Question 1

A spinal cord stimulator (SCS)is an implantable,nondestructive medical device used to treat chronic,intractable pain of the trunk and limbs.The device generates an electrical impulse to the epidural space.The goal of stimulation is to:

Accepted Answer

A spinal cord stimulator (SCS)is an implantable,nondestructive medical device used to treat chronic intractable pain of the trunk and limbs.The device generates an electrical impulse to the epidural space,which produces a tingling sensation that masks the perception of pain.The goal of the stimulation is to lower the perception of pain,reduce medication use,increase function,and improve quality of life.

Question 2

The perioperative circulating nurse has prepared the OR for a craniotomy for tumor excision and has assembled the primary bed base attachments for the head fixation positioning system.She has verified with the surgeon and anesthesia provider that the bed attachment is properly secured before the start of patient positioning and is prepared for positioning and securing the patient's head with the skull clamp.After the skull pins are secured,the nurse will step back to view the head placement and symmetry,ensuring that:

Accepted Answer

When properly placed,the pins in the rocker arm are equidistant from the centerline of the patient's head and the single pin in the extension arm is exactly at the centerline.The pins are at an angle of 90 degrees,the necessary pounds of clamping force are applied,and the rocker arm is in the "CLOSED" position.Only properly trained OR staff should be permitted to operate these devices.The nurse must verify that the bed attachment is properly secured before the start of patient positioning.Once the anesthesia provider has determined that the patient is ready for positioning,the designated member of the OR team will pin the patient's head with the skull clamp.Improper positioning of the skull pins may cause serious injury to the patient.Special attention should be paid to avoiding the areas of the frontal sinus,temporal fossa,blood vessels,and nerves.

Question 3

A 29-year-old man is admitted through the ambulatory surgery center for a microdiskectomy,one of several spinal surgeries performed to relieve pain caused by disk herniations.Select the appropriate criteria required for a patient to be considered a candidate for microdiskectomy as an ambulatory procedure.

Accepted Answer

Microdiskectomies have the flexibility of being performed either in an ambulatory surgery center or in a hospital OR suite.Ambulatory surgeries are designed for patients who have a nominal health history and pose minimal risk for operative complications.Patients selected for microdiskectomies typically complain of leg pain longer than 6 weeks in duration,and receive minimal relief from prescribed pain medications.An MRI scan confirming the level of nerve root compression as well as a detailed history and physical will determine if the patient is a candidate for surgery.The procedure is typically performed using a general or spinal anesthetic,depending on the needs of the patient.After the anesthesia provider has control of the airway,the patient is positioned prone for maximum operative accessibility.

Quiz 21: Neurosurgery

A spinal cord stimulator (SCS) is an implantable,nondestructive medical device used to treat chronic,intractable pain of the trunk and limbs.The device generates an electrical impulse to the epidural space.The goal of stimulation is to: