Chapter 24 Neuro

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1

What is the Circle of Willis

A complex vascular network. most common site for aneurysms

2

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

3

Olfactory

Smell (Nose) Nerve Number 1

4

Optic

Vision (Eyes) Nerve #2

5

Oculomotor

Movement of Eyeball (Eyebrows) Nerve Number 3

6

Trochlear

Movement of Eyeball (Right below the nose) Nerve Number 4

7

Trigeminal

Opthlamic, Mandibular, and Maxillary Sensation and Chewing Nerve Number 5

8

Abducens

Movement of the Eyeball (Cheeks) Nerve Number 6

9

Facial

Sides of the face....Facial Expression, tears, and saliva secretion Nerve # 7

10

Vestibulochochlear

Ears Hearing and balance nerve #8

11

Glossopharyngeal

Saliva (Back of the tongue) Nerve #9

12

Vagus

Secretion of Digestive Fluids (Middle of the tongue) Nerve # 10

13

Accessory

Swallowing and head movements (Sides of the Jaw) Nerve number 11

14

Hypoglossal

Tongue Movement during speech and swallowing ( Tip of the Tongue) Nerve # 12

15

Mengies

Three tissue membranes (called dura mater, arachnoid, pia mater) that enclose the brain and spinal cord

16

Dura Matter

The outermost layer is composed of tough fibrous connective tissue.

17

arachnoid

The middle layer which is a serous membrane.

18

Tumors that are benign

craniopharyngiomas, epidermoids, dermoids, hemangiomas, meningiomas, acoustic neuromas, and pituitary microadenomas.

19

Pia Matter

The layer closest to the brain it contains blood vessels and nerves to provide nourishment to the neural tissue underneath.

20

subarachnoid space,

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

21

Sinus Locations

Frontal (Forhead)

Sphenoid (In between the eyes)

Maxillary (Under the Eyes)

22

How Many Vertebrae In the Adult

33

23

Different Sections of the Human Spine

Cervical (C1-C7) C1 is Atlas and C2 is Axis

Thoracic (T1-T12)

Lumbar (L1-L5)

Sacral (S1-S5) Fuse to one in Adults

Coccyx

24

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

25

Most Distal Portion of the Spinal Nerves are called

Sacral Nerves or the Coccygeal nerve

26

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

27

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.

28

Craniosynotosis

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.

29

hydrocephalus

  • 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.
30

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.

31

Exothermic

Process of Reaction creating Heat

32

Brain Abcess

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.

33

Stereotaxis System

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.

34

Rhizotomy

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.

35

Malignant Tumors

astrocytomas or gliomas, usually cannot be totally excised, but as much tumor as possible is removed.

36

All intracranial neoplasms

Symptoms:Headache, nausea and vomiting, personality changes, increased intracranial pressure

Tests: CT scan, MRI

37

Glioma

40% of primary braintumors—majority are malignant

Test: Ct Scan, MRI

38

Most Common Bed Frame Used

Wilson Bed Frame

39

Most common form of X-ray used during surgery

C-Arm (Flouroscopy)

40

What type of Local Anesteitc is Given and Why during and Aneurysm Procedure

Papervine to prevent spasms

41

foramen magnum

the hole in the base of the skull through which the spinal cord passes.

42

Osteophyte

An abnormal bony growth

43

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.

44

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.

45

Cloward

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

46

thoracotomy

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.

47

CNS

comprising the brain and spinal cord;

48

pns

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.

49

Ulnar Nerve

  • 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.
50

Medial Nerve

  • 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.