CNIM PRACTICE EXAM 1

Ventral Nerve Roots - Answer- Lower motors neurons primarily exit the cord through the: 1 dorsal nerve roots 2 ventral nerve roots 3 dorsal columns 4 dorsal root ganglia Glutamate - Answer- Which one of the following is an excitatory neurotransmitter? 1 GABA 2 Glutamate 3 Glycine 4 Phenylalanine GABA - Answer- Which one of the following is an inhibitory neurotransmitter? 1 GABA 2 Serotonin 3 Dopamine 4 Phenlalanine the meninges - Answer- The layers of protective tissue which surround the CNS are called: 1 the ventricles 2 the meninges 3 Cerebrospinal fluid 4 The Skull Central Sulcus - Answer- What separates the motor and sensory strips? 1 Sylvian Fissure 2 Central Sulcus 3 Frontal Sulcus 4 Sagittal Fissure The Carotid Exchange - Answer- The interconnecting blood vessels at the base of the brain make up: 1 the circle of Willis 2 the Carotid exchange 3 the circle of Milford 4 the Perfect circle the left and right anterior cerebral arteries - Answer- The Anterior Communicatinig Artery connects which arteries? 1 It does not connect any arteries 2 The posterior Communicating Arteries 3 The left and right anterior cerebral arteries 4 the middle cerebral and the posterior cerebral arteries the anterior cerebral artery - Answer- The tibial nerve cortical SSEPs would be affected by a stroke in which artery? 1 the middle cerebral artery 2 the anterior cerebral artery 3 the posterior cerebral artery 4 the inferior cerebral arteray a major feeder vessel to the spinal cord - Answer- The artery of Adamkiewicz is: 1 a major blood vessel supplying the brain 2 a major branch of the iliac arteries 3 a major feeding vessel to the kidneys 4 a major feeder vessel to the spinal cord the fasciculus cuneatus - Answer- Upper extremity SSEPs transmit through which spinal cord tract? 1 the spinothalamic tract 2 the lateral corticospinal tract 3 the fasciculus gracillis 4 the fasciculus cuneatus Above the T1 vertebrae - Answer- The C8 nerve root exits the spinal cord: 1 above the C8 vertebrae 2 below the C8 vertebrae 3 above the T1 vertebrae 4 there is no C8 nerve root cauda equina - Answer- The nerve roots that extend below the spinal cord make up the: 1 cauda equina 2 spina bifida 3 Filum Terminale 4 Conus Medularis C8-T1 - Answer- The nerve root entry levels for the ulnar nerve are: 1 C1-4 2 C5-T1 3 C5-6 4 C8-T1 L4-S3 - Answer- The nerve root entry levels for posterior tibial nerve are: 1 C5-T1 2 L1-4 3 L4-S3 4 S1-S5 Sciatic - Answer- The tibial and common peroneal nerves form from what nerve? 1 Sural 2 Saphenous 3 Femora 4 Sciatic Abductor pollicis brevis - Answer- Stimulation of the MN at the wrist will activate which muscle? 1 Abductor digiti minimi 2 Abductor pollicis brevis 3 Biceps 4 Deltoid Across the head of the fibula - Answer- Stimulation of the peroneal nerve is performed: 1 across the medial malleolus 2 across the lateral malleolus 3 across the head of the fibula 4 in the medial third of the antecubital space the Sodium-Potassium pump - Answer- The resting membrane potential of a neuron is primarily maintained by: 1 passive diffusion of charged ions 2 the sodium-potassium pump 3 action potentials 4 the opening of sodium channels -70mV inside the cell - Answer- A typical resting membrane potential of a neuron is: 1 +20 mV inside the cell 2 -20 mV inside the cell 3 +70 mV inside the cell 4 -70 mV inside the cell Voltage-gated Sodium channels open - Answer- What is the initial event that occurs when the action potential threshold of a neuron is reached? 1 The ATP pump shuts down 2 Voltage-gated Sodium channels open 3 Voltage-gated Sodium channels close 4 Sodium rapidly diffuses out of the cell Depolarization of the post-synaptic membrane - Answer- An EPSP will cause what to happen? 1 Depolarization of the post-synaptic membrane 2 Hyperpolarization of the post-synaptic membrane 3 Propagation of an action potential 4 Inhibition of all action potentials Pumps K into the cell and Na out of the cell - Answer- The Sodium-Potassium Pump: 1 Pumps Na into the cell and K out of the cell 2 Pumps both Na and K out of the cell 3 Pumps K into the cell and Na out of the cell 4 Pumps both Na and K into the cell Its membrane potential based on the spatiotemporal summation of its excitatory and inhibitory inputs - Answer- Activation of an action potential of a neuron will depend on: 1 the efficiency of its Na-K pump 2 Its membrane potential based on the spatiotemporal summation of its excitatory and inhibitory inputs 3 the number of Sodium channels in the membrane 4 the number of excitatory versus inhibitory synaptic connections the lateral corticospinal tract - Answer- Transcranial motor evoked potentials transmit primarily through which spinal cord tract? 1 the spinothalamic tract 2 the lateral corticospinal tract 3 the fasciculus gracilis 4 the fasciculus cuneatus motor deficits - Answer- What is the most common result of anterior spinal artery occlusion? 1 loss of Erb's point response 2 loss of N13 3 motor deficits 4 loss of proprioception Diazepam - Answer- Which of the following has the greatest effect on SSEP monitoring? 1 Fentanyl 2 Diazepam 3 Pavulon 4 Sevoflurane minimum alveolar concentration - Answer- MAC stands for: 1 minimum anesthetic consciousness 2 maximum alveolar compromise 3 minimum alveolar concentration 4 minimum anesthetic concentration Analgesia - Answer- Opioids are used primarily for: 1 Analgesia 2 Neuromuscular blockade 3 amnesia 4 anesthesia Benzodiazepine - Answer- Midazolam is what type of drug? 1 Opioid 2 neuromuscular blocker 3 halogenated gas 4 benzodiazepine none of the above - Answer- Which of the following drugs has an appreciable effect on peripheral nerve APs? 1 Sufentanil 2 Vecuronium 3 Desflurane 4 none of the above Methohexital - Answer- Which of the following is a barbiturate? 1 Remifentanyl 2 Methohexital 3 Curare 4 Nitrous Oxide Desflurane has a higher blood solubility than Isoflurane - Answer- Desflurane has a more rapid onset and recovery than Isoflurane bc: 1 Des has a lower blood solubility than Iso 2 Des has a higher blood solubility than Iso 3 Des is injected directly into the blood stream 4 a MAC of Des is several times that of Iso bilateral reduction of cortical SSEPs only - Answer- Which of the following is consistent with increasing depth of anesthesia? 1 Bilateral reduction of all SSEPs 2 Unilateral reduction of SSEPs on the dominant side 3 Bilateral reduction of cortical SSEPs only 4 Inc latencies of all SSEPs Posterior tibial cortical potential - Answer- Which of the following is most affected by halogenated agents? 1 BAEPs 2 MN subcortical response 3 Lumbar response to tibial nerve stimulation 4 Posterior tibial cortical potential Competitive inhibition of acetylcholine receptors in the motor end plate - Answer- Neuromuscular blockers work by: 1 Competitive inhibition of acetylcholine receptors in the motor end plate 2 Continuous depolarization of muscle fibers to a state of tetany 3 Inhibiting release of neurotransmitters 4 Disabling lower motor neurons Dec amplitude, inc latency - Answer- In general, most anesthetic drugs have what effect on cortical responses? 1 inc amplitude, dec latency 2 dec amplitude, dec latency 3 dec amplitude, inc latency 4 inc amplitude, inc latency minimal effect - Answer- How could one describe the effect of anesthsia on subcortical responses? 1 abolishes 2 minimal effect 3 increases amplitude 4 no effect later cortical peaks are affected more than earlier peaks - Answer- Which of the following statements is true? 1 anesthesia tends to affect one side more than the other 2 all cortical responses are affected equally 3 later cortical peaks are affected more than earlier peaks 4 motor pathways are unaffected by anesthesia P100 - Answer- Which of the following peaks will be most affected by Desflurane? 1 P37 2 P100 3 N20 4 Wave V Succinylcholine - Answer- For spontaneous EMG monitoring, which is the most appropriate drug to use at induction? 1 Curare 2 Pavulon 3 Succinylcholine 4 Norcuron Ketamine - Answer- Which of the following are known to increase evoked potential amplitudes? 1 Nitrous Oxide 2 Ketamine 3 Halothane 4 Sufentanil increase latency and decrease amplitude - Answer- Fentanyl infusion will: 1 have no effect on amplitude or latency 2 decrease amplitude only 3 increase amplitude and increase latency 4 increase latency and decrease amplitude 0.5 MAC of halothane - Answer- Which of the following can increase SSEPs amplitude? 1 Fentanyl 2 Etomidate 3 Isoflurane 4 0.5 MAC of halothane Placing the foam inserts - Answer- What is the most important step to seting up BAEPs? 1 Cleaning the ear canal with Betadine 2 Placing the foam inserts 3 Sealing the ear closed 4 Filling the tubing with saline Change your filter from 2500 to 1500 Hz - Answer- If you have a lot of high freq. noise in your BAEPs, you can: 1 change your filter from 10 to 30 Hz 2 change your filter from 10 to 200 Hz 3 change your filter from 2500 to 150 Hz 4 change your filter from 2500 to 1500 Hz 10 - Answer- If a sound intensity is increased from 20 dB to 40 dB, then the sound pressure has increased by a factor of: 1 20 2 2 3 10 4 100 Excessive Noise - Answer- Loss of BAEPs during drilling of the internal auditory canal is most likely due to: 1 Compression of the brainstem 2 Disruption of the blood supply 3 Excessive noise 4 Transection of the auditory nerve Rarefaction - Answer- In BAEP stimulation, the stimulus type which causes a neg. pressure resulting in a slightly earlier latency is: 1 Alternating 2 Condensation 3 Triggered 4 Rarefaction Movement of the tympanic membrane toward the cochlea - Answer- BAEP condensation clicks from the transducer causes: 1 Movement of the tympanic membrane toward the cochlea. 2 Movement of the tympanic membrane away from the cochlea 3 Movement toward and away from the cochlea 4 A pure tone to be produced Check ear phones for proper side stimulation - Answer- When testing BAEPs, you get a wave 1 on the contralateral ear montage. What do you do? 1 Inc click intensity 2 Change polarity of click to condensation 3 Check ear phones for proper sid stimulation 4 Change polarity of click to rarefaction CPA tumor - Answer- A BAEP has a normal wave 1 and then delayed wave 1-V on one side. What type of Sx is this most consistent with? 1 CPA tumor 2 Thalamic tumor 3 Cerrvical spinal cord tumor 4 Tympanomastoidectomy Increased I-V interpeak latency or disappearance of wave V - Answer- What is considered criteria for alarm when monitoring BAEPs intraoperatively? 1 Dec latency of IV 2 Inc I-V interpeak latency or disappearance of wave V 3 Dec interpeak latency of waves I-V 4 Inc amplitude of wave V Midbrain - Answer- Where is the BAEP wave V generated? 1 Medulla 2 Midbrain 3 Thalamus 4 Temporal lobe Postauricular myogenic response - Answer- What is the very large amplitude potential following the BAEP waves I-V at approx. 15 ms? 1 Large latency potential 2 Postauricular myogenic response 3 Middle latency potential 4 Wave VI Acoustic Nerve - Answer- BAEPs can no longer be successfully performed after resection of the: 1 Tympanic Membrane 2 Ossicles 3 Acoustic Nerve 4 Vestibular Nerve