Brain Tumours Overview
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Questions and Answers

What are the primary indications for performing stereotactic brain surgery?

  • Endocrine disorders and optic nerve repair
  • Biopsy of a tumor and deep brain stimulation (correct)
  • Cranioplasty and brain swelling
  • Transphenoidal hypophysectomy and skull defects

    • Which anatomical area is accessed during a transphenoidal hypophysectomy?

  • The sphenoid sinus
  • The temporal lobe
  • The frontal cortex
  • The pituitary fossa (correct)

    • What is a common symptom associated with pituitary tumors?

  • Double vision (correct)
  • Involuntary tremors
  • Severe headaches
  • Loss of equilibrium

    • What materials are typically used in cranioplasty procedures to repair skull defects?

    <p>Titanium mesh or bone cement</p> Signup and view all the answers

    What is a reason for performing cranioplasty after a surgical procedure?

    <p>When the bone flap cannot be replaced due to trauma</p> Signup and view all the answers

    What is the primary purpose of the special sponges called patties in neurosurgery?

    <p>To provide radiopaque identification</p> Signup and view all the answers

    Which device is used to clip an aneurysm during a neurosurgery procedure?

    <p>Aneurysm clip applier</p> Signup and view all the answers

    What type of suture is used on the dura during neurosurgery?

    <p>Non-absorbable nylon suture</p> Signup and view all the answers

    Which of the following instruments is typically used to provide intense light and magnification during neurosurgery?

    <p>Microscope</p> Signup and view all the answers

    During a craniotomy, which device is commonly used to stabilize the head and neck?

    <p>Skull clamps</p> Signup and view all the answers

    What is the function of forced-air warming blankets in neurosurgery?

    <p>To prevent hypothermia</p> Signup and view all the answers

    What is the purpose of an initial count in neurosurgery?

    <p>To ensure all sponges and instruments are accounted for before closing</p> Signup and view all the answers

    What is a common feature of instruments used during neurosurgery, such as bipolar cautery forceps?

    <p>Bayoneted for visibility</p> Signup and view all the answers

    Which type of monitoring device is used for a patient with hydrocephalus after surgery?

    <p>ICP/EVD monitors</p> Signup and view all the answers

    Which type of suture is used on the galea during neurosurgery?

    <p>Cutting needle absorbable suture</p> Signup and view all the answers

    What primarily causes subdural hematomas?

    <p>Tearing of bridging veins</p> Signup and view all the answers

    Which layer is NOT dissected before performing a burr hole or craniotomy?

    <p>Endosteum</p> Signup and view all the answers

    What is the primary purpose of the external ventricular drain (EVD)?

    <p>To relieve intracranial pressure by draining CSF</p> Signup and view all the answers

    What type of shunt is commonly utilized when hydrocephalus is expected to be long-term?

    <p>Ventriculoperitoneal (VP) shunt</p> Signup and view all the answers

    What does the programmable valve in a VP shunt control?

    <p>Pressure levels for CSF drainage</p> Signup and view all the answers

    How is a burr hole created during neurosurgery?

    <p>Using an electric drill or perforator burr</p> Signup and view all the answers

    Why is sterile technique critical during neurosurgery?

    <p>To prevent infection at surgical sites</p> Signup and view all the answers

    What is the role of local anesthetic with epinephrine during a scalp incision?

    <p>To control bleeding through vasoconstriction</p> Signup and view all the answers

    What defines stereotactic brain surgery?

    <p>Targeting a specific area through a minimally invasive method</p> Signup and view all the answers

    What is typically left in after creating a burr hole when draining a hematoma?

    <p>A drain like JP or Hemovac</p> Signup and view all the answers

    What is the primary purpose of using an endoscope in neurosurgery?

    <p>To illuminate and magnify structures</p> Signup and view all the answers

    Which surgical procedure is primarily indicated for the removal of cerebral aneurysms?

    <p>Craniotomy</p> Signup and view all the answers

    What is the significance of monitoring a patient's temperature during surgery?

    <p>To ensure normothermia</p> Signup and view all the answers

    What is a common use of intra-operative radiology or fluoroscopy in spinal surgeries?

    <p>To visualize anatomical structures</p> Signup and view all the answers

    What is a disadvantage of performing a craniotomy under general anesthesia?

    <p>Impaired neurological monitoring</p> Signup and view all the answers

    What condition can burr holes be used to treat effectively?

    <p>Epidural hematoma</p> Signup and view all the answers

    What devices are often used in neurosurgery to prevent head movement?

    <p>Sugita pins and Mayfield fixation devices</p> Signup and view all the answers

    What procedure involves feeding a catheter through the femoral artery to treat cerebral aneurysms?

    <p>Endovascular coiling</p> Signup and view all the answers

    Which of the following conditions has an increased rate of bleeding due to abnormal vascular formation?

    <p>Arteriovenous malformation (AVM)</p> Signup and view all the answers

    What is the role of the Cavitron Ultrasonic Surgical Aspirator (CUSA) in surgery?

    <p>To remove malignant tissues using high-frequency sound waves</p> Signup and view all the answers

    What distinguishes a malignant brain tumor from a benign brain tumor?

    <p>Malignant tumors are comprised of fast-growing cells that infiltrate normal brain structures.</p> Signup and view all the answers

    Which type of brain tumor originates in brain tissue itself?

    <p>Primary brain tumor</p> Signup and view all the answers

    Which of the following is NOT a risk associated with neurosurgery?

    <p>Risk for seizure activity</p> Signup and view all the answers

    What is a critical pre-operative consideration for neurosurgery concerning blood?

    <p>Confirm the availability of blood products and blood type.</p> Signup and view all the answers

    What is a common position for a patient during neurosurgery?

    <p>Supine position</p> Signup and view all the answers

    Which device is commonly used to stabilize a patient's head during neurosurgery?

    <p>Mayfield head fixation device</p> Signup and view all the answers

    Which of the following statements is true regarding primary brain tumors?

    <p>They typically do not spread outside the original brain site.</p> Signup and view all the answers

    What aspect of patient care is particularly important during prolonged neurosurgery?

    <p>Padding pressure points to prevent skin breakdown.</p> Signup and view all the answers

    Study Notes

    Brain Tumours

    • Tumours can be classified as benign (slow-growing, non-invasive) or malignant (fast-growing, infiltrative).
    • Primary brain tumours originate in brain tissue, while secondary (metastatic) tumours spread from other body organs like breast or lung.

    Perioperative Nursing Considerations

    • Careful padding of pressure points is essential due to long duration of neurosurgeries (3-8 hours).
    • Patients must be securely positioned on the OR bed, which tilts during surgery, to prevent movement.
    • Assessments focus on risks such as infection, bleeding, and impaired skin integrity.

    Blood Management

    • Anticipation of blood transfusion is vital due to tissue dissection in vascular areas.
    • Consent and blood type must be confirmed at all stages (pre-, intra-, post-operatively).

    Patient Positioning

    • Common positions include supine, lateral, or prone using a Mayfield fixation device or similar headrest.
    • Collaboration with the surgical team is crucial to ensure safe patient positioning.

    Instrumentation

    • Key instruments include:
      • Love adson (elevator), Penfield dissector, Raney clip appliers for scalp hemostasis.
      • Hemostatic agents: bone wax, Surgicel, Gelfoam, Floseal.
      • Special radiopaque patties used on the brain for identification.
    • Minor counts required at various surgical stages ensure all instruments are accounted for.

    Equipment Used

    • Specialized OR beds, such as Jackson or Andrews tables, are used for stability.
    • Surgical microscopes provide magnification and illumination.
    • Drills create burr holes and skull flaps while minimizing dura damage.
    • Forced-air warming blankets maintain normothermia due to prolonged surgeries.
    • Endoscopes used in minimally invasive surgeries provide extended viewing and illumination.

    Surgical Interventions

    • Craniotomy: Involves removing a skull section to access the brain, addressing conditions like tumours, hemorrhages, and cerebral aneurysms.
    • Burr Holes: Created for localized access to relieve pressure from hematomas.
    • Shunt Insertion for Hydrocephalus: Allows CSF drainage; may involve external ventricular drains (EVD) or ventriculoperitoneal (VP) shunt placement.

    Stereotactic Procedures

    • Minimally invasive approach utilizing CT or MRI for accurate navigation to biopsy or treat brain targets.
    • Common indications include tumour biopsy and deep brain stimulation for disorders like Parkinson's Disease.

    Transphenoidal Hypophysectomies

    • Endoscopic procedure addressing pituitary disorders, performed through the sphenoid sinus.
    • Pituitary tumours, often benign, may result in symptoms like double vision due to proximity to the optic chiasm.

    Cranioplasty

    • Surgical repair of skull defects due to trauma or previous surgeries, using materials like titanium mesh or bone cement.

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    MODULE 21 Neurosurgery PDF RPN2023

    Description

    This quiz explores the characteristics of brain tumours, including the differences between benign and malignant types. Learn about their growth patterns, surgical removal possibilities, and their behavior within the brain. Test your knowledge on this critical topic in neuroscience.

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