CNIM 3

1. 1During an anterior lumbar fusion (L4-L5), a loss of all right PTN responses occurs over the course of about five minutes. What should you do?

   1. AInform the surgeon the right stimulator has failed, but that you will continue to diligently monitor the left side.
   2. BCheck the current output and stimulator connections quickly. Then inform the surgeon you are seeing changes consistent with ischemia of the right leg.
   3. CInform the surgeon there may be spinal cord changes.
   4. DCheck MN responses for possible anesthetic changes.
2. 2Electrical amplitude of the SEP is

   1. A0.1 to 10uV
   2. B10 to 100 uV
   3. C100 to 1000uV
   4. D1000 to 10,000 uV
3. 3Which of the following can increase SEP amplitude?

   1. Afentanyl
   2. Betomidate
   3. Cisoflurane
   4. D0.5 MAC of halothane
4. 4For peroneal nerve stimulation, the ground should be placed:

   1. Afoot
   2. Bcalf
   3. Cankle
   4. Dthigh
5. 5When testing SSEP from the upper extremity, an electrode placed at Erb's point will record activity generated from:

   1. Abrachial plexus
   2. Blumbar plexus
   3. Ccauda equina
   4. Dthalamocortical radiations
6. 6SEP recordings are thought to be generated by which of the following sensory tracts?  

   1. Acorticospinal tract
   2. Blateral spinothalamic tract 
   3. Cposterior columns and medial lemnisci
   4. Dlateral geniculate
7. 7Which montage would you use to confirm a change in the Cz'-Fz cortical response to PTN Stim?

   1. ACpc-Cpi
   2. BPopliteal fossa
   3. CErb's point
   4. DCs5-Fz
8. 8In order to reduce stimulus artifact, the ground electrode should be placed:

   1. Aon the scalp
   2. Bon the limb between the stimulating and recording electrodes
   3. Con the contralateral limb
   4. Don the foot
9. 9Somatosensory evoked potential monitoring during scoliosis surgery may replace the need for the:

   1. AO'Hara clonus test
   2. BStagnara wake-up test
   3. CRuben hematocrit test
   4. DRemoval of hardware
10. 10Somatosensory evoked potentials are less reliable in patients with:

    1. ASevere scoliosis
    2. BHistory of nicotine abuse
    3. CA tethered spinal cord
    4. DNeuromuscular disease

11. 11Monitoring somatosensory function may fail to recognize change in:

    1. AAnterior spinal cord function
    2. BDorsal column function
    3. CPeripheral nerve function
    4. DAscending spinal cord tracts
12. 12The median nerve is an excellent measure of:

    1. ACerebral blood flow
    2. BCentral spinal cord function
    3. CLower motor neuron function
    4. DLateral lemniscal function
13. 13Pre-operative baseline evaluation is not indicated for which of the following modalities?

    1. AMedian nerve somatosensory
    2. BBrainstem evoked potentials
    3. CFacial nerve EMG
    4. DPeroneal nerve somatosensory
14. 14Nerve fibers activated during SEP recording carry what type of information?

    1. APropIception and vibrotactile sensation
    2. BPain and temperature sensation
    3. CEfferent motor signals
    4. DVisceral sensation
15. 15What are Dermatomes?

    1. APatches of muscle innervated by motor fibers that pass through individual nerve roots of the spinal cord
    2. BPatches of skin that send pain information through individual nerve roots of the spinal cord.
    3. CPeripheral nerves that send proprioceptive and vibrotactile information to the brain.
    4. DSpecific stimulus sites on the skin used for SEP monitoring
16. 16What is the preferred alternate when the PTN is unavailable?

    1. APeroneal
    2. BSciatic
    3. CFemoral
    4. DUlnar
17. 17In an epidural response, what is the advantage of the bipolar response?

    1. APresence of myogenic activity Oft
    2. BImproved in-phase cancellation of noise components
    3. CNeedles are far apart
    4. DLarge cardiac artifact
18. 18What is not an advantage of epidural recording?

    1. AReproducible morphology,
    2. BAbsence of significant artifact
    3. CResistant to anesthesia
    4. DStability of responses
19. 19A loss of response would most likely be ____from the surgical site.

    1. ARostral
    2. BCaudal
    3. CAnterior
    4. DPosterior
20. 20Why are SSEP and MEP used simultaneously?

    1. ASpinal cord damage can occur in only one tract causing loss of MEP but not SSEP
    2. BBecause MEPs indicate spinothalamic tract function
    3. CBecause SSEP monitoring alone is not very sensitive to changes in spinal cord function
    4. DAll of the above
21. 21What type of procedures are used that may require intraoperative spinal cord monitoring?

    1. AArteriovenous malformations
    2. BKyphosis
    3. CHerniated disc
    4. DAll of the above
22. 22Platinum electrodes are used to record epidural potentials because:

    1. AThey eliminate the possibility of allergic reaction
    2. BThey have better impedance than other metal electrodes
    3. CThey yield larger responses
    4. DOther elements cause neurotoxicity when current is passed through them
23. 23Rapid loss of cortical PTN responses with preservation of subcortical responses is most often caused by:

    1. ABlood loss
    2. BAnesthesia
    3. CSpinal cord lesioning
    4. DHypothermia
24. 24Stimulating the median nerve at the wrist yields an Erb's point response at 10 mS and an NCV of 60 m/S. What is the distance between the cathode and the Erb's point recording electrode?

    1. A50cm
    2. B60cm
    3. C166cm
    4. DCannot be determined with this information
25. 25Synchronous stimulation with a time delay:

    1. AWill yield the sum of left and right responses
    2. BAllows one to monitor left and right responses on a single channel
    3. CWill cause asymmetric responses
    4. DIs insensitive to unilateral response changes
26. 26The P31 response to posterior tibial nerve stimulation:

    1. AReflects post-synaptic activity in the cervical spinal cord
    2. BIs generated by the thalamus
    3. CIs recordable over a generalized region of scalp  
    4. DIs best recorded by an electrode placed at Cs5
27. 27Which of the following responses increases linearly with an increase in stimulus intensity?

    1. APopliteal fossa
    2. BP31
    3. CPTN cortical
    4. DMN cortical
28. 28The central conduction time for median nerve SSEP is:

    1. AN9—N20
    2. BP14—P23
    3. CN13—N20
    4. DN13—N18
29. 29A patient with a body temperature of 30 degrees C will have:

    1. AIncreased latencies
    2. BIncreased latencies, decreased amplitudes
    3. CDecreased latencies
    4. DDecreased latencies, decreased amplitudes
30. 30What is the period of a 200 Hz signal?

    1. A200mS
    2. B50ms
    3. C2mS
31. 31A 60 Hz artifact most likely be caused by:

    1. APneumatic drill
    2. BBlanket warmer
    3. CInfusion pump
    4. DUltrasonic aspirator
32. 32What will be the frequency of a signal if in a 30 msec sweep the interval between each sample is 0.03 msec?

    1. A3 KHz
    2. B33 KHz
    3. C333 KHz
    4. D3333 KHz
33. 33What is the noise reduction technique that reduces EKG artifact?

    1. AArtifact reject
    2. BHighcut filter
    3. CCommon mode rejection
    4. DAveraging
34. 34The ground on a differential amplifier:

    1. AIs always connected to Earth ground
    2. BIs typically used as a common reference for each of the inputs
    3. CHas no bearing on the recorded signals
    4. DIs a common source of 60 Hz Noise and stimulus artifact
35. 35How frequently should the evoked potential machines be calibrated and safety tested?

    1. AOnly when there is a problem
    2. BEvery 6 months
    3. COnce a year
    4. DOnce every two years
36. 36Having poor ground resistance represents a safety problem because:

    1. ANo, it really is not a safety issue
    2. BAny current leaking to the chassis may find a path to ground through your body
    3. CThe machine might not function properly
    4. DIt may affect other electrical equipment that have connections to Earth ground
37. 37How should needle electrodes be discarded?

    1. AIt doesn't matter as long as they are not contaminated with blood
    2. BCarefully discarded in a plastic or metal trash can
    3. COnly in a red puncture-proof sharps container
    4. DToss onto the OR floor. Housekeeping will sweep it up
38. 38Why are surface electrodes preferred over needles for stimulation?

    1. ASurface electrodes are less likely to cause burns with high current stimulation
    2. BSurface electrodes are not preferred
    3. CSurface electrodes are easier to place
    4. DSurface electrodes require prepping of the skin to reduce impedance
39. 39How is tuberculosis transmitted?

    1. AIt is sexually transmitted
    2. BBy airborne droplets
    3. CBy contact with blood
    4. DVia skin to skin contact
40. 40What is the most important means of preventing the spread of infection?

    1. AWearing gloves
    2. BHandwashing
    3. CUsing a condom
    4. DWearing a mask
41. 41Personal Protection Devices (PPDs) consist of:

    1. AGloves
    2. BMasks 
    3. CGowns
    4. DAll of the above
42. 42Hands should be washed:

    1. AOnly when they are contaminated with bodily fluids
    2. BBefore and after contact with the patient
    3. COnly after eating
    4. DOnly when prepping for surgery
43. 43Gloves should be worn:

    1. AWhenever there is potential for exposure to contaminants
    2. BAll the time
    3. CWhenever a patient looks like they have HIV
    4. DWhenever you forget to wash your hands
44. 44Which would not be considered contamination of the sterile field:

    1. AReaching your arm over the sterile table
    2. BBrushing your bouffant cap against the microscope drape  
    3. CReaching underneath the surgeon's gown to grab his pager
    4. DDropping a junior mint into the wound
45. 45The most frequent source of patient infection in the operating room derives from:

    1. AThe patient's own endogenous flora
    2. BNon-sterile instruments
    3. CBacteria from the surgical staff
    4. DBacteria from the operating room environment
46. 46The main source of airborne bacteria in the operating room is from:

    1. APlume resulting from electrocautery
    2. BOperating room personnel talking, laughing and coughing
    3. CExfoliated skin particles from the operating room staff
    4. DFlies in the operating room
47. 47Which of the following drugs significantly affect the Transcranial Motor D-wave amplitude?

    1. AIsoflurane
    2. BPavulon
    3. CPropofol
    4. DNone of the above
48. 48Compound muscle action potentials to transcranial electric stimulation are susceptible to:

    1. AIsoflurane
    2. BPavulon
    3. CPropofol
    4. DAll of the above
49. 49Train stimuli are used for TCMEP's in order to

    1. ACharge the patient more
    2. BOvercome anesthetic suppression of synaptic transmissions in the motor pathway
    3. CActivate D-waves in the peripheral muscle
    4. DNegate the effects of neuromuscular blockade
50. 50The D-wave is recorded from the

    1. APeripheral nerve
    2. BPeripheral limb muscle
    3. CSpinal cord
    4. DCerebral cortex

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Certificate Practice Quizzes Quiz sobre CNIM 3, criado por eds neuro em 26-04-2016.

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eds neuro

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