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XII Hypoglossal - what muscle is used for EMG monitoring?
Tongue
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X Vagus - what muscle is used for EMG monitoring?
Crycothyroid
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IX Glossopharyngeal - what muscle is used for EMG monitoring?
Stylopharyngeus
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VII Facial - what muscle(s) is/are used for EMG monitoring?
- • Orbicularis Oris
- • Orbicularis Oculi
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VI Abducens - what muscle is used for EMG monitoring?
Lateral rectus
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V Trigeminal- what muscle is used for EMG monitoring?
Masseter
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IV Trochlear - what muscle is used for EMG monitoring?
Superior Oblique
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III Oculomotor - what muscle is used for EMG monitoring?
Inferior Rectus
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What is the number of the Spinal Accessory cranial nerve?
XI
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What are the functions of the Spinal Accessory nerve?
- •Motor - trapezius
- •Motor - sternocleidomastoid
-
What is the name of the 11th cranial nerve (XI)?
Spinal accessory
-
What are the functions of the 11th (XI) cranial nerve?
- •Motor - trapezius
- •Motor - sternocleidomastoid
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What is the number of the Hypoglossal cranial nerve?
XII
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What is the name of the twelfth (XII) cranial nerve?
Hypoglossal
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What is the function of the Hypoglossal cranial nerve?
Motor - tongue
-
What is the function of the twelfth (XII) cranial nerve?
Motor - tongue
-
What is the number of the Vagus cranial nerve?
X
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What is the name of the tenth (X) cranial nerve?
Vagus
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What are the functions of the Vagus cranial nerve?
- •Sensory - pharynx and larynx
- •Sensory - thorax
- •Sensory - abdomen
- •Motor - soft palate, pharynx and larynx
- •Autonomic - heart, blood vessels, trachea, bronchi, esophagus, stomach, intestines
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What are the functions of the tenth (X) cranial nerve?
- •Sensory - pharynx and larynx
- •Sensory - thorax
- •Sensory - abdomen
- •Motor - soft palate, pharynx and larynx
- •Autonomic - heart, blood vessels, trachea, bronchi, esophagus, stomach, intestines
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What is the name of the ninth (IX) cranial nerve?
Glossopharyngeal
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What is the number of the Glossopharyngeal cranial nerve?
IX
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What is the function of the ninth (IX) cranial nerve?
- •Sensory - Taste
- •Sensory - Palate
- •Sensory - Posterior 1/3 of tongue
- •Motor - Posterior throat
- •Autonomic - Parotid gland
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What is the function of the Glossopharyngeal cranial nerve?
- •Sensory - Taste
- •Sensory - Palate
- •Sensory - Posterior 1/3 of tongue
- •Motor - Posterior throat
- •Autonomic - Parotid gland
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What is the name of the eighth (VIII) cranial nerve?
Vestibulocochlear
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What is the number of the Vestibulocochlear cranial nerve?
VIII
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What is the function of the eighth (VIII) cranial nerve?
Sensory - hearing and equilibrium
-
What is the function of the Vestibulocochlear cranial nerve?
Sensory - hearing and equilibrium
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What is the name of the seventh (VII) cranial nerve?
Facial
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What is the number of the Facial cranial nerve?
VII
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What is the function of the seventh (VII) cranial nerve?
- •Motor - facial expression
- •Sensory - taste
- •Autonomic - salivary and lacrimal
-
What is the function of the Facial cranial nerve?
- •Motor - facial expression
- •Sensory - taste
- •Autonomic - salivary and lacrimal
-
What is the name of the sixth (VI) cranial nerve?
Abducens
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What is the number of the Abducens cranial nerve?
VI
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What is the function of the sixth (VI) cranial nerve?
Motor - eye movement
-
What is the function of the Abducens cranial nerve?
Motor - eye movement
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What is the name of the fifth (V) cranial nerve?
Trigeminal
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What is the number of the Trigeminal cranial nerve?
V
-
What is the function of the fifth (V) cranial nerve?
- •Sensory - face, mouth, teeth, front 2/3 of tongue
- •Motor - mastication
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What is the function of the Trigeminal cranial nerve?
- •Sensory - face, mouth, teeth, front 2/3 of tongue
- •Motor - mastication
-
What is the name of the fourth (IV) cranial nerve?
Trochlear
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What is the number of the Trochlear cranial nerve?
IV
-
What is the function of the fourth (IV) cranial nerve?
Motor - eye movement
-
What is the function of the Trochlear cranial nerve?
Motor - eye movement
-
What is the name of the third (III) cranial nerve?
Oculomotor
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What is the number of the Oculomotor cranial nerve?
III
-
What is the function of the Oculomotor cranial nerve?
- •Motor - eye movement, eyelids
- •Autonomic - pupil constriction
-
What is the function of the third (III) cranial nerve?
- •Motor - eye movement, eyelids
- •Autonomic - pupil constriction
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What is the name of the second (II) cranial nerve?
Optic
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What is the number of the Optic cranial nerve?
II
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What is the function of the second (II) cranial nerve?
Sensory - vision
-
What is the function of the Optic cranial nerve?
Sensory - vision
-
What is the name of the first (I) cranial nerve?
Olfactory
-
What is the number of the Olfactory cranial nerve?
I
-
What is the function of the first cranial nerve?
Sensory - smell
-
What is the function of the Olfactory cranial nerve?
Sensory - smell
-
Which spinal nerve roots innervate the Trapezius?
C3, C4
-
Which muscle is preferred for EMG monitoring of the C3 and C4 nerve roots?
Trapezius
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Which spinal nerve root innervates the Deltoid?
C5
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Which muscle is preferred for EMG monitoring of the C5 nerve root?
Deltoid
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Which spinal nerve root innervates the Biceps?
C6
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Which muscle is preferred for EMG monitoring of the C6 nerve root?
Biceps
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Which spinal nerve root innervates the Triceps?
C7
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Which muscle is preferred for EMG monitoring of the C7 nerve root?
Triceps
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Which spinal nerve root innervates the Flexor carpi ulnaris?
C8
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Which muscle is preferred for EMG monitoring of the C8 nerve root?
Flexor carpi ulnaris
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Which spinal nerve root innervates the Sartorius?
L1
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Which spinal nerve root innervates the Iliopsoas?
L1
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Which muscles are preferred for EMG monitoring of the L1 nerve root?
-
Which spinal nerve roots innervate the Rectus femoris?
L2, L3, L4
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Which spinal nerve roots innervate the Vastus lateralis?
L2, L3
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Which muscles are preferred for EMG monitoring of the L2-L3 nerve roots?
- •Rectus femoris
- •Vastus lateralis
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Which spinal nerve roots innervate the Tibialis anterior?
L4, L5
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Which spinal nerve roots innervate the Biceps femoris?
L5, S1, S2
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Which muscles are preferred for EMG monitoring of the L4 nerve root?
- •Tibialis anterior
- •Rectus femoris
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Which muscles are preferred for EMG monitoring of the L5 nerve root?
- •Tibialis anterior
- •Biceps femoris
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Which muscle is preferred for EMG monitoring of the S1 nerve root?
Biceps femoris
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Which spinal nerve root innervates the Gastrocnemius?
S2
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Which muscles are preferred for EMG monitoring of the S2 nerve root?
- •Gastrocnemius
- •Biceps femoris
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Which spinal nerve roots innervate the Anal sphincter?
S3, S4
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Which muscle is preferred for EMG monitoring of the S3 - S4 nerve roots?
Anal sphincter
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Impedance can be defined as the opposition to what?
Alternating current
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Resistance can be described as the opposition to what?
Direct current
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What range of impedance is considered acceptable for EEG scalp electrodes?
1000 - 5000 ohms (1 - 5 kiloohms)
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What is the generator of Wave I of the BAEP?
The distal VIII cranial nerve.
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What is the generartor of Wave II of the BAEP?
The cochlear nucleus.
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What is the generator of Wave III of the BAEP?
The superior olivary nucleus.
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What is the generator of Wave IV of the BAEP?
Lateral lemnisus.
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What is the generator of Wave V of the BAEP?
Inferior colliculus.
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How often should IOM equipment undergo electrical safety checks?
Every 6 months.
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What is a typical filter setting for BAEPs?
-
What is a typical stimulation rate for BAEPs?
11 Hz.
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What is the frequency range of delta activity?
<4 Hz
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What is the frequency range of theta activity?
4 to 7 Hz
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What is the frequency range of alpha activity?
8 - 12 Hz
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What is the frequency range of beta activity?
13 - 30 Hz
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In the event of occlusion of either the internal carotid artery (ICA) or middle cerebral artery (MCA), where are SEP changes likely to occur?
Cortical Median SEPs (ipsilateral hand)
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In the event of occlusion of the posterior cerebral artery (PCA), where are SEP changes likely to occur?
- Loss of Median Cervical SEP signals (according to practice test)
- Cortical Median SEPs (contralateral hand)
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What EP is used as an indicator of occlusion of the anterior cerebral artery (ACA)?
Cortical posterior tibial SEP from the contralateral leg.
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What EPs should be employed for procedures involving the superior cerebellar artery (SuCA) or the anterior inferior cerebellar artery (AICA)?
Median SEPs to the contralateral hand.
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What EPs should be employed for procedures involving the posterior inferior cerebellar artery (PICA)?
Median SEPs to the ipsilateral hand.
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What is the likely effect of occlusion of the basilar artery on SEPs?
Bilateral loss of cortical and cervical signals.
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Which arteries supply the brainstem?
- Basilar artery (BA)
- Posterior inferior cerebellar artery (PICA)
- Anterior inferior cerebellar artery (AICA)
- Superior cerebellar artery (SuCA)
- Posterior cerebral artery (PCA)
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What monitoring modalities are recommended for procedures in the area of the posterior fossa?
- BAEPs
- SEPs
- Cranial EMGs/tEMGs
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What monitoring modalities are recommended for procedures in the area of the supratentorium?
-
What arteries are at risk during procedures in the supratentorium region?
- Anterior cerebral artery(ACA)
- Anterior communicating artery(ACom)
- (MCA)
- (PCA)
- (BA)
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What artery may be paritally obstructed if the temporal lobe is retracted during surgical procedure?
Middle cerebral artery (MCA)
-
Which artery is the main blood supply for the hand area of the medial somatosensory cortex?
Middle cerebral artery (MCA)
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What artery is the main source of blood supply to the leg area of the somatosensory cortex?
Anterior cerebral artery (ACA)
-
What artery is most commonly linked to trigeminal neuralgia?
Anterior cerebral artery (ACA)
-
What artery is most commonly linked to hemifacial spasm?
Posterior inferior cerebellar artery (PICA)
-
What modalities should be used if blood vessels supplying the brainstem are involved in a surgical procedure?
SEPs and BAEPs.
-
What modality should be used for procedures involving the ICA, MCA, PCA, PCom or BA arteries?
Median SEPs.
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What modality should be employed for surgical procedures involving teh ACA or ACom arteries?
Posterior tibial nerve SEPs.
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What cortical signal might a newborn infant show after stimulation of the median nerve?
N30.
-
What cortical signal might a newborn infant show after stimulation of the posterior tibial nerve?
P50.
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At what age to SEPs normally reach adult form?
3 - 10 years.
-
What effect will inhalational anesthetics have on SEPs?
- Significant amplitude decrease
- Significant increase in latency
-
What effect will Propofol have on SEPs?
- No change in amplitude
- Moderate increase in latency
-
What effects will Barbituates have on SEPs?
- Moderate decrease in amplitude
- Significant increase in latency
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What effect will Etomidate have on SEPs?
- Increase in amplitude by 200-600%
- Moderate decrease in latency
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What effect does Ketamine have on SEPs?
- Increase in amplitude by 200-600%
- Moderate decrease in latency
-
What effect do opiates have on SEPs?
- No change in amplitude
- Moderate increase in latency
-
What effects do Benzodiazepines have on SEPs?
- Significant decrease in amplitude
- Significan increase in latency
-
What effect do muscle relaxants have on SEPs?
No direct effects
-
What effects do hypotensive agents have on SEPs?
- Moderate decrease in amplitude
- Moderate increase in latency
-
What effects does Nitrous Oxide have on BAEPs?
- Moderate decrease in amplitude
- No change in latency
-
What effects do inhalational anesthetics (other than Nitrous Oxide) have on BAEPs?isi
- No change in amplitude
- Moderate increase in latency
-
What is Ohm's Law?
I = V/R
-
Define microshock.
Shock as low as 100 uA
-
What is the maximum allowable leakage current through patient leads?
10 uA
-
With ground open, what is the maximum acceptable chassis leakage?
300 uA
-
The brachial plexus is innervated by which spinal root levels?
C5 through T1
-
The median nerve is innervated by which spinal roots?
C5 - T1
-
What nerve of the brachial plexus innervates the abductor poolicis brevis?
Median nerve
-
What spinal roots innervate the abductor pollicis brevis?
C8 - T1
-
What brachial plexus nerve innervates the pronator teres?
Medial nerve
-
What spinal root levels innervate the pronator teres?
C6 - C7
-
What spinal root levels innervate the ulnar nerve?
C8 - T1
-
What brachial nerve innervates the Adductor Pollicis?
Ulnar nerve
-
What spinal nerve roots innervate the Adductor pollicis?
C8 - T1
-
What brachial plexus nerve innervates the first dorsal interosseous?
Ulnar nerve
-
What spinal nerve roots innervate the First Dorsal Interosseous?
C8 - T1
-
What brachial plexus nerve innervates the abductor digiti minimi?
Ulnar nerve
-
What spinal nerve roots innervate the abductor digiti minimi?
C8 - T1
-
What brachial plexus nerve innervates the Flexor Carpi Ulnaris?
Ulnar nerve
-
What spinal nerve root levels innervate the Flexor Carpi Ulnaris?
C8 - T1
-
What nerve root levels innervate the radial nerve?
C5- T1
-
What brachial plexus nerve innervates the brachioradialis?
Radial nerve
-
What spinal nerve root levels innervate the brachioradialis?
C5 -C6
-
What brachial plexus nerve innervates the triceps?
Radial nerve
-
What spinal nerve root levels innervate the triceps?
C6 - C8
-
What spinal nerve roots innervate the axillary nerve?
C5 - C6
-
What brachial plexus nerve innervates the deltoid?
Axillary nerve
-
What spinal nerve root innervates the musculocutaneous nerve?
C5 - C6
-
What brachial plexus nerve innervates the biceps?
C5 - C6
-
What muscle is innervated by the accessory cranial nerve (XI) and spinal roots C2 - C3?
Sternocleidomastoid
-
What muscle is innervated by C2 - C3 and the XI cranial nerve (Accessory)?
Sternocleidomastoid
-
What muscle is innervated by C3-C4 and the XI cranial nerve (Accessory)?
Trapezius
-
What is a reasonable rate of stimulation to obtain transient signals for pattern-reversal VEPs?
4/sec or less
-
What is the formula for obtaining visual angle for pattern-reversal VEPs in minutes of arc?
3438 x W/D
-
What can a change in contrast in stimulus do to pattern shift VEPs?
Latency shift
-
What level of contrast is acceptable for visual stimulus in pattern-shift VEPs?
>50%
-
What are acceptable field size and check size ranges for stimulating central vision in pattern-shift VEPs?
12-16' check size and 2-4 degree field size
-
What are acceptable field size and check size ranges for stimulating the peripheral vision in pattern-shift VEPs?
40-50' check size and 16-32 degree field size
-
What are acceptable field size and check size ranges for initial pattern-shift VEP testing?
24-32' check size and 6-12 degree field size
-
What bandpass is used for pattern-shift VEPs?
1-100 Hz
-
What analysis time is used for pattern-shift VEPs?
250 msec
-
If P100 appears excessively delayed, what changes can be made to VEP recording parameters?
- Extend analysis time to 500 msec
- Reduce stimulation rate to 2/msec or less
-
How many averaged responses should be acquired for pattern-shift VEPs?
At least 2
-
In VEPs, where is N100 generated?
Midfrontal region (MF)
-
What 3 criteria are used to determine abnormal VEPs?
- Intraocular latency difference
- Intraocular amplitude ratio
- Interhemispheric amplitude ratio
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