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43 Cards in this Set

  • Front
  • Back
What nerves are involved in looking to the side?
What are acoustic neuromas?
• tumors that are found in the posterior fossa that originate off CN VIII
• patients will initially complain of tinnitus and balance problems
What nerve can be injured from a carotid enarterectomy?
hypoglossal nerve
What lobe is located in the middle cranial fossa?
temporal lobe
What structures are located in the tectum?
• superior colliculi: involved in visual processing and control of eye movements
• inferior colliculi: involved in auditory processing

* collectively called quadrigeminal plate
What are Chiari malformations?
• congenital abnormalities of the posterior fossa
• characterized by extension of cerebellar tissue (the tonsils) through the foremen magnum
What is the anterior & posterior complex?
• anterior complex: the interal carotid artery that bifurcates into the middle cerebral artery and the anterior cerebral artery
• posterior complex: the vertebral artery » basilar artery » posterior cerebral arteries
What is the most common area of aneurysms?
anterior communicating artery
What are the perforating arteries and what are their functions?
endarteries that perfuse the basal ganglia and brainstem (areas that are not perfused by the major vessels)
What is the blood-brain barrier made of?
astrocytes and tightly joined endothelial cells
What muscles are found in the neck, from superficial to deep?
• platsyma
• scalenes
How can you distinguish between the internal and external carotid on an angiogram?
• internal carotid has no branches in the neck
• external carotid has branches (ex. superficlal temporal artery)
What nerve lies above and below C7?
• C7 above
• C8 below
What is a pre-fixed plexus? a post-plexus?
• textbook brachial plexus is from C5-T1
• prefixed: C4-C8
• postfixed: C6-T2
At what level cervical spine do the spinous process become bifid?
What factors cause increased stability of the thoracic spine?
• sagittal alignment of the facets
• rib cage adds stability
What is spondylolisthesis and how is it treated surgically?
• occurs when one vertebra slips forward in relation to an adjacent vertebra, usually in the lumbar spine
• surg TX: pedical screw fusion
What is the most common congenital/pediatric disorder seen in neurosurgery?
Name and describe the 2 types of hydrocephalus
• obstructive: occurs when obstruction in the ventricular system prevents CSF from reaching the arachnoid villi

• non-obstructive or communicating: results from impaired reabsorption of CSF from the aracnoid villi into the venous system
What are some medical treatments of hydrocephalus?
• Acetazolamide (Diamox): a carbonic anhydrase inhibitor that will decrease production of CSF
• mannitol
• steroids
What are interventional treatments for hydrocephalus?
• VP shunts (ventriculo-peritoneum)
• VA shunts (ventriculo-atrium)

* also can go to bladder and gallbladder
If a patient is having problems with a shunt, how can you tell if the problem is in the proximal or distal part?
• if you are unable to push the shunt in, the problem is in the distal part
• if the shunt does not come back when released, the problem is in the proximal part
What is myelomeningocele?
when an unfused portion of the spinal cord protrudes through an opening in the overlying vertebrae
What is tethered spinal cord syndrome?
• when the spinal cord is bound to the skin ectoderm causing the spinal cord to become stretched and ischemic
• presents with orthopedic, urologic, and back pain problems
• occurs with myelomeningocele
What is Chiari I malformation?
tonsillar displacement greater than 5 mm through the foramen magnum
What is a Klipplefile abnormality?
fusion of two vertebrae
Which type of head injury produces biconvex, lens-shaped hematomas that do not cross suture lines?
epidural hematoma
Which type of head injury produces a cresent-shaped hematoma on CT and does cross suture lines?
subdural hematoma
What are two ways to monitor intracranial pressure?
• ventriculostomy
• parenchymal intracranial pressure monitor
How can you differentiate between acute and old blood on a CT scan?
• acute blood appears white
• old blood appears dark
Why would you choose to do either a burr hole or a craniotomy to treat a subdural hematoma?
• for acute hematoma, the blood has a thicker consistency; therefore, treat with a craniotomy
• for chronic hematoma, the blood has a liquid consistency and can be evacuated with a Burr hole
When do you have to surgically repair a depressed skull fracture?
• when the depression is deeper than the thickness of the skull
• patients with depression fractures can have a high incidence of seizures if left untreated
What is the standard of care of spinal trauma?
• high dose steroids to stop secondary injury
• Methylprednisolone 30 mg/kg (given less than 8 hours within injury)
What are the Nexus C-spine rules?
Plain film radiography of the traumatized portion of the spine is required when the following are present:

• midline pain or bony tenderness, crepitus, or step-off
• neurologic deficit (including complaints of paresthesia or numbness)
• presence of distracting injuries
• altered mental status (including intoxication)
True/False: A lateral c-spine xray needs to visualize all the cervical vertebrae
• lateral c-spine needs to visualize C1-T1
• The correct answer is: False
What is a test that can be done to distinguish CSF from mucus?
beta 2 transferrin
What is a diffuse axonal injury?
• also known as shear injury or brain stem contusion

• high acceleration/deceleration injury with shock waves and momentary tissue distortion causing microscopic tearing of nerve fibers

• radiographically consists of small petechial hemorrhages in white matter tracts
Why should you not use only antibiotics to treat brain abscess?
• the abscess can be encapsulated which would prevent the antibiotic from penetrating the abscess
• abscess needs to be drain
What are 6 things that you look for when examining CSF?
• cell count
• culture
• gram-stain
• glucose
• protein
• sensitivity
Herpes simplex encephalitis typically affects which lobe?
temporal lobe
What is the most common parasite infecting the brain?
What are brain mass lesions are AIDS patients more susceptible due to immunosuppresion?
• toxoplasma
• cryptococcus
• gliomas
What area of the brain is affected by leukoencephalopathy?
white matter