Docsity
Docsity
Prepare for your exams
Prepare for your exams

Study with the several resources on Docsity

Earn points to download
Earn points to download

Earn points by helping other students or get them with a premium plan

Guidelines and tips
Guidelines and tips
Sell on Docsity
Sell on Docsity
Docsity AI
Docsity AI
Log inSign up

Prepare for your exams

Study with the several resources on Docsity

Find documents

Prepare for your exams with the study notes shared by other students like you on Docsity

Search for your university

Find the specific documents for your university's exams

Docsity AINEW

Summarize your documents, ask them questions, convert them into quizzes and concept maps

Explore questions

Clear up your doubts by reading the answers to questions asked by your fellow students

Earn points to download

Earn points by helping other students or get them with a premium plan

Share documents
download point icon20 Points

For each uploaded document

Answer questions
download point icon5 Points

For each given answer (max 1 per day)

All the ways to get free points
Get points immediately

Choose a premium plan with all the points you need

Study Opportunities

Choose your next study program

Get in touch with the best universities in the world. Search through thousands of universities and official partners

Community

Ask the community

Ask the community for help and clear up your study doubts

Free resources

Our save-the-student-ebooks!

Download our free guides on studying techniques, anxiety management strategies, and thesis advice from Docsity tutors

Central Nervous System: Anatomy, Physiology, and Diagnostic Procedures, Lab Reports of Anatomy

Ateneo de Davao University (ADDU)Anatomy

about the CNS and its branches

Typology: Lab Reports

2020/2021

Uploaded on 02/02/2023

Omsimmm
Omsimmm 🇵🇭

46 documents

1 / 15

Toggle sidebar

This page cannot be seen from the preview

Don't miss anything!

bg1
CENTRAL NERVOUS SYSTEM
- the central nervous system (CNS) is divided into two parts: (1) the brain, which
occupies the cranial cavity, and (2) the spinal cord, which is suspended within the vertebral
canal.
Brain
Spinal Cord
Meninges
Ventricular System
RADIOGRAPHIC PROCEDURES
A. VENTRICUGRAPHY/ PNEUMOGRAPHY- is an interconnected series of cavities filled
with cerebrospinal fluid (CSF) that cushions the brain. Though the presence of cerebral
ventricles was known since ancient times, its function was obscure.
i. Anatomy and Physiology
Cerebrospinal fluid (CSF, shown in blue) is made by
tissue that lines the ventricles (hollow spaces) in the
brain. It flows in and around the brain and spinal cord
to help cushion them from injury and provide
nutrients.
Right and left lateral ventricles - are situated one on
each side of the midsagittal plane, in the inferior
medial part of the corresponding hemisphere of the
cerebrum.
Body of the cavity - central portion in each lateral
ventricle.
Interventricular foramen or foramen of Monroe -
communicates directly with the third ventricle and indirectly with the opposite
lateral ventricle.
Third ventricle - is a slit-like cavity with a somewhat quadrilateral shape. This
cavity extends antero-inferiorly from the pineal gland, which produces a recess in
its posterior wall, to the optic chiasm, which produces a recess in its anteroinferior
wall.
Cerebral aqueduct or aqueduct of Sylvius - the structure within the brainstem
that connects the third ventricle to the fourth.
Fourth ventricle - is diamond shaped and is in the area of the hindbrain.
Cerebrospinal fluid exits the fourth ventricle into the subarachnoid space via the
median aperture (foramen of Magendie) and the lateral apertures (foramen
Lushka).
pf3
pf4
pf5
pf8
pf9
pfa
pfd
pfe
pff

Partial preview of the text

Download Central Nervous System: Anatomy, Physiology, and Diagnostic Procedures and more Lab Reports Anatomy in PDF only on Docsity!

CENTRAL NERVOUS SYSTEM

  • the central nervous system (CNS) is divided into two parts: (1) the brain , which occupies the cranial cavity, and (2) the spinal cord , which is suspended within the vertebral canal.  BrainSpinal CordMeningesVentricular System RADIOGRAPHIC PROCEDURES A. VENTRICUGRAPHY/ PNEUMOGRAPHY- is an interconnected series of cavities filled with cerebrospinal fluid (CSF) that cushions the brain. Though the presence of cerebral ventricles was known since ancient times, its function was obscure. i. Anatomy and PhysiologyCerebrospinal fluid (CSF, shown in blue) is made by tissue that lines the ventricles (hollow spaces) in the brain. It flows in and around the brain and spinal cord to help cushion them from injury and provide nutrients.  Right and left lateral ventricles - are situated one on each side of the midsagittal plane, in the inferior medial part of the corresponding hemisphere of the cerebrum.  Body of the cavity - central portion in each lateral ventricle.  Interventricular foramen or foramen of Monroe - communicates directly with the third ventricle and indirectly with the opposite lateral ventricle.  Third ventricle - is a slit-like cavity with a somewhat quadrilateral shape. This cavity extends antero-inferiorly from the pineal gland, which produces a recess in its posterior wall, to the optic chiasm, which produces a recess in its anteroinferior wall.  Cerebral aqueduct or aqueduct of Sylvius - the structure within the brainstem that connects the third ventricle to the fourth.  Fourth ventricle - is diamond shaped and is in the area of the hindbrain. Cerebrospinal fluid exits the fourth ventricle into the subarachnoid space via the median aperture (foramen of Magendie) and the lateral apertures (foramen Lushka).

ii. Preparation  Do not eat or drink after midnight.  IV line is inserted into the arm and sedative medication is given through the line to make the patient relax. Procedure

  1. The patient is placed in the sitting position resting his head and chin on a suitable support.
  2. Antiseptic solution is applied to the skin of the skull.
  3. Local anesthesia is given on the examination site.
  4. Two openings are made above the occipital bone with the help of Trephine.
  5. The cannula is inserted into the opening and advanced into the ventricle cavity.
  6. A manometer is used to measure intracranial pressure.
  7. Then the CSF is drained slowly from the lateral ventricles.
  8. After draining CSF, contrast media is advanced in the same amount of drained CSF.
  9. After the injection of contrast media, the cannula is removed then the scalp is sutured, and applying dressing at the drilled site.

B. PNEUMOENCEPHALOGRAPHY

 Abbreviated as PEG; sometimes called an “ air study ”  An old invasive technique that involved the draining of the majority of the cerebrospinal fluid (CSF) from around the brain through a lumbar puncture.  Technique of diagnostic radiology that produces X-ray films of the head after injection of air or gas between the membranes lining the brain and spinal cord to sharpen the outlines of various brain structures.  An intraspinal injection of air into the subarachnoid space, which replaced some cerebrospinal fluid (CSF) and provided tissue contrast, leading to a better diagnostic outline of intracranial lesions.  Is a radiological examination of brain to demonstrate meninges space between meninges and ventricular system by introducing the radiological contrast media into the central canal of spinal cord by lumbar puncture. i. Anatomy and Physiology

BRAIN (MENINGES)

 Brain and spinal cord are covered with three tissue layer.  In brain they are found between the skull and the brain.  In spinal cord these layers are found between the spinal cord and vertebral foramen.  These three layers are named from outside to inside.  Dura Mater – outermost covering of the brain.

  • contains a drainage system, called the dural venous sinuses, which allows blood to leave your brain and allows cerebrospinal fluid to re- enter the circulation.  Arachnoid Mater – middle layer of meninges.
  • houses the arachnoid space created by the crisscrossing fibers called arachnoid trabeculae which connect the layer to the pia mater while creating a passageway.  Pia Mater – inner most layer.
  • contains denticulate ligaments for the thickening of the pia mater and protect spinal cord against sudden displacement. ii. PathologySPACE OCCUPYING LESION - are pathological structures that have a recognizable volume and that can affect nearby structures.
  • Such lesions can form a mass or deformities at the level of the organs of the abdominal cavity that can be tumor and non-tumor.  SUBDURAL HEMORRHAGE – Such lesions can form a mass or deformities at the level of the organs of the abdominal cavity that can be tumor and non-tumor.  EXTRADURAL HEMORRHAGE - a type of head injury involving bleeding into the space between the skull and the dura mater.  MENINGITIS - an inflammation of the protective membranes covering the brain and spinal cord.  INTRACRANIAL PRESSURE - is the pressure inside the skull, which is reflected by the pressure of the cerebrospinal fluid. iii. Patient Preparation
  1. Patient should be nill by mouth at least five hours prior to the examination.
  2. The part from where contrast media planned to be injected should be shaved and cleaned properly for surgical preparation.
  3. An iodine solution scrubbing can be performed to prevent any procedure infection.
  4. Routine test and sensitivity test can be performed.
  5. Any radio opaque objects around the skull and lumbar should be removed.
  6. Inform the patient all about the procedure and obtain the patients consent.
  7. A local anesthesia of lignocaine should be injected around the planned puncture site.
  8. An I.V. sedative also can be given if it is needed. iv. Contrast Media Both positive and negative contrast media can be used.  IOHEXOL – for positive contrast media.
  1. For every 10 to 12ml of CSF withdrawal, 45ml of water-soluble contrast media needs to be injected.
  2. And in the case of pneumoencephalography, for every 10 ml of CSF withdrawal an equal amount (10ml) of air should be injected.
  3. Now appropriate radiographs of spinal canal in AP and lateral position can be performed.
  4. Complication (The procedure is extremely painful, severe headache, vomiting and fever). AFTERCARE o After lumbar puncture, spinal needle should be removed, and site should be covered with bandages. o A little amount of blood injects into the puncture site (take form the arm of the patient) to compensate for the CSF loss. o Ask the patient for any discomfort, if there are so, then the vital signs of the patient can be measured, and patient can be shifted in the respected word. o Tell the patient to take enough rest and lie down in the supine position for a little longer. C. MYELOGRAPHY / RADICULOGRAPHY  Greek word myelos means marrow;the spinal cord  to radiologic examination of the central nervous system (CNS) situated within the vertebral canal.  performed by introducing a nonionic, water-soluble contrast medium into the subarachnoid space by spinal puncture, most at the L2-3 or L3-4 interspace or at the cisterna magna between C1 and occipital bone. Figure 1. A needle is placed in the subarachnoid space to inject the contrast dye.

Figure 2. The contrast dye makes the spinal canal clearly visible on an x-ray (left). Stenosis and scoliosis can be seen compressing the spinal nerves on the CT scan (right)  employed to show extrinsic spinal cord compression caused by a herniated disk, bone fragments, or tumors and spinal cord swelling resulting from traumatic injury.  It is useful in identifying narrowing of the subarachnoid space by evaluating the dynamic flow patterns of the cerebrospinal fluid (CSF) i. Anatomy and Physiology SPINAL CORD  long, cylindrical structure that connects your brain and lower back.  It contains tissues, fluids and nerve cells  helps carry electrical nerve signals throughout your body.  18 inches (45 centimeters) long. THREE PARTS:

  1. CERVICAL (neck)
  2. THORACIC (chest)
  3. LUMBAR (lower back) ii. PathologyHerniated disks. These are disks that bulge and press on nerves or the spinal cord.  Spinal cord tumors. an abnormal growth of cells within or surrounding your spinal cord and/or spinal column.  Spinal stenosis. This is a breakdown and swelling of the bones and tissues around the spinal cord. This breakdown makes the canal narrow.  Bone spurs or osteophyte. bony growths that form in your joints or in the spine  Arthritic disks. Osteoarthritis in the spine most commonly occurs in the neck and lower back.  Cysts. These are noncancerous (benign) capsules that may be filled with fluid or solid matter.
  1. Drink lots of fluids for 18 hours, at least 8 ounces every 2 hours while awake. If possible, drink caffeinated beverages, which create a diuretic effect, causing increased urination and thus eliminating the dye used during the myelogram.
  2. If your headache, nausea, or vomiting persists after 48 hours of bed rest, call your doctor.
  3. In general, you can resume normal activities the next day. iv. Contrast Media Nonionic water soluble  Metrizamide  Iopamidol (isovue)  Iohexol (omnipque) v. Position and ProjectionLateral Scout Projection Patient position:  prone position Position of part:  the patient adjusted in lateral position, however, with the spine flexed to widen the interspinous spaces for easier introduction of the needle  approximately 9 to12 mL of nonionic contrast medium is slowly injected  Travel of the contrast medium column is observed and controlled fluoroscopically.  Spot images are taken throughout the procedure.  The radiographer obtains images at the level of any blockage or distortion in the outline of the contrast column. Structure shown:  Shows dentate ligament and posterior nerve roots  Conus Projection Image Receptor: 10 x 12 inch (24 x 30 cm) Patient position:  The patient is placed in AP Position Position of part:

 The position of the patient's head must be guarded as the contrast column nears the cervical area to prevent the medium from passing into the cerebral ventricles. Central Ray:  Centered to T12-L AFTERCARE:  After completion of the procedure the patient must be monitored in an appropriate recovery area.  Most physicians recommend that the patient's head and shoulders be elevated 30 to 45 degrees during recovery.  Bed rest for several hours is recommended, and fluids are encouraged.  The puncture site must be examined before the patient is released from the recovery area. D. DISKOGRAPHY/ NUCLEOGRAPHY- are terms used to denote the radiographic examination of individual intervertebral disks by means of injecting a small amount of contrast media into the center of the disk by way of double needle entry. a. Cervical Diskography - procedure used to diagnose which tissue is causing someone’s neck pain. b. Lumbar Diskography - radiology examination which makes it possible to study the structure of one or more intervertebral discs of the lumbar spine suspected of causing chronic low back pain. i. Anatomy and PhysiologyVertebra - series of small bones forming the backbone, having several projections for articulation and muscle attachment, and a hole through which the spinal cord passes.

  1. Patient must stop taking aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) or blood thinners before your procedure.
  2. Will be given a gown to wear during the procedure.
  3. Women should always tell their doctor and technologist if they are pregnant. PROCEDURE
  4. A technologist will insert an intravenous (IV) line into a vein in patient`s hand or arm so that sedative medication can be given intravenously. The patient must be awake during the procedure to communicate any of the symptoms that might be experienced during the test.
  5. The area of the body where the IV is to be inserted will be shaved, sterilized and covered with a surgical drape. Hair at or near the site of the discography procedure will also be shaved.
  6. The technologist may connect the patient to monitors that track the heart rate, blood pressure, oxygen level, and pulse of the patient.
  7. The technologist will numb the area with a local anesthetic. This may briefly burn or sting before the area becomes numb.
  8. Guided by real-time x-ray images (fluoroscopy), the technologist will insert a needle to the outer layer of the suspected disc, next, the second needle is moved and guided to the center of the disc. After the second needle is impositioned, contrast dye injected, and the needle is removed. If more than one disc is suspected, the process is repeated.
  9. The patient may be asked to describe the pain in terms of location, distribution and severity. If the injected disc is the source of back pain, one may feel pain like what is experienced on a day-to-day basis.
  10. If the dye stays in the center of the disk, the disk is normal. If the dye spreads outside the center of the disk, it may indicate that there are fissures in the outer ring of the disc.
  1. After the injections are complete, an x-ray is performed to show where the contrast dye has spread. The pattern of the dye within the disc can help identify if the disc is abnormal.
  2. Once it shows abnormality, a CT scan may be used to show more detail about the extent of the rupture or tear pattern, as well as the size and shape of the disc. AFTERCARE
  3. The patient will remain in the procedure room for approximately 30 to 60 minutes for observation.
  4. After that, the patient will be able to go home, but need someone to drive him/her.
  5. It is normal to have some pain at the injection site or in the low back for several hours after the procedure. Applying an ice pack to the area for 20 minutes at a time might help. The patient will need to keep his/her back dry for 24 hours.
  6. If one develops severe back pain or a fever one to two weeks after the procedure, call the doctor right away.
  7. The doctor will discuss the results and options for future treatment after the patient receives the diagnosis. iv. Materials  Intravenous Line (IV)  Ultrasound Machine  Heartbeat and blood pressure monitors  Radiographic Table  1-2 X-ray Tubes  Video monitor  Double spinal puncture needle (outer bore 20 gauge, and fine (26-gauge needle). v. Contrast Media  Water-soluble iodinated compounds vi. Position/Projection