Chapter 20 Neurosurgery


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Chapter 20  Neurosurgery



Complete chapter Questions And Answers

Sample Questions




1. What is the term for the bloodless plane that contains loose areolar tissue and permits mobility of the scalp?

  1. Pericranial plane
  2. Galea
  3. Subgaleal space
  4. Outer skull periosteum

The subgaleal space contains loose areolar tissue that permits mobility of the scalp. It is in this bloodless plane that the standard craniotomy scalp flap is created. The subcutaneous tissue, which is exceptionally dense, tough, and vascular, is firmly attached to the galea. Most of the blood vessels lie superficial to the galea. The pericranium, or outer periosteum of the skull, separates the galea from the cranium.

REF: Page 818

2. Identify the dura fold that separates the right and left cerebral hemispheres.

  1. Falx cerebri
  2. Tentorium cerebelli
  3. Falx cerebelli
  4. Tentorium cerebri

The dura mater is a tough, shiny, fibrous membrane that is close to the inner surface of the skull and folds to separate the cranial cavity into compartments. The largest fold is the falx cerebri—an arch-shaped, vertically placed, midline structure separating the right and left cerebral hemispheres.

REF: Page 820

3. An important area of the brain that is critical for learning and memory is the ___________, while emotion and social behavior are regulated by the ____________.

  1. parahippocampal gyri; limbic system
  2. amygdal; cingulate
  3. hypothalamus; septum
  4. hippocampus; amygdala


Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 20-2

The hippocampus is critical for learning and memory. The amygdala regulates the perceptive and expressive aspects of emotional and social behavior. The limbic system consists of large parts of the cortex near the medial wall of the cerebral hemisphere (cingulate and parahippocampal gyri) along with the hippocampus, amygdala, and septum. It is closely and significantly connected with the hypothalamus. The limbic system affects endocrine and autonomic functions of the body, recent memory, emotions, behaviors, and motivational and mood states.

REF: Page 824

4. The brainstem is located in the posterior fossa and forms the floor of the fourth ventricle. It is the site of many ascending and descending fiber tracts that allow for communication among the structures of the brain and between the brain and spinal cord. The brainstem consists of what three structures?

  1. Dura, epidura, and subdura
  2. Midbrain, pons, and medulla oblongata
  3. Mesencephalon, cephalon, and cerebrum
  4. Pons, medulla, and foramen magnum

The brainstem consists of the midbrain, pons, and medulla oblongata. The short, stocky portion of the brain between the cerebral hemispheres and pons is the midbrain, also referred to as the mesencephalon. The medulla oblongata is continuous with the spinal cord at the foramen magnum. It contains the vital cardiovascular and respiratory regulatory centers. Damage to the brainstem is often devastating and life-threatening, because it can affect movement, senses, consciousness, perception, and cognition.

REF: Pages 822-825 (Figures 20-7 and 20-9)

5. At each vertebral level is a pair of spinal nerves, each consisting of an anterior and a posterior root. Select the statement that represents true information about motor or sensory distribution.

  1. The posterior root is the sensory root.
  2. Skin dermatomes represent motor innervations.
  3. The anterior root is the sensory root.
  4. Spinal ganglia exit the spinal cord through the cauda equina.

The posterior, or sensory, root contains cell bodies that lie in the spinal ganglia located in the intervertebral foramina, the opening through which the nerves exit from the spinal canal and emerge from the cord. In the lumbar region, the course of the nerves is nearly vertical, forming the cauda equina. The normal segmental sensory distribution is valuable in the anatomic localization of sensory disorders. Dermatomes are bands of skin innervated by a sensory root of a single spinal nerve.

REF: Page 838

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 20-3

6. Twelve pairs of cranial nerves arise within the cranial cavity. Although they are part of the peripheral nervous system, from a surgical standpoint they are considered part of the anatomy of the head. Which three pairs of nerves, conveniently considered together because of their motor influence on the eye, are subject to toxic, inflammatory, vascular, and neoplastic lesions?

  1. Ninth, tenth, and eleventh cranial nerves
  2. Second, third, and fourth cranial nerves
  3. Third, fourth, and sixth cranial nerves
  4. First, second, and third cranial nerves

The third, fourth, and sixth cranial nerves are the oculomotor, trochlear, and abducens, respectively. They are conveniently considered together because they are the motor nerves to the muscles of the eyes. They are affected by many toxic, inflammatory, vascular, and neoplastic lesions. The third cranial nerve may be affected by aneurysms of the posterior communicating artery, and pressure against this nerve accounts for pupillary dilation when temporal lobe herniation, resulting from increased ICP, is present.

REF: Pages 833-834 (Figure 20-21)

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