, secured to cranium with titanium plates and screws What is the ideal temperature for irrigation fluid that will be used withing the cranium? Body temperature saline and antibiotic What is the master gland of the body? Hypophysis (pituitary gland) What are the two sections of the pituitary gland? adenohypophysis & neurohypophysis Which gland controls gland based functions? adenohypophysis Which gland is responsible for nerve functions? neurohypophysis Where does the pituitary gland sit? sella turcica of the sphenoid bone What surgery is done to treat tumors in the pituitary gland? Transsphenoidal hyposhysectomy What is the C.U.S.A. (what does it stand for)? Cavitron Ultrasonic Aspirator Describe the mechanism of the CUSA: Emits a variable ultrasonic energy field that emulsifies abnormal tissue while preserving normal neural tissue. Saline ejected from the tip of the handheld unit liquefies the tissue, which is then aspirated back to the unit. What is ICP? intracranial pressure What procedure is completed to place an ICP monitor? Intracranial pressure burr hole What is the most common approach for a pituitary tumor? transsphenoidal approach Where can the incision be made for a transsphenoidal approach? at the upper gum margin just under the upper lip What is a laminectomy? Surgical removal of the bony arches of one or more vertebrae, performed to relieve compression of the spinal cord What is used to remove the pituitary tumor? pituitary curette, dissector, enucleator, and suction What are the tissue layers involved in neurosurgery? Skin, SubQ, fascia/muscle, periosteum, bone, dura mater, arachnoid mater, subarachnoid space, and pia mater What are the 3 layers of the meninges? dura mater, arachnoid mater, pia mater What part of the meninges is cerebral spinal fluid found in? subarachnoid space What is the function of the myelin sheath? to protect the neuron, provide insulation, and increase the speed of impulse transmission There are two types of myelin sheath, one is found in the peripheral nervous system and the other is found in the central nervous system. What is the name of the one found in the central nervous system? Schwan What special function does the subarachnoid space have? stores the cerebral spinal fluid What is the function of cerebral spinal fluid found in the meninges? Aids and nourishes the meninges and helps cool the brain What are the divisions of the nervous system? Central nervous system and peripheral nervous system What is contained within the CNS? brain and spinal cord What is the largest part of the brain? cerebrum What part of the brain controls higher function? frontal lobe What part of the brain controls memory? temporal lobe What part of the brain controls hearing, memory, and speech? temporal lobe What part of the brain is responsible for somatic function (receives sensory input for touch and body position) parietal lobe What part of the brain is responsible for vision perception (processes visual information)? occipital lobe Folds that allow more surface space in the brain are called: gyri A shallow depression or deep grooves in the brain are called: sulci Canals in the brain that contain cerebrospinal fluid are called: Ventricles What is the second largest part of the brain? cerebellum What is the function of the cerebellum? Balance and coordination Epithalamus Contains pineal gland and is involved in olfactory senses and sleep/wake cycle Hypothalamus a neural structure lying below the thalamus; directs eating, drinking, body temperature; helps govern the endocrine system via the pituitary gland, and is linked to emotion Pons function Assists medulla in regulating autonomic functions like breathing medulla oblongata the posterior part of the brain that controls the cardiac rhythm, blood pressure and vasomotor control system Which area of the brain is responsible for motor speech (speech production)? broca's area Which area of the brain controls auditory comprehension? Wernicke's area Circle of Willis A circle of arteries at the base of the brain that supply blood to the brain Lateral sulcas pre-motor cortex that allows us to control our body The opening of the occipital bone through which the spinal cord passes through is called what? Foramen magnum What is a disectomy? Removal of a disk