Chapter 24 Neuro
What is the Circle of Willis
A complex vascular network. most common site for aneurysms
Where is the Circle of Willis Located
located at the base of the brain and formed by the following interconnected arteries: internal carotid, anterior cerebral, posterior cerebral, basilar, anterior communicating, and posterior communicating Arterial Bifurcation is here
Smell (Nose) Nerve Number 1
Vision (Eyes) Nerve #2
Movement of Eyeball (Eyebrows) Nerve Number 3
Movement of Eyeball (Right below the nose) Nerve Number 4
Opthlamic, Mandibular, and Maxillary Sensation and Chewing Nerve Number 5
Movement of the Eyeball (Cheeks) Nerve Number 6
Sides of the face....Facial Expression, tears, and saliva secretion Nerve # 7
Ears Hearing and balance nerve #8
Saliva (Back of the tongue) Nerve #9
Secretion of Digestive Fluids (Middle of the tongue) Nerve # 10
Swallowing and head movements (Sides of the Jaw) Nerve number 11
Tongue Movement during speech and swallowing ( Tip of the Tongue) Nerve # 12
Three tissue membranes (called dura mater, arachnoid, pia mater) that enclose the brain and spinal cord
The outermost layer is composed of tough fibrous connective tissue.
The middle layer which is a serous membrane.
Tumors that are benign
craniopharyngiomas, epidermoids, dermoids, hemangiomas, meningiomas, acoustic neuromas, and pituitary microadenomas.
The layer closest to the brain it contains blood vessels and nerves to provide nourishment to the neural tissue underneath.
te space created between the arachnoid mater and the pia mater an area that contains cerebral spinal fluid. Most common space for Hematomas and Hemorrhage
Sphenoid (In between the eyes)
Maxillary (Under the Eyes)
How Many Vertebrae In the Adult
Different Sections of the Human Spine
Cervical (C1-C7) C1 is Atlas and C2 is Axis
Sacral (S1-S5) Fuse to one in Adults
CSF is formed in what location
produced by specialized capillaries called choroid plexuses. The choroid plexuses are located in the lateral ventricles and the third and fourth ventricles. However, the choroid plexuses located in the lateral ventricles produce the largest amount
Most Distal Portion of the Spinal Nerves are called
Sacral Nerves or the Coccygeal nerve
Largest Portion of the Human Brain
The cerebrum . Its surface is covered with convolutions (gyri) that are separated by shallow depressions (sulci) and deep grooves (fissures) into specific lobes, each with complex functions and named for the cranial bone that covers it
Smallest Portion of the Brain
The cerebellum is located posterior to the medulla oblongata and inferior to the cerebrum’s occipital lobe. The structure of the cerebellum is similar to that of the cerebrum.
is a premature closure of the cranial sutures of an infant. These sutures should remain open up to the age of 2 to allow for brain expansion. If the sutures fuse too early, the brain may be damaged because of insufficient space for growth.
- Childhood hydrocephalus may be a result of meningitis, tumors, hemorrhage, or aqueductal stenosis. Hydrocephalus in adults may be caused by obstructive tumors, meningitis, or hemorrhage.
- Infants with hydrocephalus have an enlarged head circumference and present with enlarged and distended scalp veins. Increased intracranial pressure may cause optic atrophy.
Arteriovenous malformations (AVMs)
are congenital defects causing abnormal communication between arteries and veins that divert blood from surrounding brain tissue. The surgery involves microsurgical resection of the malformation. Many AVMs have associated aneurysms, increasing the danger of hemorrhage. High-resolution MRI confirms the existence of an AVM, but selective cerebral angiography is usually necessary to identify details of the lesion.
Process of Reaction creating Heat
requires surgical drainage to relieve pressure if the abscess is not treated in its early stages. arises from any of several causative factors, among them secondary infection from a primary infection such as bacterial endocarditis, direct contamination of the brain from a penetrating wound, and bone fragments or debris from traumatic injury.
These systems can precisely deliver an instrument to a target at any point within a defined space. The target space is defined by CT or MRI scanning with reference points attached to the head. Various monitoring devices and amplifiers are used in conjunction with these systems.
is a surgical procedure to sever nerve roots in the spinal cord.is also performed on patients with spasticity that is insufficiently responsive to oral medications or injectable therapies. It is most commonly performed for those patients with lower extremity spasticity that interferes with walking. It is most commonly performed on children with cerebral palsy.
astrocytomas or gliomas, usually cannot be totally excised, but as much tumor as possible is removed.
All intracranial neoplasms
Symptoms:Headache, nausea and vomiting, personality changes, increased intracranial pressure
Tests: CT scan, MRI
40% of primary braintumors—majority are malignant
Test: Ct Scan, MRI
Most Common Bed Frame Used
Wilson Bed Frame
Most common form of X-ray used during surgery
What type of Local Anesteitc is Given and Why during and Aneurysm Procedure
Papervine to prevent spasms
the hole in the base of the skull through which the spinal cord passes.
An abnormal bony growth
Laminectomy for diskectomy
s a common surgical procedure for the decompression of a nerve root that has been impinged by an extruded fragment of disk material in the cervical, thoracic, or lumbar region of the spine. Due to its weight-bearing configuration, the lower lumbar region is affected the most often. Surgical treatment is often necessary to remove the extruded fragment and decompress the nerve root.
Anterior Cervical Diskectomy and Fusion (ACDF)
Certain spondylitic lesions, some fractures, and procedures for correction of spinal stenosis may require an anterior approach to the spine. Extreme cases require an anterior approach followed by a posterior approach. The anterior approach is especially useful for treatment of spinal stenosis at the cervical and thoracic levels.
Technique for ACDF...Mainly uses handheld and self-retaining retractors with detachable blades, vertebral spreader, cervical drill with guards, bone dowel cutter, bone graft holder and impactor, bone curettes and rongeurs
approach is popular for diskectomies in the thoracic region because of the small diameter of the thoracic spinal canal. An alternative approach is the removal of the medial segment of a rib and transverse process to expose the intervertebral disk. For these procedures, the rib is often used as autograft bone material and is packed into the disk space after the disk and cartilage plates have been removed and the vertebral bodies have been curetted.
comprising the brain and spinal cord;
comprising the nerves that link the various parts of the body to the CNS. Includes the cranial nerves that originate from the brain, and the spinal nerves that originate from the spinal cord. Trauma and various compression syndromes that affect often lead to surgery.
- At the elbow, travels through a tunnel of tissue (the cubital tunnel) that runs under the medial epicondyle of the elbow. This is commonly referred to as the “funny bone.”
- Beyond the elbow, travels under muscles in relation to the ulna. As the nerve enters the hand, it travels through another tunnel (Guyon’s canal).
- gives feeling to the little finger and half of the ring finger. It also controls most of the little muscles in the hand that help with fine movements, and some of the bigger muscles in the forearm that create a strong grip.
- Carpal tunnel syndrome is a condition nerve is compressed by the transverse carpal ligament.
- Decompression of the nerve is achieved by incising part of the fibrous sheath of the ligament.