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Central Nervous System CNS

brain and spinal cord

Peripheral Nervous System PNS

12 cranial, 31 spinal nerves, divided into somatic, autonomic, and enteric nervous system

Somatic nerve

sensory or motor nerve

Autonomic nervous system

divided into sympathetic (responds to stress) and parasympathetic (constricts pupils, slows heartbeat dilates blood vessels, stimulates digestion)

Enteric nervous system

manages digestion; not under conscious control

Cerebrum

largest part of brain

Cerebral hemispheres

paired halves of the cerebrum, each hemisphere is divided into 4 major lobes, frontal, parietal, occipital, temporal

Cerebellum

posterior part of the brain that coordinates the voluntary muscle movements and maintains balance

Cerebral cortex

outer region of the cerebrum (gray matter)

Fissure

groove in the surface of the cerebral cortex

Medulla oblongata

part of the brain located just above the spinal cord that controls breathing, heartbeat and blood vessel size

Ventricles

reservoirs in the interior of the brain filled with cerebrospinal fluid

Spinal cord

column of nerve tissue extending from medulla oblongata to 2nd lumbar vertebra

cauda equina

located at end of spinal cord, (group of nerve fibers below 2nd lumbar vertebra) carries all the nerves that affect the lower part and limbs and serves as the pathway for impulses going to and from brain

Meniges

consists of 3 layers of connective membranes that surround the brain and spinal cord
1st outermost- dura mater
2nd layer- arachnoid membrane
3rd layer- pia mater

Neurological diseases of meninges

congenital, degenerative (movement and seizure), infectious, neoplastic, traumatic, vascular

Ventrical puncture

puncture through the top portion of skull

Cisternal puncture

approach at the base of the skull

Cranium

that part of the skeleton that encloses the brain

Skull

entire skeletal framework of the head

Stereotaxis

a method of identifying a specific area or point in the brain

Laminectomy

surgical excision of the lamina

Sympathetic nerve

part of the peripheral nervous sytem that controls automatic body function; activate under stress

Shunt

divert or make an artifical passage

Puncture, Twists, or Burr Holes

deal with conditions that may require holes or openings be made into the brain to relieve pressure, insertion of monitoring devices, placement of tubing, injection of contrast material, or to drain a hemorrhage

Craniectomy/ Craniotomy

procedures that deal with incision into the skull with possible removal of a portion of the skull to open the operative site to the surgeon. Based on site and condition, many procedures are bundled. Additional grafting is reported seperately

Skull Base

area at base of cranium where the lobes of the brain rest. Procedures are divided on approach, definitive and reconstruction/ repair procedure

Aneurysm, Arteriovenous Malformation, or Vascular Disease

arteriovenous malformation is a condition in which the arteries and veins are not in the correct anatomical position, usually congenital. codes are divided on the basis of approach and method

Cerebrospinal Fluid Shunts CSF

drainage device, category describes all the various types of shunting procedures including placement and subsequent repair, replacement, and removal.

Spine and Spinal Cord

includes codes for injections, laminectomies, excisions, repairs, and shunting, based on condition and approach

lumbar puncture

spinal tap obtains cerebrospinal fluid by insertion of a needle into the subarachnoid space in the lumbar region

neurolytic agent

chemical denervation (alcohol or glycerol injection) radiofrequency (passes a current through an electrode) cryogenic surgery (inserting a probe into tissue with fluoroscopy guidance and freezing a region of tissue)

Extracranial Nerves, Peripheral Nerves, and Autonomic Nerves

common procedure: injection, destruction, decompression, and suture/repair. code assigned according to type of nerve being injected for nerve block introduction/injection of anesthetic agent

Trigeminal nerve

5th cranial nerve, sensory nerve that supplies the face, teeth, mouth and nasal cavity, and motor nerve that supplies the muscles of mastication (chewing)

Facial nerve

7th cranial nerve, consists of large motor root (supplies muscles of facial expression) and smaller root (nervus intermendius) that contains the sensory and parasympathetic fibers of the facial nerve

Greater occipital nerve

spinal nerve orginating from the cervical spinal nerve C2, supplies stimuli to the scalp, over the ears, and the parotid gland

Vagus nerve

10th cranial nerve, supplies sensory fibers to the ear, tongue, pharynx, and larynx and motor fibers to the pharnx, larynx, and esophagus

Phrenic nerve

affects the pleura, pericardium, diaphragm, peritoneum, and sympathetic plexus

Cervical plexus

plexus in the posterior cervical region that is formed by the dorsal rami of the first three or four cervical spinal nerves

Axillary nerve

originates from the brachial plexus at th axilla (armpit) sensory information from the shoulder joint and the inferior region of the deltoid muscle

Suprascapular nerve

orgin in the brachial plexus at the C5-C6 level that descends through suprascapular and spineiglenoid notches and supplies acromioclavicular and shoulder joints and supraspinatus muscles

Pudendal

orginates in the sacral plexus at the S2-S4 and sometimes S5, divides into the perineal nerve and the dorsal nerve of the penis distributed to the muscles, skin, and erectile tissue of perineum

Neuroplasty

decompression (freeing) of intact nerves, most common procedure is carpal tunnel release (median nerve and the transverse carpal ligament of the wrist are surgically released

Thyroid Gland

Composed of a right and left lobe on either side of the trachea; secretes 80% T4 and 20% T3

Parathyroid Glands

Four small oval bodies located on the dorsal aspect of the thyroid gland

Adrenal Glands

Two small glands situated one on top of each kidney (suprarenal)

Thymus Gland

Located behind the breast bone, head of the organ is attached to the duodenum

Carotid Body

Tissue rich in capillaries that act as receptors located near the bifurcation of the carotid arteries

Endocrine

Ductless glands; secrete hormones directly into the bloodstream

Exocrine

Send their chemical substances into ducts and then out of the body; sweat, mammary, mucous, salivary and lacrimal

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