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Cnim - Brainstem Auditory Evoked Potentials Questions And Answers With Verified Solutions Already Passed!!!

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  • August 20, 2024
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  • 2024/2025
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Cnim - Brainstem Auditory Evoked
Potentials Questions And Answers With
Verified Solutions Already Passed!!!
In the operating room, we are mostly concerned with... - ANSWER✔✔ Short-
latency, subcortical responses.


Why run BAEPs? - ANSWER✔✔ To monitor the integrity of the auditory nerve,
and often as a marker of brainstem health,


Auditory Pathway - ANSWER✔✔ Consists of classical lemniscal pathway and an
extralemniscal pathway.


Lemniscal pathway generates the short-latency BAEPs through series of relay
stations.


CN VIII - ANSWER✔✔ Has an auditory portion and a vestibular portion, for which
no monitoring exists.


Intracranial portion of nerve runs in close proximity to CN VII


Synapse 1 of the Lemniscal Pathway - ANSWER✔✔ Cochlear nucleus


Synapses of the Lemniscal Pathway - ANSWER✔✔ Cochlear nucleus (bilateral
response generated)

,Fibers exit cochlear nucleus and either cross the midline to the contralateral
superior olivary complex (SOC) or remain uncrossed and project to the ipsilateral
SOC.


SOC gives off projections that travel to the inferior colliculus in a fiber tract called
the lateral lemniscus.


Projection from the inferior colliculus to the inferior colliculus of the contralateral
side.


Projection from the inferior colliculus to the ipsilateral medial geniculate nucleus
of the thalamus.


From thalamus, fibers travel as the auditory radiations to the auditory cortex in
the temporal lobe.


Tumors of CN VIII - ANSWER✔✔ Acoustic neuroma, vestibular schwannoma,
vestibular neuroma.


Posterior Fossa Craniotomy - ANSWER✔✔ Places the brainstem at risk, therefore
BAEPs are monitored to detect brainstem ischemia.


Microvascular Decompressions (MVDs) - ANSWER✔✔ Can pose a risk to CN VIII
and is indicated in patients with disabling tinnitus or positional vertigo.


BAEP monitoring should also be considered in procedures to relieve trigeminal
neuralgia (CN V), hemifacial spasm (CN VII), or glossopharyngeal neuralgia (CN IX)

, Brainstem and BAEPs - ANSWER✔✔ BAEP is a useful monitor of brainstem health,
but only directly assess a small function of the brainstem.


Tumors of the Cerebellar Pontine Angle (CPA) - ANSWER✔✔ Most often
indication for BAEP monitoring.


Usually involves monitoring of the lower CNs as well.


Controversy over Peaks - ANSWER✔✔ The generator of Peak I has never been
debated, but the generators of the other peaks are debated.


Peak I - ANSWER✔✔ Generated in the distal auditory nerve.


Peak II - ANSWER✔✔ Generated from the intracranial (proximal) portion of the
auditory nerve.


Peak III - ANSWER✔✔ The first that originates from the secondary neurons.


Generator is the caudal pontine tegmentum, which is also the generator of the
negative peak between III and IV (also known as IIIa)


Also evidence of a contribution from the cochlear nucleus to peak III, as well as a
contribution from the ascending activity within the lateral lemniscus.

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