CNIM IV Exam 2023 with Complete Solutions

A pneumatic drill would introduce what kind of artifact? - ANSWER-500 Hz Which of the following diseases results from infection by a bloodborne pathogen? - ANSWER-Hepatitis B Annular disruption - ANSWER-Disc herniation Which of the following the down going potential recorded at about 12 msec following stimulation of the ear in the following diagram? - ANSWER-Postauricular muscle reflex Facial nerve spontaneous EMG is recommended to be recorded with - ANSWER-subdermal electrodes which of the following components is most likely to be increased in amplitude by synchronous bilateral stimulation of tibial nerves? - ANSWER-P37 Surgical procedures within the posterior fossa may directly result in postoperative deficits from damage to the - ANSWER-brainstem the pneumatic drill has which of the following effects on BAEPs? - ANSWER-prolonged wave V How long must an IONM case report be saved? - ANSWER-according to state law regulations the combination of nitrous oxide and volatile anesthetic gases affects SSEPs - ANSWER-Increasing latency and decreasing amplitudes after median nerve stimulation, the N13 is generated at the - ANSWER-Post-synaptic cervical cord What will cause a delay in PTN SSEP responses? - ANSWER-Charcot Marie Tooth disease The post central gyrus handles which function - ANSWER-somatosensory evoked potential data is obliterated with - ANSWER-monopolar cautery What is the recommended bandpass setting for facial nerve compound muscle action potential recording? - ANSWER-1-250 to 1500 Hz For which of the following procedures would it be important to monitor cochlear function - ANSWER-Vestibular neurectomy Anterior spinal artery occlusion - ANSWER-motor loss Which derivation is scalp to non-cephalic? - ANSWER-Fz-C5s According to the ACNS guidelines, system bandpass settings for monitoring facial nerve spontaneous muscle activity should be - ANSWER-10-30 to 16,000 Hz Phase reversal of SSEPs following intraoperative median nerve stimulation is used for localizing - ANSWER-sensorimotor cortex How do you avoid a ground loop? - ANSWER-Place only a single ground Penetration of the sterile surgical field occurs when: - ANSWER-The surgeon's arm brushes recording equipment After T12 laminectomy, the patient can move both lower extremities but has left upper extremity weakness. Which of the following could explain this? - ANSWER-Trauma to the left brachial plexus Reversible loss of ABRs indicate - ANSWER-Complete neurological recovery What is the machine that measures current leakage? - ANSWER-Ammeter Neuromuscular blocking agents should NOT be used when recording which of the following evoked responses? - ANSWER-Facial nerve EMG Why should platinum electrodes be used for cortical mapping cases? - ANSWER-Avoid toxic deposition during stimulation Stimulation of a breached L4 screw would most likely produce a CMAP from: - ANSWER-Tibialis anterior SSEPs to posterior tibial nerve stimulation are most appropriate to monitor during surgery for - ANSWER-Scoliosis Which of the following is most likely to happen when fluids enter the electrode jackbox? - ANSWER-Various inputs may be short circuited Stimulating PTN contracts - ANSWER-Toe flexors The thalamus is involved in which pathways - ANSWER-Dorsal column Dyskinesia - ANSWER-Involuntary movement Upper extremity SSEPs would be monitored in lumbar patients to evaluate: - ANSWER-Positioning and anesthesia effects If you get artifact in your subcortical channel you: - ANSWER-Use a spare CS5 electrode Which of the following increases amplitude of cortical potentials? - ANSWER-Etomidate Which of the following is a HIPPA complaint? - ANSWER-Posting a photo of your favorite patient Which is characteristic of AC polarity? - ANSWER-Reduces stimulation artifact An objective measure of meaningful change to use to warn the surgeon is the - ANSWER-50% amplitude decrease What do the ABRET guidelines not list as a penalty for a felony related to IONM? - ANSWER-Denying neurodiagnostic training You have 60 Hz interference in all channels during preoperative median nerve SSEP recording. Which electrode should be adjusted first? - ANSWER-Ground What should be done with electrodes used on a patient with Jacob-Creutzfeld disease? - ANSWER-Discard electrodes after use Which of the following would most affect the ability to record BAEPs? - ANSWER-Coagulator Where should epidural electrodes be placed? - ANSWER-On the dura What are the waveforms indicated by the arrows following the stimulus? - ANSWER-After discharges Which of the following electrode sites is the best for recording the cortical response to PTN stimulation? - ANSWER-CPz The stimulation rate is determined by the - ANSWER-Analysis time When setting up for BAEP monitoring, which is more critical? - ANSWER-Using a foam insert What do Nursing Guidelines indicate that appropriate distance from the sterile field is? - ANSWER-18 inches Which anesthesia technique is optimal for recording MEPs? - ANSWER-Intravenous propofol and narcotic In Compressed Density Spectral Array, frequency is depicted by - ANSWER-X-Axis Pedicle screws are used for - ANSWER-Spinal fixation What is the suggested intraoperative auditory stimulation according to ACNS guidelines? - ANSWER-100 dB pe SPL with masking To record the afferent volley after posterior tibial nerve stimulation, an electrode should be placed on the - ANSWER-T5 Spine What nerve roots are being monitored using the Peroneus longus muscle? - ANSWER-L5 - S2 What is the most common reason for loss of BAEPs during retromastoid microvascular decompression? - ANSWER-Compromise vascular supply During posterior fossa surgery, when BAEPs are used for monitoring brainstem function, it is most important to - ANSWER-Stimulate and record from the contralateral side In SSEP monitoring during spinal cord surgery, an epidural electrode placed caudal to the surgical site is used to: - ANSWER-Verify adequate stimulation Changes can be reported to the surgeon as quickly as possible when the surgeon is asked to - ANSWER-Inform the technologist when critical structures are approached Fentanyl infusion will: - ANSWER-Increase latency and decrease amplitude The best anesthesia for SSEPs: - ANSWER-Infusion fentanyl Which of the following most often causes a temporary threshold shift on the Brainstem auditory evoked potentials during CPA surgery? - ANSWER-Drilling Which of the following measurements would be most helpful during monitoring of endolymphatic sac surgery? - ANSWER-Summating potential/AP amplitude ratio If you need 100 trials to get a SNR of 2:1, how many trials are needed for a SNR of 20:1? - ANSWER-10000 Which will enhance the analog to digital conversion? - ANSWER-Ensure that the range is appropriate to the size of the signal being recorded