Platinum electrodes are C)in guarding against neurotoxicity for direct stimulation
ideal under what or recording
circumstances?
A)when high voltage
stimulation is applied
B)when stimulating through
the cranium
C)in guarding against
neurotoxicity for direct
stimulation or recording
D)in guarding against
artifact for cortical
recordings
In this image, the P31 D)Pz and Fz
brainstem potential is
recorded by what The recording electrode is the first one in the montage
electrode(s)? (input I). Montage for P31: FPZ-C5s (far field, Caudal
Medial Lemniscus. Basilar Artery)
A)Cv6
B)A2
C)Pz
D)Pz and Fz
Where is the motor cortex? B)2
A)1 In phase reversal, you look for the N20 as reference. This
B)2 peak should point upwards if placed in the
C)3 somatosensory cortex, if it's downward (P20), then it is in
D)4 the motor cortex.
,Which of the following is D)Fpz-Cs5
NOT a bipolar SSEP
recording montage? Bipolar montage means both electrodes are on the
scalp. If one of them is not on the scalp, then it's a
A)Cpz-Fz referential montage.
B)Cp3-Cp4
C)Cp3-Fpz
D)Fpz-Cs5
To eliminate crossover, B)60 dB SPL
ACNS guidelines suggest
masking noise be set to ____. Or 30-35dBHL would have also being the correct
answer.
A)60 db HL
B)60 dB SPL
C)75 dB HL
D)75 dB nHL
When stimulating TES-MEPs B)C4
from C3-C4, responses are
mostly present on the TcMEP (TES-MEP) uses anodal stimulation, so anode at
patient's right sided C3 (Left) = MEPs MOSTLY on the RIGHT side of the body.
muscles. Where is the Cathode would be on the opposite side at C4.
cathode?
A)C3
B)C4
C)C2
D)Cz
, C)Unaffected by muscle relaxant
D waves:
D waves are "direct" waves elicited by stimulation of the
pyramidal neurons in the corticospinal pathway.
A)Stimulated epidurally
Conversely, I waves are "indirect" waves elicited by
B)More sensitive to
stimulation of interneurons in the cortex which then
ischemia than TcMEPs
synapse with pyramidal neurons and result in
C)Unaffected by muscle
depolarization of the corticospinal pathway in the spinal
relaxant
cord. D and I waves are recorded over the epidural
D)Differentiate between
space of the spinal cord and are therefore unaffected by
Left and Right corticospinal
muscle relaxant and cannot clearly distinguish left and
tracts
right. D waves are also less sensitive to ischemia than
muscle MEPs.
What modalities should you A)BAER and CN EMG
run for a MVD
(Microvascular These surgeries are performed to alleviate pressure on a
Decompression)? cranial nerve from an offending vessel. You should
perform EMG from that cranial nerve. You also need to
A)BAER and CN EMG monitor the brainstem so BAERs are great for that.
B)SSEP and EEG
C)MEP and EEG
D)SSEP and MEP
Which of the following D)R PTN Cortical SSEPs
techniques would be the
most useful in IONM of a Don't be fooled on the pathway though and remember
Left ACA aneurysm? where the axons land in the longitudinal fissure on the
OPPOSITE side of stimulation. The are just best recorded
A)L MN Cortical SSEPs ipsilateral to the side of stim.
B)R MN Cortical SSEPs
C)L PTN Cortical SSEPs
D)R PTN Cortical SSEPs
, Which nerve innervates the B)Median
Abductor Pollicis Brevis
Muscle?
A)Radial
B)Median
C)Ulnar
D)Sural
Which derivation is optimal B)CPi - EPc
for isolating brainstem
potentials following median To isolate cortical it would be CPc-CPi
nerve stimulation?
A)CS5 - FPZ
B)CPi - EPc
C)CS5 - EPc
D)CPc - EPi
With a signal to noise ratio D)Improve the ratio to 4:1
of 1:2, averaging 64
responses will: Signal to Noise Ratio out = SNRin ∙ √N
SNRin is 1:2.
A)Reduce the noise by 50% N is the number of averages (here it is 64).
B)Not change the ratio We are solving for SNRout.
C)Improve the ratio to 8:1
D)Improve the ratio to 4:1
SSEP acquisition is C)monopolar cautery
obliterated by the use of:
A)midas rex drilling
B)Instrument artifact when
surgeon hammers in
implants
C)monopolar cautery
D)the use of C-Arm
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