Exam 20: Neurosurgery

Select the name of the procedure for which this patient is positioned.

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?

Jordan Gribbins,a 69-year-old pipe smoker with a history of cardiac disease and atrial rhythm disturbance,is scheduled for a supratentorial craniotomy and is securely positioned in a semisitting position.The perioperative nurse and anesthesia provider have discussed the anesthesia plan and Mr.Gribbin's surgical and anesthesia risks,and agree that he is at risk for venous air embolism (VAE).Sequential compression devices have been placed on both legs.Pulmonary lines have been placed and the nurse has prepared an area for preparation of TEE (transesophageal electrocardiography),if needed.During the procedure,Mr.Gribbins reacted with decreases in arterial pressure and end-tidal CO₂.Precordial "washing machine" sounds emanated from the Doppler.What should the perioperative nurse anticipate as a possible next response?