Superior And Posterior Spread

A. Protrusion of the disk material may impinge on nerve roots that exit through intervertebral foramina.

Imagine a football player is tackled and hits the back of his head. As a result, his brain has hit the back of the cranium, then the front.

Chordomas are cancerous tumors that occur anywhere on the spine. They grow slowly and can metastasize to other areas of the body. Other names for this disorder include CHDM, chordocarcinoma, chordoepithelioma, notochordal sarcoma, and notochordoma. Chordomas are rare and most often occur in people ages 40 to 70. Males are affected twice as often as females. About half of all chordoma cases appear at the base of the spine, while about a third occur at the base of the skull, and the rest appear in the kneck, upper back, or lower back vertebrae of the spine. Chordomas in the spine can cause the back, arms, or legs of the affected individual to feal weak or numb. Chordomas occurring at the base of the skull can cause double vision or headaches. Chordomas on the tailbone result in a large lump and can affect the function of the bladder or bowel..

Label the Mid Sagittal View of the brain below using the table from the Procedures.

The nasal septum divides the medially into the right and left portion. The nasal septum separates the cranial cavity by the cribriform plate of the ethmoid bone and by the oral cavity by the hand palate. Passageways called the superior, middle and inferior meatuses are the nasal conchae or turbinate bone that curl out from the lateral walls of the nasal cavity on each side. Nasal conchae support the mucous membranes that line the nasal cavity that help increase the surface area. The upper posterior portion of the nasal cavity is slit like and lines and contains the factory receptors that give use the sense of smell. The rest of the cavity conducts air to and from the nasopharynx.

Remove the dorsal portion of the carapace to observe other organs in the head and thorax.

Patients with a tumor that has spread to the spinal bones possibly will build up nerve damage that can lead to paralysis or loss of the use of the legs and/or arms (Fischer and Quinn, 2011).

American Cancer Society says, “The term neuro refers to nerves, while blastoma refers to a cancer that affects immature or developing cells.” It is usually found in the small glands on top of the kidneys. The glands are called adrenal glands. Places where it can develop are the belly, chest, neck, pelvis, and bones. Possible symptoms can include fatigue (a feeling of tiredness or exhaustion or a need to rest because of lack of energy or strength), loss of appetite, and fever. Mayo Clinic says, “There may be a lump or compression of tissues in the affected area.” Treatments for the cancer include surgery or chemotherapy. For smaller tumors that have not spread, surgery is usually the only treatment needed. American Cancer Society, “If the tumor is in the abdomen (belly), the surgeon may do the biopsy with the aid of a laparoscope. This is a long, thin tube with a tiny video camera on the end. It is put into the abdomen through a small incision to allow the surgeon to see inside. The surgeon then makes a second small incision to reach inside the abdomen with long, thin instruments and remove pieces of tumor.” Alex’s original tumor of Neuroblastoma was in her adrenal gland. They did a similar process to Alex for the surgery, except for that they had to make an incision near the kidney to remove the tumor from her

Chordomas are considered rare neoplasms with an incidence of 0.08/100 000.(1) chordomas arise from remnant notochord cells found mainly within the clivus and sacrococcygeal regions . But also, can be found at any site along the vertebral column (2). The presentation of clival chordomas tend to be late, associated neurological impairment due to involvement of the lower cranial nerves (3). Clival chordomas are also challenging to treat due to their site , anterior to the brainstem, and their aggressive locally invasive nature (4,5) and they are radioresistant lesions . clival chordomas have relatively poor survival of 0.9 years without treatment (6). Extended open skull base approaches to the clival region are traditionally the mainstay for achieving gross total resection in chordoma. Extended subfrontal transbasal, anterior transfacial, and lateral transtemporal or far-lateral approaches have been described, as well as staged surgical approaches. (7-9) . These approaches to the anterior midline skull base often require extensive removal of skull base bone and brain retraction, and they put critical neurovascular structures between the operating surgeon and the pathology. With the advent and incorporation of the rigid endoscope into neurosurgical practice and the active collaboration between ENT surgeons and neurosurgeons, extended endonasal endoscopic approaches have become well-accepted, minimally invasive routes to the midline and paramedian skull base. The endoscopic

and near the base of the skull. The nasopharynx is the upper part of the throat, the pharynx,

Extradural, subdural, and subarachnoid hemorrhages are best understood by reviewing the anatomy of the meninges. The meninges are divided into three layers: the dura mater, arachnoid layer, and pia mater. The dura mater lines the inner surfaces of the skull and forms partial divisions in the cortex of the brain. The dura mater is attached to the skull, particularly at the cranial sutures of the bones that make up the skull. In infants and small children this attachment has not yet taken place. The space between the skull and the dura mater is the extradural space. A hemorrhage into this space is referred to as an extradural hemorrhage. These hemorrhages are usually the result of a tear in a meningeal artery.

A Pancoast tumor is a carcinoma in the apex of the lung that involves the brachial plexus, subclavian, sympathetic chain, upper ribs, or vertebral body.1 Involvement of these structures causes pain or tingling in the arm, and possible paralysis. A Pancoast tumor is most commonly a non-small cell lung carcinoma. 2 In the case where the tumor involves the sympathetic pathway leading to the eye, the patient can present with constriction of the pupil (miosis), drooping of the eyelid (ptosis), and diminished sweating (anhydrosis).3 These symptoms will present on the ipsilateral side of the face as the tumor. Interestingly, although Horner’s syndrome suggests there is more invasion, there is no correlation to prognosis.4 In treatment of a Pancoast

Cystic retrochiasmatic craniopharyngiomas may reach enormous size by expanding into the posterior fossa along the retroclival area, which is very unusual finding. A 5-year-old boy presented with headache for 2 month. On the neurological examination, it was normal. Initial magnetic resonance (MR) images revealed a huge, thin-capsuled multi-cystic mass, which extended around brain stem & extending bilaterally along the base of the middle and posterior cranial fossa. Subtotal excision of the cystic wall was done followed by applying of a catheter within the cyst attached to a reservoir with a favorable outcome.

For AP-PA fields the lateral borders extended to cover pelvic sidewalls, i.e. 1.5 cm outside pelvic inlet. The superior border was at the L5-S1 inter-vertebral space, and the lower border was kept at 3-5 cm below tumor volume. Anterior border of lateral fields was 3-5 cm anterior to sacral promontory and posterior border was behind bony sacrum to cover presacral tissues. All ethical issues

Look at the photo of a Pacinian corpuscle. Notice the onion-like bulb of connective tissue. Describe briefly —