Term
| What does the hypothalamus do to stimulate the pituitary gland to release hormones? |
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Definition
| The hypothalamus releases a neurosecretory substance to stimulate it. |
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Term
| What connects the pituitary gland to the hypothalamus? |
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Definition
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Term
| What is often the cause of overproduction of the specific pituitary hormones? |
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Definition
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Term
| What type of tumors are the most common of the pituitary? |
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Definition
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Term
| What are the two surgical treatments for pituitary tumors? |
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Definition
Craniotomy: indicated for large tumors pressing on the optic nerve.
Trannsphenoidal resection indicated for smaller tumors. |
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Term
| What are the advantages of the transphenoidal approach? |
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Definition
| Cranium is not opened, so recovery is shorter. Pain is less. |
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Term
| What are the preoperative diagnostic tests for a trannsphenoidal hypophysectomy? |
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Definition
| MRI and an Endocrine function test. |
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Term
| Where is the sella turcica located? |
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Definition
| Inside the sphenoid bone. |
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Term
| Why is it important to know where the sella turcica is located? |
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Definition
| Because the pituitary is located within the sella turcia, which is located within the sphenoid bone. |
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Term
| Why does the surgeon inject lidocaine with epinephrine into the nasal mucosa? |
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Definition
| For hemostasis. May also apply cocaine for the same reason. |
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Term
| How is the sella turcica approached? |
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Definition
| Through the sphenoid sinus either through the upper gum or through the nasal cavity. |
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Term
| Besides a neurosurgeon what other surgeon might be working on the case? |
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Definition
| An ENT surgeon and neurosurgeon may be working on this case. Have both instruments opened. |
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Term
| What special instrument is designed for this procedure and what does it do? |
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Definition
| Special bivalved speculum, it is used to view the floor of the sella turcica after the floor of the sphenoid sinus is removed. |
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Term
| Why do you need two mayo stands for this procedure? |
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Definition
| All nasal/oral instruments are considered contaminated and need to be isolated on a separate mayo stand. |
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Term
| What type of graft is taken and where from? |
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Definition
| A facial graft is taken from the thigh while the pituitary is being exposed. |
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