ANSWERS FOR THE QUIZ SEVEN :

QUESTION NUMBER 1 . ANSWER IS : e) all of the above

QUESTION NUMBER 2 . ANSWER IS: b)   aneurysms

QUESTION NUMBER 3 . ANSWER IS:  b)  aneurysms of the circle of willis

QUESTION NUMBER 4 . ANSWER IS:

a) congenital or acquired hydrocephalus 

QUESTION NUMBER 5 . ANSWER IS:   a) to treat vascular disorders

QUESTION NUMBER 6 . ANSWER IS: c) silver,mckenzie or hemoclips

QUESTION NUMBER 7 . ANSWER IS: b) iliac crest

QUESTION NUMBER 8 . ANSWER IS: a)  is impacted with bone tamp

QUESTION NUMBER 9 . ANSWER IS: c)  a median nerve decompression

QUESTION NUMBER 10 . ANSWER IS: b) olivecrona clips

DRAPING THE MICROSCOPE:
It is lot easier if you attach the black ring to the objective first and then proceed with the rest of the draping. This allows confinement of the drape and less worrying whether or not you will drop it. I always put extra gloves to drape the microscope, and take the outer gloves off after the draping.

QUIZ EIGHT :

Match  neurosurgical procedures with the correct description.

1. Tumor of the coverings of the brain  

a) neurofibroma

b) meningoma

c) angioma

d) meningomyelocele

e) none of the above

2. Curvature of the spine

a) scoliosis

b) spina bifida

c) herniated disc

d) spondylolisthesis

e)  neurofibroma

3. Non-closure of the vertebral canal

a) craniosynostosis

b) lordosis

c) spina bifida

d) spondylolisthesis

e) scoliosis

4. Premature closure of the cranial suture

a) acquired hydrocephalus

b) craniosynostosis

c) spondylolisthesis

d) scoliosis

e) angioma

5. Tumor made up of blood vessels  

a) angioma 

b)  sarcoma

c) meningioma

d) fibroma

e) none of the above

6. Herniation of the meninges through an abnormal opening in the vertebrae

a)  herniated disc

b)  scoliosis

c) meningomyelocele

d) spondylolisthesis

7. Herniation of the meninges and the spinal cord through an abnormal opening in the vertebrae

a) spondylolisthesis

b) scoliosis

c) herniated disc

d) spina bifida

8. Tumor of cranial nerve fibers

a) neurofibroma

b)  pons varolii

c) meningomyelocele

d)  angioma

e) none of the above

9. Trigeminal neuralgia

a) pons varolii

b)  tic douloureux

c) neuroma

d) neurofibroma

e) none of the above

10.  Forward dislocation of lumbar vertebrae

a) scoliosis

b) nucleus pulposa

c)  contusion

d) spondylolisthesis

e) herniated disc

Have fun with this Quiz Eight.

Answers will be posted on my next blog.

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SURGICAL TECHNOLOGY TUTOR

SURGICAL TECHNOLOGY TUTOR

ANSWERS FOR THE QUIZ SIX :

QUESTION NUMBER 1 . ANSWER IS : e) b,c,d

QUESTION NUMBER 2 . ANSWER IS: b) dependent upon the position of the patient and type of procedure

QUESTION NUMBER 3 . ANSWER IS: a) A-P and lateral spine x-rays, myelogram, discogram

QUESTION NUMBER 4 . ANSWER IS: b) pneumoencephalogram, visual field examination, brain scan 

QUESTION NUMBER 5 . ANSWER IS:   e) c and d ............. c) may be done to diagnose cerebral thrombosis, subdural hematoma, or tumor

d) is done in the x-ray department and patient come to the operating room right after diagnosis.

QUESTION NUMBER 6 . ANSWER IS: c) requires surgical treatment if they are either compound or depressed

QUESTION NUMBER 7 . ANSWER IS: d) all of the above

QUESTION NUMBER 8 . ANSWER IS: a) may be due to a ruptured aneurysm or injury

QUESTION NUMBER 9 . ANSWER IS: a) extradural or subdural

QUESTION NUMBER 10 . ANSWER IS: e) a and b

QUESTION NUMBER 11.  ANSWER IS:   e) all of the above                                 a) astrocytoma

b) menigiomas

c) neurofibromas

d) gliomase

The location of the incision and bone flap for craniotomy:

will determine the position of the patient and orientation of the room set up, depends on the location of the pathology, is usually within the hairline so it won't show when healed. 

QUIZ SEVEN:

Match  neurosurgical procedures with the correct descriptions.

1. Brain tumors  

a) can be benign or malignant

b) cause symptoms because of brain tissue destruction

c) cause symptoms because of increased intracranial pressure

d) may be both primary and metastatic lesions

e) all of the above

2. Vascular disorders of the brain that are treatable by surgery include

a) atherosclerosis

b) aneurysms

c) cerebral embolisms

d) all of the above

e)  b and c

3. Carotid artery ligation is done for

a) atherosclerosis

b) aneurysms of the circle of willis

c) angiomas of the jugular vein

d) an increased blood flow to occipital region

e) all of the above

4. Shunt operations are done for

a) congenital or acquired hydrocephalus

b) craniosynostosis

c) spondylolisthesis

d) scoliosis

e) angioma

5. A sympathectomy may be done  

a) to treat vascular disorders 

b)  through burr holes

c) in the knee-chest position

d) to relieve headaches

e) to treat tic douloureux

6. Special equipment used during sympathectomy includes

a)  crutchfield tongs

b)  vinke tongs

c) silver,mckenzie or hemoclips

d) steinman pins

7. Most common donor site of bone for a spinal fusion is

a) ischium

b) iliac crest

c) femur

d) scapula

8. During a spinal fusion, the bone graft 

a)  is impacted with bone tamp

b)  sewed in with silk

c)  is held with a bolt

d)  a and b

e) none of the above

9. The surgical procedure done to relieve carpal tunnel syndrome is

a)  release of hamstring

b)  excision of the navicular head

c)  a median nerve decompression

d) a radial nerve decompression

e) an ulnar nerve decompression

10.  Surgical clips used on an aneurysm of the circle of willis include

a) sugiclips medium

b) olivecrona clips

c)  towel clip

d) vesclips

e) a and b

Have fun with this Quiz Seven.

Answers will be posted on my next blog.

Folks buy these Dagacci Scrubs for your every day practice. I have used them they are comfortable for the long time usage. Cotton blended very natural scrubs you can get for a reasonable price.

SURGICAL TECHNOLOGY TUTOR

SURGICAL TECHNOLOGY TUTOR

ANSWERS FOR THE QUIZ FIVE :

QUESTION NUMBER 1 . ANSWER IS : SHUNT OPERATIONS

QUESTION NUMBER 2 . ANSWER IS: CRANIOPLASTY

QUESTION NUMBER 3 . ANSWER IS: TRANSSPHENOIDAL HYPOPHYSECTOMY

QUESTION NUMBER 4 . ANSWER IS: CRANIOTOMY

QUESTION NUMBER 5 . ANSWER IS: BUR HOLES 

QUESTION NUMBER 6 . ANSWER IS: CRANIECTOMY

While positioning the neuro-surgical patient, it is important to remember:

to protect against trauma to the eyes

pressure areas must be padded

to allow room for adequate respiratory expansion

QUIZ SIX:

Match cranial neurosurgical procedures with the correct descriptions.

1. Pre-anesthesia medications are given to the neurosurgical patients

a) To sedate them heavily so they won't remember

b) To depress secretions and increase the stability of the heart

c) To replace anesthesia

d) To control seizures

e) b,c,d

2. Anesthesia for neurosurgery is generally

a) local

b) dependent upon the position of the patient and type of procedure

c) general inhalation with an endotracheal tube in place

d) deep, because there is much pain involved with neurosurgery

3. Diagnostic procedures done for a patient with a suspected herniated intravertebral disc may include

a) A-P and lateral spine x-rays, myelogram, discogram

b) A-P and lateral spine x-rays, myelogram, saggital sinus venogram

c)A-P  and lateral spine x-rays,myelogram,cisternal puncture

d)A-P and lateral spine x-rays, discogram, pneumoencephalogram

4. Diagnostic procedures done for a patient with a suspected brain tumor may include

a) pneumoencephalogram, cerebral angiogram, discogram

b) pneumoencephalogram, visual field examination, brain scan

c) electroncephalogram, spine puncture,thalamotomy

d) electroencephalogram, myelogram,pallidotomy

e) a and b

5.Brain scan

a) is the recording of electrical activity of the brain

b) requires general anesthesia

c) may be done to diagnose cerebral thrombosis, subdural hematoma, or tumor

d) is done in the x-ray department and patient come to the operating room right after diagnosis.

e) c and d

6. Fractures of the skull

a) require surgical treatment in all cases

b) require craniotomy if there is a scalp laceration

c) requires surgical treatment if they are either compound or depressed

d) require surgical treatment if the patient has been unconscious

e) require surgical hemostasis

7. Indications for a cranioplasty include

a) cosmetic effect

b) fear of injury

c) local discomfort

d) all of the above

8.Intracranial hemorrhage

a) may be due to a ruptured aneurysm or injury

b) occurs more often in men then in women

c) is not serious if it does not occur within 24 hours of an accident

d) required surgery only if the skull fragment can not be removed

e) is a cerebral vascular accident 

9. An intracranial hemorrhage may be

a) extradural or subdural

b) subdural or subhepatic

c) subhepatic or subphrenic

d) subphrenic or subclavian

e) epidural or subphrenic

10. Treatment of intracranial hemorrhage may be

a) immidiate craniotomy

b) burr holes for evacuation of clot with possible craniotomy

c) burr holes only if there is a skull fracture

d) depends upon how many black eyes the patient has

e) a and b

11. Brain tumors may be

a) astrocytoma

b) menigiomas

c) neurofibromas

d) gliomas

e) all of the above

Have fun with this Quiz SIX.

Answers will be posted on my next blog.

Folks buy these Dagacci Scrubs for your every day practice. I have used them they are comfortable for the long time usage. Cotton blended very natural scrubs you can get for a reasonable price.

SURGICAL TECHNOLOGY TUTOR

ANSWERS FOR THE QUIZ FOUR :

QUESTION NUMBER 1 . ANSWER IS : BEFORE THE FULL PREP

QUESTION NUMBER 2 . ANSWER IS: #3 KNIFE HANDLE WITH #10 BLADE  

QUESTION NUMBER 3 . ANSWER IS:  CRANIOTOME

QUESTION NUMBER 4 . ANSWER IS:  FREER 

QUESTION NUMBER 5 . ANSWER IS: RONGEUR

QUESTION NUMBER 6 . ANSWER IS: PERIOSTEAL ELEVATOR 

QUESTION NUMBER 7. ANSWER IS: MOIST COTTONOID STRIPS

QUESTION NUMBER 8 . ANSWER IS: # THREE FRAIZIERS 

QUESTION NUMBER 9 . ANSWER IS: NORMAL SALINE SOLUTIONS

QUESTION NUMBER 10 . ANSWER IS: SURGICAL LOUPES

QUESTION NUMBER 11 . ANSWER IS: BIPOLAR UNITS

QUESTION NUMBER 12 . ANSWER IS: MAYFIELD OR SUGITA

QUESTION NUMBER 13 . ANSWER IS: NITROGEN OR ELECTRICITY

QUESTION NUMBER 14 . ANSWER IS: DOUBLE MAYO STANDS

QUESTION NUMBER 15 . ANSWER IS: GELFOAM

QUESTION NUMBER 16 . ANSWER IS: MANNITOL A DIURETIC

QUESTION NUMBER 17 . ANSWER IS: HYPOTHERMIA

QUESTION NUMBER 18 . ANSWER IS: # 4 PENFIELD 

QUESTION NUMBER 19 . ANSWER IS: SILK

QUESTION NUMBER 20 . ANSWER IS: 3-0 NYLON

Examples of  position used during neurosurgery:

1. SUPINE: Supranteriol craniotomy, Anterior cervical fusion-decompression procedures etc.
2. LATERAL RECUMBENT: Lumbar, Thoracic laminectomy etc.
3.MODIFICATIONS OF PRONE: Posterior fossa cranioectomy, Laminectomy etc.
4. SITTING: Ventriculogram, Temporal cranioectomy, Posterio-inferior cranioectomy etc.
5. EXTREME SITTING: Infranterial cranial surgery, Posterior spinal surgery etc.

QUIZ FIVE:

Match cranial neurosurgical procedures with the correct descriptions.

1. Procedures to treat hydrocephalus by shunting excessive cerebrospinal fluid from the ventricles to the abdominal cavities where the fluid is absorbed.                                                                                                                                      a. Bur holes
2. Reconstruction of a skull defect resulted from malformation, trauma etc; requires covering the defect with prosthetic material e.g. silicone rubber, bone,cartilage and methyl methacrylate.                                                                                                                                                                                                        b. Craniectomy
3. Removal of pituitary gland or tumor of the pituitary gland by  an incision is made in the upper gum margin through the inferior nasal cavity and sphenoid sinus to the floor of the sella turcica.                                                                                                                                                                                                       c. Cranioplasty
4. Incision into the cranium to treat intracranial disorders.                                                                                                                                                                                                            d. Craniotomy
5. Drill of holes into the skull to tap a ventricle to relieve pressure, or to remove fluid accumulated under the dura mater, or to aspirate brain abscess, or to find and drain subdural hematoma, or to pump air into the lateral ventricles for ventriculography.                                                                                                                                                                                                                            e. Shunting
6. Incision into the skull and removal of bone flap to treat craniosynostosis or to decompress the brain from depressed bone or internal hemorrhage or to remove tumors; subdural and epidural hematomas; infections of the bone.                                                                                                                                                                                  f. Transsphenoidal hypophysectomy

Have fun with this Quiz Five.

Answers will be posted on my next blog.

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SURGICAL TECHNOLOGY TUTOR

ANSWERS FOR THE QUIZ THREE :

QUESTION NUMBER 1 a. ANSWER IS:  Cerebral angiography

QUESTION NUMBER 1 b. ANSWER IS:  Myelography

QUESTION NUMBER 1 c. ANSWER IS:  Pneumoencephalography

QUESTION NUMBER 1 d. ANSWER IS:  Lumbar puncture

QUESTION NUMBER 1 e. ANSWER IS:  Ventriculography

QUESTION NUMBER 1 f. ANSWER IS:   Electroencephalography

QUESTION NUMBER 1 g. ANSWER IS:  Echoencephalography

QUESTION NUMBER 1 h. ANSWER IS:  Digitalized angiography

QUESTION NUMBER 1 i. ANSWER IS:  Computerized axial tomography

Examples of mechanical methods of hemostasis used during neurosurgery:

1. Scalp clips, 2. Gauge sponges, 3. Hemostatic clips, 4. Compressed rayon cotton sponges  (cottonoids), 5. Monopolar and Bipolar electrocoagulation, 6. Bone wax

QUIZ FOUR:

Write which option is correct e.g This is Neurosurgery quiz three / four. 

Correct answer is 'four'. 

During the Craniotomy procedure: 

1. Mayfield Headrest pins are placed before / after the prep.

2. #3 Knife handles with #10 / #7 knife handles with #11 scalpel blades are used to make the incision for the burr holes.

3. Burr hole are made with craniotome / stryker saw and burrholes drill bit / 5093 saw blade.

4. Bone wax is used on a freer / cobb elevator to control bleeding.

5. Burr holes are enlarged with Rongeur / Scalpel / knife / Burr hole enlarger / Kerrison.

6. Periosteum is stripped from the bone with a Periosteal knife / Periosteal elevator / Scalpel / Knife.

7. After exposing, brain surface is protected with Moist sponge / Bone wax / Moist Cottonoid strips / Dry gauge.

8. #Three Fraiziers / Yankauer suction tips  are used to suction the blood from the site.

9. Copious amount of Lactated ringers / Normal saline solutions are used to irrigate the site.

10. Operating Microscopes / Surgical Loupes are used for all Craniotomy.

11. Always Bovie / Bipolar units are used to cauterize the galea,periostrum, surface of the dura, and in the brain.

12. Mayfield / Sugita / Bean bag is always used to securely position the skull during the surgery.

13. Drills and Perforators used for the drilling are powered by Nitrogen / Oxygen / Electricity.

14. Mayfield overhead instrument table / Double Mayo stands are used for all craniotomy.

15. Gelfoam / Seprafilm is soaked in topical Thrombin always used for hemostasis on the brain.

16. Calcium chloride / Mannitol a diuretic, may be given to prevent brain swelling, increased intracranial pressure.

17. Hyperthermia / Hypothermia units are always used for the surgery.

18. # 4 Penfield / Hagar dissector is used for blunt dissection.

19. Silk / Chromic suture is used to close the dura.

20. 3-O Nylon / Vicryl is used to suture any drains to the scalp. 

Have fun with this Quiz Four.

Answers will be posted on my next blog.

Folks buy these Dagacci Scrubs for your every day practice. I have used them they are comfortable for the long time usage. Cotton blended very natural scrubs you can get for a reasonable price.

SURGICAL TECHNOLOGY TUTOR

QUESTION NUMBER 1 ANSWER IS: N; HEARNIATED DISC

QUESTION NUMBER 2 ANSWER IS: E; INTRACTABLE PAIN

QUESTION NUMBER 3 ANSWER IS: M; MENINGOCELE

QUESTION NUMBER 4 ANSWER IS: A; BRAIN TUMOR

QUESTION NUMBER 5 ANSWER IS: B; HEMATOMA

QUESTION NUMBER 6 ANSWER IS: O; SPINAL CORD TUMOR

QUESTION NUMBER 7 ANSWER IS: C; BRAIN ABCESS

QUESTION NUMBER 8 ANSWER IS: K; TIC DOULOUREUX

QUESTION NUMBER 9 ANSWER IS: J; PITUITARY TUMOR

QUESTION NUMBER 10 ANSWER IS: F; CRANIOSYNOSTOSIS

QUESTION NUMBER 11 ANSWER IS: I; INTRACRANIAL ANEURYSM

QUESTION NUMBER 12 ANSWER IS:D; CARPAL TUNNEL SYNDROME

QUESTION NUMBER 13 ANSWER IS: G; HYDROCEPHALUS

QUESTION NUMBER 14 ANSWER IS: L; MENIERE'S DISEASE

QUESTION NUMBER 15 ANSWER IS: H; A-V MALFORMATIONS

QUIZ THREE

Match neurological diagnostic procedures with the correct descriptions.

1. a  ------------  X-rays are done with the contrast medium into the intracranial vessels; to visualize aneurysms, tumors, or other vascular lesions.

                                                                                                         

                                                                                                   
 1. Echoencephalography

1.  b -------------- Contrast medium is injected into the sub-arachnoid space of the spinal canal to visualize a herniated disc, tumor, or other abnormality.

                                                                                                   
 2. Cerebral angiography

1. c  --------------- Air is injected through a lumbar puncture into the sub-arachnoid space and x-rays are taken to reveal the outline of the ventricular system and sub-arachonoid cisterns.

                                                                                                        
 3. Digitalized angiography

1. d --------------- A needle puncture is made into the sub-arachonoid space between third  and fourth or the fourth and fifth lumbar vertebrae performed for various reasons.

                                                                                            
4. Computerized axial tomography

1. e --------------- X-rays are taken after the cerebrospinal fluid is substituted with air to diagnose tumors.

                                                                                                      
 5. Electroencephalography

1. f ---------------- Electric impulses emitted by the brain cells are recorded by specialized equipment for detection of abnormalities in the central nervous system. The recording is made on special paper, results from the electrodes attached on the head of the patient.

                                                                                                                      
6. Myelography

1. g --------------- Ultrasonic waves are used to detect brain tumors, hematomas, swelling or abscesses.

                                                                                                                    
7. Lumbar puncture

1. h --------------- Cerebral angiography with the computer is used to digitize the x-rays to an image on the computer screen, creates clear image of the  vessel of the brain.

                                                                                                      
 8. Pneumoencephalography

1. i ----------------Produces multiple x-rays of the brain, spinal cord, or other areas of the body in cross section.

                                                                                                                 
9. Ventriculography

Enjoy taking this quiz and send your answers through the comment box.

My answers will be posted on the next blog.