Intraoperative Neurophysiological Monitoring (IONM) Practice Exam Flashcards

Vocabulary-style flashcards covering all 250 practice questions from the IONM exam review transcript, detailing exact terms, parameters, pathways, and clinical concepts.

Which of the following is least likely to cause electrical interference in the operating room? a. The operating table b. Blood warmers c. The bovie coagulator d. The pneumatic drill e. The operating microscope

The pneumatic drill

Which of the following most likely reflects sustained traction or compression of a nerve during EMG? a. Any spontaneous EMG response b. A “burst” of neural activity c. A “train” response d. A nonrepetitive asynchronous potential e. Varying EMG activity

A “train” response

During tibial nerve stimulation, a decreased nerve conduction velocity between the popliteal fossa and L3 potential, with normal NCV to the popliteal indicates: a. A lesion between the popliteal fossa and cauda equina b. That the extremity should be cooled and the study repeated c. A normal pathway d. A lesion between the ankle and popliteal fossa

A lesion between the popliteal fossa and cauda equina

“Prestimulus triggering”: a. Presents a positive signal to the averager prior to initiating the display b. Delays the synchronizing pulse to the computer c. Eliminates the problems associated with recording the stimulus artifact d. Includes a period of recording before the stimulus

Includes a period of recording before the stimulus

Which of the following can inhibit the postsynaptic neuron? a. Acetylcholine b. Gamma amino butyric acid c. Glutamate d. Para amino butyric acid

Gamma amino butyric acid

When blood supply to the brainstem is markedly reduced, an expected change in the BAEP would be: a. An increased amplitude of wave V b. An increased latency of wave V c. A decreased latency of wave V d. An increased latency of wave I

An increased latency of wave V

One effect of Ketamine on the somatosensory evoked potential is to: a. Decrease amplitudes b. Decrease latencies c. Increase latencies d. Increase amplitudes

Increase amplitudes

Severe Hypothermia: a. Has no effect on evoked potentials b. Decreases evoked potential latencies c. Increases evoked potential latencies d. Has a variable effect on evoked potential latencies

Increases evoked potential latencies

The posterior tibial nerve arises from which branch of the sciatic nerve? a. External popliteal b. Internal popliteal c. Superior peroneal d. Superior tibial

Superior tibial

With significant changes in cervical and cortical SSEPs during intraoperative monitoring, adequate stimulation of the median nerve is indicated by: a. A loss of the peripheral response b. No change in the peripheral responses c. A persistent thumb twitch d. Consistent anesthetic levels

No change in the peripheral responses

How many waves of a $60\,Hz$ signal should you see in a $100\,msec$ sweep? a. $6$ b. $20$ c. $4$ d. $12$

$$6$$

What is the minimum acceptable sweep for BAEPs? a. $15\,msec$ b. $35\,msec$ c. $5\,msec$ d. $25\,msec$

$$15\,msec$$

Delta activity in awake adults with eyes open is usually: a. Normal b. Normal only in the parietal-occipital area c. Abnormal d. Often found between the ages of 30-50

Abnormal

Which of the following potentials will reverse with click polarity? a. Cochlear microphonic b. Wave V c. CAP (cochlear action potential) d. Summating potential

Cochlear microphonic

When testing BAEPs you get a wave I on your contralateral ear montage. What do you do? a. Check ear inserts for proper side stimulation b. Don’t do anything c. Change polarity of click to condensation d. Increase click intensity

Check ear inserts for proper side stimulation

Which of the following will affect the facial nerve EMG? a. Isoflurane b. Fentanyl c. Pancuronium d. Methohexital

Pancuronium

A thoracic spinal fracture surgery should be monitored using: a. Ulnar nerve b. Median nerve c. Sural nerve d. Posterior tibial nerve

Posterior tibial nerve

One difference between PTN and Peroneal responses is that Peroneal: a. Has a shorter latency b. Has a larger amplitude response c. Is less affected by anesthesia d. Has a longer latency

Has a shorter latency

Myogenic motor monitoring with spinal cord stimulation is most susceptible to: a. Halothane b. Isoflurane c. Sufentanil d. Vecuronium

Vecuronium

Evoked potential systems should be safety tested every: a. Five years b. One year c. Two years d. Six months

Six months

What is the color code for Ground in an AC power line? a. White b. Red c. Black d. Green

Green

Which montage would you use to confirm a change in the Cz’-Fz cortical response to PTN Stimulation? a. Cs5-Fz b. Erb’s point c. Cpc-Cpi d. Popliteal fossa

Cpc-Cpi

What is the most critical thing to document? a. Patient hematocrit b. Blood pressure c. Urine output d. Important surgical events

Important surgical events

To record the afferent volley after posterior tibial nerve stimulation, an electrode should be placed on the: a. Erbs point b. T5 spine c. Mastoid d. Index finger

T5 spine

Which response depends most highly on the precision of electrode placement on the scalp? a. P14 of the MN SSEP b. LP of the PTN SSEP c. P37 of the PTN SSEP d. Wave V of the BAEP

P37 of the PTN SSEP

For the intraoperative recording of EEG, the impedance of a scalp electrode should range from: a. $1,000\text{ to }5,000\,\Omega$ b. $500\text{ to }1,000\,\Omega$ c. $5,000\text{ to }10,000\,\Omega$ d. $250\text{ to }500\,\Omega$

$$1,000\text{ to }5,000\,\Omega$$

To optimally monitor cranial nerve VIII function in the operating room, it is desirable to be able to simultaneously perform: a. BAEPs and EEG b. BAEPs and SSEPs c. Median SSEPs and CMAPs d. BAEPs and electrocochleograms (ECochG)

BAEPs and electrocochleograms (ECochG)

When at the state of surgical anesthesia, the principal effect of Etomidate on evoked potentials is to: a. Increase amplitudes b. Decrease absolute latencies c. Increase latencies d. Decrease amplitudes

Increase amplitudes

Following the final application of corrective forces to the spinal column, the spinal cord should typically be monitored for at least: a. $30\,minutes$ b. $10\,minutes$ c. $5\,minutes$ d. $20\,minutes$

$$30\,minutes$$

If all channels are showing excessive $60\,Hz$ noise, what should you do? a. Reboot the machine b. Use a $60\,Hz$ notch filter c. Move your machine as far

Assist in identifying asymmetries or focal abnormalities