Neurosurgery Module 21 Quiz

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Questions and Answers

Which layer of the meninges is responsible for producing cerebrospinal fluid (CSF)?

  • Arachnoid
  • Pia (correct)
  • Sub-arachnoid
  • Dura

What injury may occur if the middle meningeal artery is ruptured?

  • Subarachnoid hemorrhage
  • Epidural hemorrhage (correct)
  • Cerebral edema
  • Subdural hemorrhage

Which structure is located in the sella turcica and is crucial for endocrine function?

  • Thalamus
  • Hypothalamus
  • Pineal gland
  • Pituitary gland (correct)

Which of the following accurately describes the role of cerebrospinal fluid (CSF)?

<p>It protects the brain from external trauma. (B)</p> Signup and view all the answers

What connects the lateral ventricles to the third ventricle in the brain?

<p>Foramen of Monro (A)</p> Signup and view all the answers

Which cranial nerve is at particular risk of injury during ENT surgery due to its proximity to another nerve?

<p>Facial nerve (A)</p> Signup and view all the answers

What arteries supply blood to the anterior circulation of the brain?

<p>Internal carotid arteries (B)</p> Signup and view all the answers

Which structure allows CSF to circulate between the fourth ventricle and the subarachnoid space?

<p>Foramen of Luschka (A), Foramen of Magendie (B)</p> Signup and view all the answers

Which of the following conditions describes an abnormal mass resulting from uncontrolled cell growth in the brain?

<p>Brain tumor (C)</p> Signup and view all the answers

What is one of the most common indications for performing stereotactic brain surgery?

<p>Biopsy of tumor (A)</p> Signup and view all the answers

What is a common symptom associated with pituitary tumors?

<p>Double vision (C)</p> Signup and view all the answers

Which procedure is used to treat endocrine pituitary disorders through the sphenoid sinus?

<p>Transphenoidal hypophysectomy (A)</p> Signup and view all the answers

During cranioplasty, which material is often used to replace defects in the skull?

<p>Titanium mesh (B)</p> Signup and view all the answers

What is the purpose of inserting a needle into the brain during stereotactic brain surgery?

<p>To navigate and target structures for biopsy or destruction (D)</p> Signup and view all the answers

What is the primary control function of the brain stem?

<p>Basic vital functions such as heart rate and respiration (B)</p> Signup and view all the answers

Which lobe of the brain is primarily responsible for intellect and personality?

<p>Frontal lobe (B)</p> Signup and view all the answers

What distinguishes a burr hole from a craniotomy?

<p>A burr hole can be done with local anesthesia, while craniotomy requires general anesthesia. (D)</p> Signup and view all the answers

Which statement is true regarding ventriculoperitoneal shunts?

<p>They divert cerebrospinal fluid to the abdomen to treat hydrocephalus. (C)</p> Signup and view all the answers

What is the main role of the cerebellum in brain function?

<p>Coordinating fine movements and maintaining balance (D)</p> Signup and view all the answers

Which type of hematoma occurs between the skull and the outer covering of the brain?

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

What distinguishes a malignant brain tumour from a benign one?

<p>Malignant tumours infiltrate normal brain structures. (A)</p> Signup and view all the answers

How many bones comprise the human skull?

<p>8 bones (D)</p> Signup and view all the answers

Which type of brain tumour arises from normal brain tissue itself?

<p>Primary brain tumour (C)</p> Signup and view all the answers

What is the function of the longitudinal fissure in the brain?

<p>Divides the brain into the left and right hemispheres (C)</p> Signup and view all the answers

What is a primary concern for neurosurgery patients regarding their surgical incisions?

<p>Risk for infection related to incisions (C)</p> Signup and view all the answers

What method is commonly used to secure a patient's head during neurosurgery?

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

Which risk is NOT commonly associated with neurosurgery patients?

<p>Impaired vision post-surgery (A)</p> Signup and view all the answers

What is the primary reason blood transfusions may be necessary during neurosurgery?

<p>Due to dissection in highly vascular areas (D)</p> Signup and view all the answers

Which of the following is NOT typically part of the perioperative nursing considerations for neurosurgery?

<p>Avoiding use of intravenous lines (A)</p> Signup and view all the answers

What positioning is commonly used for a patient undergoing neurosurgery?

<p>Supine, lateral, or prone (C)</p> Signup and view all the answers

Which of the following statements about secondary brain tumours is correct?

<p>They can metastasize from cancers in other body parts. (C)</p> Signup and view all the answers

What is a significant preparation step for blood management in neurosurgery?

<p>Confirming blood type and availability pre-, intra-, and post-operatively (D)</p> Signup and view all the answers

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

<p>To provide illumination and magnification of structures (C)</p> Signup and view all the answers

During which type of surgery is intra-operative radiology most commonly utilized?

<p>Spinal surgeries (C)</p> Signup and view all the answers

What is the main indication for coiling a cerebral aneurysm?

<p>To prevent blood flow into the aneurysm (C)</p> Signup and view all the answers

What type of surgical intervention involves the removal of a section of the cranium?

<p>Craniotomy (D)</p> Signup and view all the answers

What neurological condition might prompt an awake craniotomy due to its location in the brain?

<p>Brain tumors in eloquent areas (A)</p> Signup and view all the answers

What is a potential surgical emergency that might require burr holes to be created?

<p>Subdural hematoma (B)</p> Signup and view all the answers

Why is the continuous assessment of a patient's temperature crucial during long surgical procedures?

<p>To prevent hypothermia and ensure normothermia (D)</p> Signup and view all the answers

What is the primary function of the Cavitron Ultrasonic Surgical Aspirator (CUSA)?

<p>To emulsify and debulk tumors (B)</p> Signup and view all the answers

What are Sugita pins and Mayfield fixation devices primarily used for in neurosurgery?

<p>To immobilize the head during surgery (B)</p> Signup and view all the answers

What type of hematoma is characterized by a collection of blood located above the dura mater?

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

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Study Notes

Neurosurgery Overview

  • Neurosurgery addresses conditions like head injuries, tumors, vascular disorders, hydrocephalus, epilepsy, and Parkinson’s disease.
  • Surgical interventions also include treatment for spinal disorders and peripheral nerve issues, such as chronic pain.

Nervous System Anatomy

  • Central Nervous System (CNS): Comprises the brain and spinal cord.
  • Peripheral Nervous System (PNS): Includes cranial and spinal nerves.
  • The brain is protected by the skull, which consists of eight bones: two temporal, two parietal, frontal, occipital, ethmoid, and sphenoid.

Brain Structure

  • Cerebrum: Divided into two hemispheres (right and left), each with four lobes:
    • Frontal lobe: Intellect, personality; terminus for motor and sensory nerves.
    • Parietal lobe: Responsible for sensation, pain, and pressure interpretation.
    • Temporal lobe: Associated with speech, hearing, and comprehension.
    • Occipital lobe: Vision processing.
  • Brain Stem: Controls vital functions (heart rate, respiration) and consciousness; injuries here are life-threatening.
  • Cerebellum: Coordinates fine motor control and balance.

Meninges and Cerebrospinal Fluid (CSF)

  • The brain is enveloped by three meninges:
    • Dura mater: Tough outer layer; contains the middle meningeal artery; rupture can cause epidural hemorrhage.
    • Arachnoid mater: Contains CSF; has a continuous subarachnoid space linked to the brain's ventricles.
    • Pia mater: Delicate layer directly on the brain; produces CSF through the choroid plexus.
  • Ventricular System: Contains four fluid-filled cavities (ventricles) that circulate CSF, providing cushioning and nourishment.

Cranial Nerves and Blood Supply

  • Twelve cranial nerves emerge from the brain stem; delicate structure poses a risk in surgeries.
  • Cerebral blood supply comes from internal carotid and vertebral arteries, meeting at the Circle of Willis.

Brain Tumors

  • Categorized as benign (slow-growing) or malignant (fast-growing), affecting surrounding brain structures.
  • Primary tumors originate in the brain; secondary (metastatic) tumors spread from other body parts.
  • Symptoms may vary depending on tumor location and type.

Perioperative Nursing Considerations

  • Position patient securely; padding is essential due to long surgery times (3-8 hours).
  • Risks include infection, bleeding, impaired skin integrity, and hypothermia.
  • Blood transfusion readiness is critical due to high vascular areas being operated on.

Surgical Techniques

  • Craniotomy: Removal of a bone flap; indicated for tumors, bleeding, aneurysms, AVMs, abscesses, and neurological disorders.
  • Burr Holes: Minimized access to relieve pressure from localized fluid collections (e.g., hematomas).
  • Stereotactic Surgery: Utilizes imaging for biopsy or deep brain stimulation; typically addresses tumors or movement disorders.

Specific Surgical Procedures

  • Transphenoidal Hypophysectomy: Treats pituitary disorders via transnasal endoscopic approach.
  • Cranioplasty: Repair of skull defects; artificial materials like titanium mesh may be used.

Surgical Positioning

  • Common positions include supine, lateral, or prone; Mayfield head fixation devices stabilize the patient's head during procedures.

Technology in Neurosurgery

  • Use of endoscopes for minimally invasive surgeries enhances visibility and access.
  • Intra-operative radiology aids in precision during spinal surgeries.
  • Ultrasonic aspirators (CUSA) assist in tumor debulking through high-frequency sound waves.

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