Q&A Flashcards Part 2

Meniere's disease is treated by resection of which cranial nerve?

Vestibular portion of CN VIII

Condition due to incomplete closure of the spinal cord is called?

Spina Bifida

The inability to speak after stimulating Broca's area is known as?

Aphasia

Progressive CNS disease that affects myelin and causes weakness, vision loss, pain is called?

Multiple Sclerosis (MS)

What are other terms for stroke that can affect signals?

Cerebrovascular accident (CVA) and transient ischemic attacks (TIA)

SSEPs aren't reliable in patients with what type of disease?

Neuromuscular

Disease meaning 'fused joint' ?

Ankylosis

What body functions will be affected if the patient is diagnosed with apraxia?

Speech and motor

The ratio of an output voltage to an input voltage of the amplifier is known as

Gain

The reference input of the differential amplifier is also called:

Positive input, non-inverting input

Impedance is defined as:

Opposition to an alternating current

The active input of the differential amplifier is also called:

Negative input, inverting input

INPUT impedance should be

100 megaohms or higher

What is the minimum CMRR ?

10,000:1 or 80db

If an EP machine is sampling at 50,000 Hz what is the bin width of the signal?

40 microseconds

Minimum horizontal resolution for IONM?

20 microseconds per data point or less

Vertical resolution for ION machine depends on

Size of analong to digital converter

12bit vertical resolution (12-bit adc) will have how many data points?

4096

Isola spinal instrumentation consists of

Rods and hooks

Luque instrumentation consists of

Two flexible L-shaped rods and sablaminar waves

What is the wavelength in milliseconds of 60 Hz noise?

16.67 milliseconds

If you have 60 hz noise in an epoch of 200 milliseconds, how many spikes should you be able to count?

12

Machine used in the OR that suctions, washes and filters blood so it can be given back to the patient is called

Cell Saver

Why would you check impedance of ECoG?

Checking integrity

What is a disadvantage of synchronous stimulation?

Unable to verify unilateral change

Input voltage = 200v. Resistance = 10 Ohms. What is the current?

I = V/R. 200/10 = 20 amperes.

What is the ISI for 400hz stim?

2.5 milliseconds

The sound pressure is increased by what factor if we increase stimulation from 40db to 80db?

2

What is the period in milliseconds of a 250hz signal?

4ms

SNR is 2:1. Signal is 2uV and noise is 10 uV. How many averages do you need?

100

How can we avoid electrode polarization in the OR?

Use of the same electrode metals

What is CMR?

Cancellation of signals common to both amplifier inputs

Probable cause of noise if its in all channels?

Poor ground electrode

How many data points does an 8 bit filter have?

256

Distance from sterile field should be at least

12 inches

Most common source of airborne bacteria in the OR?

Deadskin particles from OR Staff

The most frequent source of patient infection in the OR?

Patient's own indogenous flora.

If you feel a shock from the equipment what is the first thing you should do?

Disconnect the patient from the equipment.

In a fire. R.A.C.E stands for:

Rescue, Alarm, Call, Extinguish

Patient privacy act is known as

HIPAA

Back of a surgeon's gown is non-sterile

True

What is the motor strip located?

Anterior of the central sulcus

A multi-pulse stimulation is optimal for activation of which structure to produce CMAP in distal muscles?

Alpha Motor Neurons

Direct activation of corticospinal tract produces what?

D waves

Indirect activation of corticospinal tract produces what?

I waves

Increasing stim intensity will effect d-wave by

Decreased latency

Excitation of D-wave can be caused by cooling of the gray matter

False

Part of the spine removed to place an epidural electrode is known as?

Lamina

What is a major risk of a wake up test?

Accidental extubation

Best muscle for TCMeps?

Abductor Hallucis Brevis

Best time to do wake up test during scoliosis surgery?

Distraction

Latency of D-wave in upper cervical spine is how fast?

3ms

D-wave responses are sensitive to anesthetic agents

False

I-wave responses are sensitive to anesthetic agents

True

MEPs are known as cathodal or anodal stimulation?

Anodal

Most likely cause of abnormalities in baseline EEG is

Stroke

Summation of positive and negative charges by cortical cells produce EEG are generated by what type of neuron?

Pyramidal cells

What intravenous anesthetic agents can cause burst suppression

Propofol, sodium thiopental

Which of the following is not part of the brainstem?

Cerebellum

Dilantin is used to treat what?

Seizures

Electrode impedance can be measured using what device?

Ohm meter

P300 is what type of an evoked response?

Event-related potentials (ERP)

What can cause a decrease in the power spectral edge?

More EEG power at lower frequencies

What are the recommended bandpass filter settings for EEG recording?

1 - 70 Hz

EEG equipment for routine recording should be at what sensitivity?

5-10 uv/mm

Sodium amytal is used for performing what type of testing?

WADA

Which artery is used during WADA testing?

ICA

During left CEA surgery, which cortical SSEP is at risk?

Right median nerve

Loss of BAER during MVD of CN VII may be result of

Compression of auditory nerve or blood supply

Which cranival nerve is sacrificed during the trans-labrynthine approach surgery?

CN VIII

Why is a cage placed?

To restore the height of the disk space

Pedicle screws are placed to perform what?

Spinal fixation

Bloodborne pathogens may cause which of the following diseases?

Hep B

Purpose of IONM during tethered cord surgery is to

Identify and resect filum terminale

Epidural electrode should be placed where?

Above the dura

A selective dorsal root rhizotomy is used for the treatment of

Spasticity and ideal for patients with spastic cerebral palsy.

When is the best time to set baselines?

Post induction, pre incision

EEG range of pen deflection (sensitivity) should be set at what?

5-10 uv/mm

Sodium amytal is used in what test?

Wada

What artery is used for the WADA test?

ICA

During a left CEA, the cortical SSEP at risk will be:

Right median nerve

Loss BAER during an MVD of CN VII may be result of:

Compression of nerve or compression of blood supply

What CN is sacrificed during translabryinthe approach?

Vestibulocochlear Nerve (CN VIII)

Interbody cage is placed to do what?

Restore the height of lost disc space.

Pedicle screws are placed to perform what procedure?

Spinal fixation

Bloodborne Pathogens may cause what type of disease?

Hep B

Purpose for IONM during tethered cord surgery?

Identification and resection of filum terminale

Epidural electrode should be placed where?

Above the dura

Selective dorsal root rhizotomy is used for treatment of;

Spasticity and is an ideal option for select patients with spastic CP

During continuous cautery what should you do doing surgery?

Pause the recording

True or False: TLIF is related to the lumbar region

True

ECoG is a high amp EEG from the cortex. It requires sensitivity in the range of:

10-200 uv/mm

Localization of the central sulcus is based on what observation?

Median nerve SSEP polarity from sensory and motor gyri is reversed

Cerebral cortex is mapped by:

Placed a cortical grid across the central sulcus

Pre-central somatosensory gyrus is localized by which peak?

Positive peak with latency around 22 ms.

Post-central somatosensory gyrus is localized by which peak?

Negative peak with latency around 20ms.

The _____ nerve should be stimulated to the _____ side of cortical mapping.

Median, Contralateral

SSEP during Cortical Mapping filter settings should be:

LF: 1-30

HF: 250-3000

Localization of cortex peformed by

Direct electrical cortical stimulation

Contralateral tonic movements can be elicited by electrical stimulation of the motor cortex at the rate of:

50-60Hz