CNIM WRONG/ NEED TO KNOW

1. 1The Post Central Gyrus is most likely located at?

   

   1. AD
   2. BA
   3. CB
   4. DC
2. 2When placing PF you want the active electrode:

   1. ALateral to the PF
   2. BBelow the PF crease
   3. CMedial to the PF
   4. DAbove the PF crease
3. 3The bin width of your system is 20 uS; then the highest frequency signal that can be resolved is:

   1. A50 KHz
   2. B25 KHz
   3. C20 KHz
   4. D100 KHz
4. 4Cortel-Dubousset Instrumentation involves which of the following?

   1. AIntervertebral Diskectomy
   2. BSublaminar Wires
   3. CDistraction
   4. DDerotation
5. 5Stimulating the median nerve at the wrist yields an Erbs Point response at 10ms and an NCV of 60m/S. What is the distance between the cathode and the Erbs point recording electrode?

   1. A166 cm
   2. B60 cm
   3. CCannot be determined with this information
   4. D50 cm
6. 6Which of the following responses increases linearly with an increase in stimulus intensity?

   1. APop Fossa
   2. BP31
   3. CMN cortical
   4. DPTN cortical
7. 7Why are SSEP and MEP used simultaneously?

   1. ASpinal cord damage can occur in only one tract causing loss of MEP but not SSEP
   2. BAll of the above
   3. CBecause SSEP monitoring alone is not very sensitive to changes in spinal cord function
   4. DBecause MEPs indicate spinothalamic function
8. 8For Peroneal Nerve Stimulation, the ground should be placed at?

   1. AFoot
   2. BCalf
   3. CAnkle
   4. DThigh
9. 9Upon seeing the traces collected at 19:54, the first thing you should do is?

   

   1. ACheck anesthetic Levels
   2. BReset the amplifier
   3. CInform the surgeon of an abrupt loss of the BAER
   4. DContinue to monitor for return of the response
10. 10A major advantage of digital filters over analog filters is:

    1. AThey impose no phase effects on the recorded signal
    2. BThey operate faster than analog signals
    3. CThey require digitization of the analog signal
    4. DThey reduce or eliminate frequencies above or below a given cutoff

11. 11Stimulation of the peroneal nerve is performed:

    1. AIn the medial third of the antecubital space
    2. BAcross the head of the fibula
    3. CAcross the lateral malleolus
    4. DAcross the medial malleolus
12. 12The EEG traces above are witnessed during a carotid. Which of the following best describes this pattern?

    

    1. AIschemic changes due to cross-clamping of the carotid artery
    2. BBurst Suppression
    3. CReperfusion of the brain from clamping
    4. DNormal EEG pattern
13. 13A 60 Hz artifact would most likely be caused by:

    1. AUltrasonic aspirator
    2. BPenumatic Drill
    3. CInfusion Pump
    4. DBlanket Warmer
14. 14What is an appropriate filter for a short latency SSEP cortical response?

    1. A100-1000 Hz
    2. B1-100 Hz
    3. C0.1 - 250 Hz
    4. D10-3000 Hz
15. 15An optimal rep rate for BAERS is

    1. A31 Hz
    2. B56 Hz
    3. C4.47 Hz
    4. D100 Hz
16. 16What will most likely affect SSEPs?

    1. ASpinal cord tumor
    2. BScoliosis
    3. CAnterior spinal hypoperfusion
    4. DDegenerative motor condition
17. 17What is the minimal required vertical resolution of an evoked potential system?

    1. A8 bits
    2. B256 bits
    3. C80 bits
    4. D16 bits
18. 18Kyphosis

    1. ASide to side curvature of the spine
    2. BFractured Spine
    3. CCurvature of the thoracic spine
    4. DCurvature of the lumbar spine
19. 19Of the following, the most appropriate filter, timebase, and sensitivity for monitoring of cortical ischemia during a carotid surgery are?

    1. A0.3-70 Hz, 15 mm/sec, 3 uV/mm
    2. B1-70 Hz, 15 mm/sec, 30 uV/mm
    3. C0.3-70 Hz, 30 mm/sec, 30 uV/mm
    4. D0.3-35 Hz, 60 mm/sec, 3 uV/mm
20. 20According to guidelines, what are the optimal filter settings for recording ABRs?

    1. A100-300 Hz to 3000-5000 Hz
    2. B10-30 Hz to 2500-3000 Hz
    3. C50-100 Hz to 5000-10000 Hz
    4. D100 Hz to 500 Hz
21. 21According to guidelines, what is the acceptable sweep for ABRs?

    1. A25 msec
    2. B10-15 msec
    3. C5 msec
    4. D20-30 msec
22. 22The most appropriate ABR interstimulus interval is?

    1. A5 mS
    2. B0.02 mS
    3. C20 mS
    4. D50 mS
23. 23What is the maximum allowable chassis leakage current?

    1. A0.1 mA
    2. B10 mA
    3. C10 uA
    4. D20 uA
24. 24What is the maximum allowable chassis leakage current from the isolated amplifier inputs through the patient leads?

    1. A10 mA
    2. B10 uA
    3. C100 uA
    4. D1 mA
25. 25Nerve fibers activated during SSEP recording carry what type of information?

    1. AProprioception and vibrotactile sensation
    2. BEfferent motor signals
    3. CPain and temperature sensation
    4. DVisceral sensation
26. 26The appropriate analysis time for ABRs is:

    1. A50 mS
    2. B100 mS
    3. C20 mS
    4. D15 mS
27. 27Horizontal Dipole

    1. AN13
    2. BN18
    3. CN34
    4. DEP
28. 28Cardiac activity appears on the CSA/DSA display as:

    1. ABeta activity
    2. BBurst suppression
    3. CAlpha activity
    4. DDelta activity
29. 29When no phase reversal is present in an anterior-posterior cortical grid recording:

    1. AThe grid is over the pre-central gyrus
    2. BThe grid should be turned 90 degrees in order to find the phase reversal
    3. CThe maximum amplitude response is closes to the central sulcus
    4. DThe grid is over the post-central sulcus
30. 30A 10 Hz signal passing through a 10 Hz lowcut filter will be:

    1. Aeliminated
    2. Breduced in amplitude by approximately 30%
    3. Creduced in frequency to approximately 7 Hz
    4. DAffected in no way
31. 31What determines the latency of SSEPs most?

    1. Alimb length
    2. Bneuromuscular block
    3. Cpatient gender
    4. Danesthesia level
32. 32Desflurane has a more rapid onset and recovery than isoflurane because:

    1. ADesflurane has a higher blood solubility than Isoflurane
    2. BDesflurane has a lower blood solubility than Isoflurane
    3. CDesflurane injected directly into the blood stream
    4. DA MAC of Desflurane is several times that of Isoflurane
33. 33Loss of BAEPs during drilling of the internal auditory canal is most likely due to:

    1. ADisruption of the blood supply
    2. BCompression of the brain stem
    3. CTransection of the auditory nerve
    4. DExcessive noise
34. 34Most strokes associated with carotid surgeries occur:

    1. AAfter the cross-clamping is released
    2. BBefore cross-clamping
    3. C10-30 days after leaving the hospital
    4. DDuring cross-clamping
35. 35Dykenesia

    1. ASeizures
    2. BRinging in ears
    3. CAbnormal movement
    4. DAbnormal sensation
36. 36A loss of SSEP response would most likely occur ________ to the surgical site.

    1. ACaudal
    2. BAnterior
    3. CPosterior
    4. DRostral
37. 37What is a benefit of using epidural electrodes?

    1. AThey are more sensitive to anesthetic changes
    2. BThey are placed in the sterile field
    3. CThey can be placed by a technician
    4. DThey are highly sensitive
38. 38The central conduction time (CCT) for median nerve SSEP is:

    1. AN13-N18
    2. BP14-N20
    3. CN9-N20
    4. DP14-P23
39. 39The input impedance of a differential amplifier should be:

    1. AA least 100 Megaohms
    2. BLess than 500 ohms
    3. CAt least 80 decibels
    4. DAt least 10,000 ohms
40. 40CMAPS to TCEMEP are susceptible to:

    1. APropofol
    2. BAll of the above
    3. CPavulon
    4. DIsoflurane
41. 41The median nerve data in the picture are most likely consistent with

    

    1. AFailure of the left stimulator
    2. BIschemia of the anterior cerebral artery
    3. CCervical spinal cord lesion
    4. DLesion in the right pons
42. 42Harrington rod instrumentation uses:

    1. AWires and rods
    2. BRods, hooks, and screws
    3. CHooks and a rod
    4. DRods and screws
43. 43If you have a 5 uV signal amplitude and a 20 uV noise amplitude, how many averages would you need to get a signal to noise ratio of 2:1

    1. A20
    2. B16
    3. C100
    4. D64
44. 44The nerve root entry levels for the PTN are:

    1. AL4-S3
    2. BS1-S5
    3. CC5-T1
    4. DL1-L4
45. 45Fentanyl infusion will:

    1. AHave no affect on amplitude or latency
    2. BIncrease latency and decrease amplitude
    3. CDecrease amplitude only
    4. DIncrease amplitude and increase latency
46. 46The integrity of the facial nerve in acoustic neuroma surgery is determined by:

    1. AProximal CMAP
    2. BSpontaneous EMG
    3. CStagnara Wake-Up test
    4. DDistal CMAP
47. 47During the recording of somatosensory evoked responses in the operating room, electromyographic artifact may be reduced by

    1. Aincreasing the duration of the stimulus
    2. Bincreasing stimulus intensity
    3. Cneuromuscular blocking agents
    4. Dchanging stimulation sites
48. 48To dissect a vestibular schwannoma, which surgical approach usually sacrifices hearing?

    1. Amiddle cranial fossa
    2. Bretrosigmoid
    3. Csuboccipital
    4. Dtranslabyrinthine
49. 49Decreased synchronization of the auditory nerve firing will likely result in

    1. Aa decrease in wave latency
    2. Ba decrease in wave amplitude
    3. Cno change in wave latency or amplitude
    4. Dan increase in wave amplitude
50. 50Nitroprusside

    1. AIncrease Blood Pressure
    2. BIncreased SSEP amplitude
    3. CDecreased SSEP amplitude
    4. DDecrease Blood Pressure
51. 51When placing stimulating electrodes over a peripheral nerve to elicit a muscle response:

    1. Aneuromuscular blockade must be in effect during stimulation
    2. Bthe positive electrode must be directly over the nerve whereas the negative electrode needn't be
    3. Cthe negative electrode should be toward the peripheral portion of the nerve to be stimulated
    4. Dthe positive electrode should be toward the peripheral portion of the nerve to be stimulated
52. 52Which of the following are most likely to cause airborne contamination in an operating room?
    

    1. AKerrison particles
    2. Bventilation devices
    3. Cbloodborne pathogens
    4. Ddust particles
53. 53Vasospasm of AICA will result in

    1. AIncreased inter peak waves I-III ABR latencies
    2. BIncreased inter peak waves III-V ABR latencies
    3. CComplete loss of all ABR waves with exception of cochlear microphonic
    4. DLoss of waves III-V
54. 54Movement artifact on the EEG is most likely to produce

    1. ASlow EEG wave activity
    2. Basymmetrical activity at 60 Hz
    3. Cfast EEG wave activity
    4. Dburst-suppression
55. 55The pudendal nerve

    1. AT12, L5, S1 nerve roots
    2. BL5 spinal roots
    3. Carises from S2, S3, and S4 spinal roots
    4. Dcannot be directly stimulated with electrical current
56. 56Hypercapnia

    1. AHct higher than normal
    2. BPC02 higher than normal
    3. CInhalational agent > 1 MAC
    4. DpO2 higher than normal
57. 57A TOF following PTN stimulation can be recorded from:

    1. AGastrocnemius
    2. BTibialis Anterior
    3. CAbductor Digiti Quinti Pedi
    4. DExtensor Hallucis Brevis
58. 58EEG waves with a frequency of 5 Hz can be classified as what type of EEG?

    1. Atheta activity
    2. Bdelta activity
    3. Calpha activity
    4. Dbeta activity
59. 59The D wave should be recorded

    1. AFrom the proximal limb muscles
    2. BCaudal to the surgical site
    3. CFrom the distal limb muscles
    4. DRostral to the surgical site
60. 60Hoffmans sign is:

    1. Aplantar extension of the hallux when the sole of the foot is stroked
    2. Bpalmar flexion of the thumb when the distal phalanx of the middle finger of the same hand is rapidly stroked
    3. Closs of deep pain sensation as evidenced by diminished sensation to the
       application of pressure to the testicle
    4. Dloss of deep pain sensation as evidenced by diminished sensation to the application of pressure to the ulnar nerve
61. 61Which of the following is not true?

    1. Aformaldehyde is highly germicidal and sporicidal in a strong concentration
    2. Bboiling water can be used to sterilize surgical instruments
    3. Cagents that sterilize are also injurious to the living tissues of the skin
    4. Dsodium hypochlorite (bleach) is effective in the deactivation of HIV and hepatitis B virus
62. 62The first synaptic junction of the VIII cranial nerve as it enters the brainstem is:

    1. Athe superior olivary complex
    2. Bthe medial geniculate bodies
    3. Cthe inferior colliculus
    4. Dthe cochlear nucleus
63. 63In monopolar facial nerve stimulation, positive charge flows

    1. Afrom cathode to anode
    2. Bfrom cathode to ground
    3. Cmuscle to ground
    4. Dfrom anode to cathode
64. 64The monitoring modality most likely to be affected by a large bolus of muscle relaxant is the
    

    1. Acortical SSEP
    2. BNMEP
    3. CMyogenic Evoked Potential
    4. DBAEP
65. 65Stimulating electrodes during SEP

    1. AShould produce about 1/2 the current needed to cause a twitch
    2. BShould be made of zinc to eliminate electrolysis
    3. CShould not be placed near catheters leading into the heart or the great vessels
    4. DShould produce about 1/3 the current needed to cause a twitch .
66. 66What is Meckles Cave

    1. AForamen from which the facial nerve exits the skull to innervate the face
    2. BSpinal tract by which the posterior tibial nerve pathway runs
    3. CCranial depression directly above the fourth ventricle
    4. DDepression in the medial middle fossa where the trigeminal nerve ganglion sits
67. 67An advantage of referential, as opposed to bipolar recording of spinal cord somatosensory evoked potentials, is
    

    1. Aless invasion of the surgical field
    2. Bthe elimination of electromyographic artifact from the paraspinous muscles
    3. Cavoiding cancellation of the potentials as a result of recording from adjacent levels
    4. Dthe ease of electrode placement
68. 68The common peroneal nerve arises at the superior angle of the popliteal fossa from the

    1. Asuperior tibial nerve
    2. Bsciatic nerve
    3. Cinternal popliteal nerve
    4. Dsuperior femoral nerve
69. 69Trigeminal nerve stimulation will elicit a CMAP from which of the following?

    1. AMentalis
    2. BTemporalis
    3. CTongue
    4. DTrigeminalis
70. 70Increasing the BAEP rep rate from 3.4 to 31.1

    1. Aincreased latency, increased amplitude
    2. Bdecreased latency, increased amplitude
    3. Cincreased latency, decreased amplitude
    4. Ddecreased latency, decreased amplitude
71. 71These are median nerve responses recorded directly from the cortex using a 1x4 subdural grid electrode. The electrode closest to the post-central gyrus is:

    

    1. A2
    2. B3
    3. C1
    4. D4
72. 72Which of the following muscles would be most appropriate to monitor EMG from for L5 and S1 nerve roots?
    

    1. ASemimemembranosus and Peroneus longus
    2. BRectus Femoris and Tibialis Anterior
    3. CGastrocnemius and sphincter ani
    4. DVastus Lateralis and Gracilis
73. 73A normal curve of the lumbar spine taking place at the age of 1-2 years old is:

    1. AKyphosis
    2. BExtension
    3. CStenosis
    4. DScoliosis
74. 74Which of the following could cause a false negative in a T10 surgery?

    1. AAsynchronous MN stimulation
    2. BAsynchronous PTN stimulation
    3. CAsynchronous peroneal stimulation
    4. DSynchronous PTN stimulation
75. 75What is the minimum required bandpass for an EP system?

    1. A1-1000Hz
    2. B1 Hz - 20 KHz
    3. C0.1-5000 Hz
    4. D30-1500 Hz
76. 76Spectral analysis of raw EEG data displays power as un upward deflection and

    1. Afrequency as a linear display across the epoch line
    2. Btime horizontally on the graph
    3. Ctime as a spectral edge
    4. Dwave morphology in a compressed design
77. 77Blood supply to the spinal cord

    1. A1 anterior spinal artery, 2 posterior spinal arteries
    2. Bis through a superior spinal artery
    3. C2 anterior spinal arteries, 1 posterior spinal artery
    4. Dis through 2 superior spinal arteries
78. 78What is the main advantage of asynchronous bilateral stimulation?

    1. AFaster data acquisition
    2. BReduction of stimulus artifact
    3. CLess patient movement
    4. DDifferentiation of local vs. systemic effects
79. 79Ataxia

    1. AInability to speak
    2. BInability to pay taxes
    3. Cinability to perform coordinated movements
    4. Dinability to walk
80. 80An agent that should be excluded before Electrocorticography for interictal discharges is:

    1. AN20
    2. BSuccs
    3. CIsoflurane
    4. DPhenytoin
81. 81The data represented above is most likely:

    

    1. AFIRDA
    2. BAfter-discharges
    3. CSleep Spindles
    4. DWicket spikes
82. 82The duration of monophasic, rectangular pulse used for SSEP stimulation should be:

    1. A0.5 ms
    2. B0.05 ms
    3. C1 ms
    4. D0.02 ms
83. 83Wave III of the BAEP is generated by the

    1. Acochlear nucleus
    2. Blateral lemniscus
    3. Cmedial geniculate
    4. Dinferior colliculus
84. 84which of the following statements regarding the ABR traces is most likely true?

    

    1. ANormal ABR traces
    2. Bconsistent with conductive hearing loss
    3. CRetrocochlear lesion
    4. Dauditory stimulator is not functioning properly
85. 85During BAEP from posterior fossa craniotomy, if reversible loss of all ipsi BAEP responses occurs:

    1. Adrug effect
    2. Bhypothermia
    3. CDuring BAEP from posterior fossa craniotomy, if reversible loss of all ipsi BAEP responses occurs
    4. Dprobable neuronal deficit post-op
86. 86In general, filter settings for SEP recordings

    1. Acan be narrower for peripheral than cortical responses
    2. Bcan be narrower for cortical than peripheral responses
    3. Cshould always include 60 Hz band pass filters
    4. Dshould always be 30-3000 Hz
87. 87Stimulus artifact during SSEP can be decreased by

    1. Alowering the impedances of ground and stimulating electrodes
    2. Bkeeping the instrument away from lights and video monitors
    3. Cseparating cables from other equipment
    4. Dusing enough muscle relaxant
88. 88The recommended filter setting for the facial nerve CMAP are

    1. A10 - 1.5 kHz
    2. B1 - 1.5 kHz
    3. C1 - 15 kHz
    4. D10 - 15 kHz
89. 89Low frequency sounds are

    1. Anear the round window
    2. Bperceived along reissners membrane
    3. Cnear the stapes
    4. Dnear the apex of the cochlea
90. 90Operating room gowns are considered sterile

    1. AIn front from chest to the level of the sterile field
    2. Bover the whole surface
    3. Cbelow the elbow
    4. Daround the back of the gown
91. 91The Nyquist frequency is:

    1. A1/3 the highest frequency
    2. Btwice as great as the highest frequency
    3. C1/2 the highest frequency
    4. Dequal to the sampling rate
92. 92SSEP recordings typically require a bandpass of

    1. A100 Hz to 1000 Hz
    2. B30 Hz to 3000 Hz
    3. C1000 Hz to 5000 Hz
    4. D.5 Hz to 200 Hz
93. 93A Babinskis sign in an adult

    1. Aindicates an upper motor neuron lesion
    2. Bis abnormal if the toes plantarflex
    3. Cis elicited the same way an Oppenheims sign is elicited
    4. Dis normal
94. 94Monitoring of aneurysms involving the anterior cerebral artery should include

    1. Amedian nerve SSEP
    2. Btibial nerve SSEP
    3. CVEP
    4. DABR
95. 95Changing from standard headphones to insert transducers connected by plastic tubing will change the latency of wave I by about

    1. A+ 2 msec
    2. B-0.5 msec
    3. C+0.5 msec
    4. D+0.9 msec
96. 96Electrode lead wires used in the operating room suite must be converted to safety connectors (female electrodes) by
    

    1. A1/1997
    2. B6/1999
    3. C5/2000
    4. D1/2005
97. 97A unit of resistance is symbolized by

    1. AE
    2. BA
    3. Cmicro
    4. Dohms
98. 98The most productive electrode placement for electrocochleography is

    1. Aat FPZ
    2. Bat the ear canal
    3. Cat the promontory of the cochlea
    4. Dat the earlobe
99. 99What all raw traces are being rejected, you may need to:

    1. AIncrease the rep-rate
    2. BDecrease the stimulus intensity
    3. CTurn off the artifact reject
    4. DIncrease the vertical display sensitivity
100. 100A patient who does not have collateral blood supply during an endarterectomy can suffer a postoperative deficit if the lack of blood flow is not resolved in less than

     1. A55 min
     2. B45 min
     3. C30 min
     4. D10 min
101. 101A drop in temperature in a patients legs can cause

     1. Aan increase in the conduction velocity of the tibial nerve
     2. Ba prolongation of SSEP peak latencies
     3. Ca decrease in the amplitude of SSEP waveforms
     4. Dan increase in the amplitude of the L3S response
102. 102During a left carotid, which of the following changes is most commonly seen during cross-clamping?

     1. ABilateral decrease of median nerve cortical amplitude
     2. BUnilateral decrease of median nerve amplitude
     3. CLoss of all PTN traces including the peripheral response
     4. DBilateral decrease of peroneal nerve cortical amplitude
103. 103ANKYLOSIS

     1. AFoot drop
     2. BWrist drop
     3. CFused Joint
     4. DArterial Occlusion
104. 104All of the following are true of magnetic stimulation except:

     1. APulses of current are delivered through a coil of wire
     2. BAn electrical stimulator is required to pace the stimulus
     3. CThe stimulation is not perceived as painful
     4. DThe magnetic field created causes movement in cortical neurons
105. 105A stimulus pulse width that would tend to excite a larger population of motor fibers then sensory fibers is:

     1. A1 ms
     2. B0.2 ms
     3. C0.5 ms
     4. D0.05 ms
106. 106What is the effect on SSEPs of 50 ug/kg fentanyl

     1. Aslightly increased latency, no change in amplitude
     2. BDecreased latency, increased amplitude
     3. CIncreased latency, decreased amplitude
     4. Dno change
107. 107What bandpass filter should be used to record CMAPS for facial nerve?

     1. A10 to 500 Hz
     2. B1 to 500 Hz
     3. C10 to 1500 Hz
     4. D300 to 16000 Hz
108. 108What IV drug is used to maintain hypotension?

     1. AMethohexital
     2. BPropofol
     3. CMedazolam
     4. DNutroprusside
109. 109If a sound intensity is decreased from 80 dB to 60 dB then the sound pressure has been decreased by a factor of

     1. A20
     2. B10
     3. C2
     4. D100
110. 110Synaptic transmission, and/or changes in the thalamocortical projections, are believed to produce

     1. Aerbs point potential
     2. Bsubcortical potential
     3. CP100 potential
     4. Dcortical potentials
111. 111If all channels are showing excessive 60 Hz noise, what should you do?

     1. ACheck your ground impedance
     2. BReboot your machine
     3. CMove your machine as far away from the patient as possible
     4. DUse a 60 Hz notch filter
112. 112During a posterior fossa exploration for tic douloureaux, the monitoring of MN SSEPS will demonstrate this:

     1. Aintegrity of the brainstem
     2. Beffect of retractor placement on the cochlear and vestibular nerves
     3. Cintegrity of the somatosensory system traversing brainstem structures
     4. Dlocation of the trigeminal nerve
113. 113If unavoidable muscle artifact is present in the BAEP, you can change the locut filter to:

     1. A10 Hz
     2. B1000 Hz
     3. C200 Hz
     4. D500 Hz
114. 114Hemispheric EEG changes may be caused by:

     1. AHypothermia
     2. BDecreased blood pressure
     3. CA bolus of narcotic
     4. Dclamping of the internal carotid
115. 115A goal of intraoperative monitoring of the sensory pathway is to

     1. Adiagnose pre-existing abnormalities
     2. Bdetect global systemic changes
     3. Cdetect abnormalities (electrophysiologic change) that develop as the recordings are taken
     4. Ddifferentiate between local surgical manipulations versus anesthetic effects
116. 116Upper Motor Neurons

     1. ABrainstem
     2. BPeroneal Nerve
     3. CCerebellum
     4. DDorsal Nerve Root
117. 117Ipsilateral cranial nerve deficits combined with contralateral motor deficits indicate what site of lesion?

     1. ABrainstem
     2. BCauda Equina
     3. CSpinal Cord
     4. DCortex
118. 118The most important consideration for mapping of near field high voltage gradient signals is:

     1. AA quiet reference electrode position
     2. BClosely spaced electrodes
     3. Ccontralateral to lateral chain setup
     4. Dcomparison to scalp recorded signals
119. 119The sound stimulus intensity at the tympanic membrane depends on the:

     1. Arelation between SPL (dB) and the inverse peak equivalent SPL (dB)
     2. Brelation between SPL (dB) and peak equivalent SPL (dB)
     3. Cacoustic coupling between the sound stimulus generator and the ear
     4. Dpatients hearing threshold (dB)
120. 120The term "broadband click" refers to a

     1. Ashort peak acoustic power of 1-2 kHz
     2. Bbroad peak acoustic power of 1-5 kHz
     3. Ca peak acoustic power of 500 to 2 kHz
     4. Dpeak acoustic power of 2-4 kHz
121. 121the input impedance of a differential amplifier must be at least

     1. A>10 megaohms
     2. B10 megaohms
     3. C5 Kohms
     4. D100 megaohms
122. 122Bipolar electrodes are used for localization of:

     1. Aphase changes in instrument
     2. Bfar field signals
     3. Cdecreased common mode rejection
     4. Dsignals via phase reversal
123. 123It is important to begin monitoring EEG early during a carotid endarterectomy

     1. Ato record as much beta activity as possible before the patient is put under anesthesia
     2. Bbecause emboli can break loose and cause changes, while prepping the neck
     3. Cto prevent the anesthesiologist from removing your electrodes
     4. Dto record the EEG before anesthesia and after induction for comparison during the case
124. 124The effect of HYPOTENSION on the evoked potential includes

     1. Avariable changes in amplitude, and an increase in latency
     2. Ban increase in amplitude, and a decrease in latency
     3. Ca decrease in amplitude, and variable changes in latency
     4. Da decrease in amplitude and an increase in latency
125. 125A grounding device must be available so that, under normal conditions, no voltage greater than _______ is measured across an impedance of 1000 ohms
     

     1. A10 mV rms at 50 Hz
     2. B20 mV rms at 60 Hz
     3. C60 mV rms at 50 Hz
     4. D50 mV rms at 60 Hz
126. 126Of those patients who demonstrate significant EEG changes following cross clamping of the carotid, the majority of changes will occur within:
     

     1. A20 sec
     2. B1 min
     3. C5 min
     4. D2 min
127. 127The posterior tibial nerve arises from which branch of the sciatic nerve?

     1. Asuperior peroneal
     2. Bsuperior tibial
     3. Cexternal popliteal
     4. Dinternal popliteral
128. 128The purpose of preoperative evoked potential testing is to:

     1. ACharge the patient extra for unnecessary testing
     2. BCompare to post-induction responses
     3. CInform the surgeon of any abnormal responses
     4. DEstablish the liklihood of intraoperative changes
129. 129An unstable blood pressure during SSEP monitoring in the OR affects cortical EPs resulting in
     

     1. Afluctuating latencies
     2. Bfluctuating amplitudes
     3. Cfluctuating amplitudes and latencies
     4. Dminimal changes if the body temperature is maintained above 32° C
130. 130If you receive a shock from the system console, the first thing you should do is:

     1. Aunplug the machine
     2. Btest leakage current
     3. Cdisconnect the patient
     4. Dcall biomed
131. 131If you receive a shock from the chassis of your machine during monitoring you should first:

     1. Aturn off the machine
     2. Bdisconnect the patient
     3. Csave and print your data
     4. Dcall bioned
132. 132The purpose of isolated amplifier inputs is to

     1. Arestrict current flow to ground at 20 uA
     2. Brestrict current flow to the instrument
     3. Cprevent a flow of stray currents through connecting lines to the patient
     4. Dallow only the high voltage biological signals to pass
133. 133A patient would undergo a microvascular decompression of the facila nerve for:

     1. ATic Douloureaux
     2. BHemifacial spasm
     3. CCarotid stenosis
     4. DAcoustic neuroma
134. 134During microvascular decompression surgery to relieve a hemifacial spasm

     1. ACz'-Fpz should be monitored for median nerve stimulation
     2. Bit is necessary to monitor EMG from CN II
     3. Ca stimulation of CN VII elicits a response from the mentalis muscle
     4. Dthe buccal branch of CN V will likely show the most EMG activity
135. 135In posterior fossa craniotomy surgery for a large tumor with unilateral hearing loss, the appropriate modalities to monitor would be:
     

     1. AIpsilateral BAEP
     2. BContralateral BAEP, median nerve SSEP and facial nerve
     3. CFacial nerve and contralateral median nerve
     4. DIpsilateral BAEP and facial nerve
136. 136Which of the following would most likely result in an increased 1-111 interval?

     1. AMedullary Ependymoma
     2. BDecreased click intensity
     3. CVestibular schwannoma
     4. DCochlear lesion
137. 137Epidural electrodes should be placed:

     1. Aabove the dura
     2. Bbetween the dura and the spinal cord
     3. Cabove the lamina
     4. Dinside the spinal cord
138. 138Spinal cord ischemia during aortic surgery is best detected by changes in the

     1. Alumber N20 spinal cord potential
     2. Btibial nerve compound action potential
     3. Cposterior tibial nerve somatosensory evoked potential
     4. Dmedian nerve somatosensory evoked potential
139. 139When using constant voltage for facial nerve-stimulation and the nerve becomes bathed in CSF, what will occur after the area is suctioned?

     1. AThe output voltage will vary to maintain a preset current level
     2. BThe stimulator will stop
     3. CNo change will occur
     4. DThe current flow will vary in order to maintain the preset voltage level
140. 140Sensation Level (SL) is defined by:

     1. AThe average hearing threshold of a normal population
     2. BAn individual's hearing threshold
     3. CA measure of the ambient pressure
     4. DThe absolute sound pressure relative to atmospheric pressure
141. 141Which montage would you use to confirm a change in the Cz-Fz cortical response to PTN stim?

     1. ACS5-Fz
     2. BPop Fossa
     3. CErb's point
     4. DCPc - CPi
142. 142Subdermal needle electrodes must be inserted symmetrically over homologous brain areas to avoid:
     

     1. Aartificial amplitude asymmetries
     2. Bexcessive high impedance
     3. Cexcessive bleeding
     4. Dcommon mode rejection of the EEG signal
143. 143You are most likely to see changes during exposure of a spine surgery due to:

     1. AAltered recording parameter
     2. BSpinal cord compression
     3. CAnesthesia induced hypotension
     4. DUse of electrocautery
144. 144For stimulation in MEP, the anode should be placed:

     1. Amedial to the cathode
     2. Bcaudal to the cathode
     3. Clateral to the cathode
     4. Drostral to the cathode
145. 145In posterior fossa surgery, an increase in the 111-V interpeak interval would most likely be due to:

     1. ACompression of the medial geniculate nucleus
     2. BTraction on the cerebellum
     3. CTraction on the acoustic nerve
     4. DFluid in the middle ear
146. 146An advantage to using grid or strip electrodes over the "Crown of Thorns" for recording ECOG is the ability to:
     

     1. Aindividually position each contact
     2. Bsterilize and reuse them
     3. Cplace electrodes precisely on gyri
     4. Dslide them under the dura to unexposed areas
147. 147If the highest frequency component of an evoked potential is 400 Hz, then the minimum sampling rate required to accurately represent the signal is:
     

     1. A1600 Hz
     2. B200 Hz
     3. C400 Hz
     4. D800 Hz
148. 148Which of the following can cause generalized seizure activity?

     1. AHalothane
     2. BEnflurane
     3. CN20
     4. DIsoflurane
149. 149The median nerve SSEP - N18 potential is recorded:

     1. Ausing a bipolar scalp derivation
     2. Bfrom the cervical spine electrode
     3. Creferentially from scalp electrodes ipsilateral to the stimulated nerve
     4. Dfrom Erb's point to an off-site reference
150. 150What is the min. bandpass for an evoked potential system?

     1. A0.1 - 5000 Hz
     2. B1000 - 10000 Hz
     3. C100 - 3000 Hz
     4. D0 - 100 Hz
151. 151If the monitoring instrument develops an inability to average, steps to take would include all of the following except:

     1. Acheck that all cables are routed separately
     2. Bcheck electrode impedances
     3. Censure that the stimulus rate is not a multiple of the interference frequency
     4. Dconsult with the anesthesiologist regarding anesthesia changes
152. 152With a sampling rate of 10 kHz the shortest sine wave resolved would be:

     1. A0.02 msec
     2. B0.2 msec
     3. C0.4 msec
     4. D2 msec
153. 153If a 10 microvolt signal inside 50 microvolts of noise is averaged for 100 traces, the final signal to noise ratio will be:

     1. A2:1
     2. B5:1
     3. C1:1
     4. D1:5
154. 154If you have a signal to noise ratio of 1:2, averaging 64 responses will:

     1. Aimprove the ratio to 8:1
     2. Breduce the noise by 50%
     3. Cno change the ratio
     4. Dimprove the ratio to 4:1
155. 155For spinal cord monitoring using SSEPs, epidural electrodes should be placed:

     1. ARostral to the surgical site
     2. BCaudal to the surgical site
     3. CInto the patient's external auditory canal
     4. DIn the center of the surgical site
156. 156A constant voltage stimulator

     1. Avaries the current in order to maintain a preset voltage level
     2. Bvaries the output in order to maintain a preset current level
     3. Cmaintains a constant voltage of 100 volts
     4. Dmaintains a current level of 10 mA
157. 157It is recommended that while recording intraoperative BAEPs, the recording electrodes be sealed with tape in order to:
     

     1. Aprevent them from oxidizing
     2. Bkeep the impedances high
     3. Cprevent drying and to protect from fluids
     4. Dkeep stimulation artifact to a minimum
158. 158In a normal adult, stimulation of the median nerve at the wrist will:

     1. Aproduce a visible twitch in the abductor hallucis muscle
     2. Belicit a primary cortical response at about 20 msec
     3. Celicit a cervical response at approximately 18 msec
     4. Delicit an Erb's point response at about 15 msec
159. 159What is the best montage to use to evaluate dorsal column activity?

     1. ACPc - EP
     2. BCS5 - EPc
     3. CEPi - EPc
     4. DCPi - EPc
160. 160The motor strip corresponding to the hand is most likely at:

     

     1. A6D
     2. B6B
     3. C6C
     4. D6E
161. 161Which electrode indicates the location of the sensory strip?

     

     1. A6C
     2. B6D
     3. C6A
     4. D6B
162. 162When using a bipolar montage during EEG recording, the localizing sign is:

     1. Athe maximum amplitude activity is replicated in all channels display the highest amplitude in the electrode referred to a common reference
     2. Ba phase reversal between adjacent channels having a common electrode
     3. Cat the end of the chain of electrode selections
     4. Dthe highest amplitude in the electrode referred to a common reference
163. 163Which of the following peaks in tibial nerve SSEPs is most analogous to P14 of median nerve SSEP?

     1. AN20
     2. BP31
     3. CN34
     4. DP37
164. 164Which of the following cranial nerves innervates the extraocular muscles?

     1. AAbducens
     2. BFacial
     3. COptic
     4. DTrigeminal
165. 165In SSEP monitoring during spinal cord surgery, an epidural electrode placed caudal to the surgical site is
     used to:
     

     1. AEvaluate anesthetic levels
     2. BReflect motor action potential
     3. CVerify adequate stimulation
     4. DMeasure neuromuscular blockade
166. 166What is the average number of trials for BAERS?

     1. A700-800
     2. B>1000
     3. C500-600
     4. D<200
167. 167What is the optimal stimulus rate for PTN?

     1. A6.0 Hz
     2. B16 Hz
     3. C15 Hz
     4. D3.7 Hz
168. 168How do you increase your horizontal resolution?

     1. AIncrease stim rate
     2. Bincrease hi cut filter
     3. Cdecrease data points
     4. Ddecrease analysis time
169. 169Vascular compromise of the posterior cerebral artery will most likely have what effect on the MN SEP?

     1. ALoss of P14/N18
     2. BLoss of N13
     3. CLoss of N20/P22
     4. DLoss of Erb's point
170. 170Which of the following nerve injuries usually does NOT produce spontaneous EMG activity during intraoperative monitoring?

     1. AIrrigation
     2. BPressure
     3. CHeat
     4. DIschemia
171. 171Which is the most common type of change observed during CEA?

     1. AContalateral EEG slowing, reduced cortical SSEP to contralateral stimulation
     2. BIpsilateral EEG slowing, reduced cortical SSEP to ipsilateral stimulation
     3. CIpsilateral EEG slowing, reduced cortical SSEP to contralateral stimulation
     4. DBilateral EEG slowing, reduced cortical SSEP to bilateral stimulation
172. 172If an amplifier is rated as having 120dB common mode rejection ratio, which of the following ratios of in phase to out-of-phase signals would be expected?

     1. A1,000,000:1
     2. B100,000:1
     3. C500,000:1
     4. D10,000:1
173. 173Which of the following would enhance wave 1 of the BAEP?

     1. ADecrease the number of repititions
     2. BIncrease the rate
     3. CDecrease the analysis time
     4. DIncrease the intensity
174. 174In a bipolar montage, the key element in localization is the

     1. ARelative voltage in each channel
     2. BInstrument phase reversal
     3. CSynchronization of discharges
     4. DCommon mode rejection of in-phase noise
175. 175You do not want to use a power extension cord because:

     1. AIt may interfere with the operation of other devices in the operating room
     2. BIt is a fire hazard
     3. CIt will mean that more current could be delivered to the patient if the ground fails
     4. DIt will increase your risk of ground leakage
176. 176What will enhance the analog to digital conversion?

     1. Amake sure the sampling rate is at least half the signal frequency
     2. Buse the shortest possible stimulus interval
     3. CUse the longest timebase possible
     4. DEnsure that the range is appropriate to the size of the signal being recorded
177. 177What is the most appropriate BRANCH to monitor for a cervical surgery at C7

     1. ARadial
     2. BMedian
     3. CMusculocutaneous
     4. DUlnar
178. 178Imbalanced Impedances

     1. ADegrade Common Mode Rejection
     2. BReduce 60 Hz artifact
     3. CCause electrode polarization
     4. DReduce Stimulus Artifact
179. 179In a compressed density spectral array, frequency is depicted by:

     1. AData points
     2. BY axis
     3. CX axis
     4. DEpoch
180. 180If you cannot evaluate motor twitch you:

     1. ALeave intensity at 20 mA
     2. BIncrease intensity until the peripheral response no longer increases
     3. CIncrease pulse duration
     4. DIncrease intensity until any discernible response is present
181. 181Which of the following must be removed before placing an epidural electrode?

     1. APedicles
     2. BLamina
     3. CDisc
     4. DVertebral Body
182. 182The length of a patients limb directly influences:

     1. AInterpeak latencies
     2. BAmplitude Ratio
     3. CAbsolute peak latencies
     4. DResponse amplitude
183. 183What is the minimum sampling rate needed to identify an evoked potential containing 500 Hz frequency?

     1. A750 Hz
     2. B500 Hz
     3. C1000 Hz
     4. D200 Hz
184. 184What is the main reason for measuring impedances of all electrodes?

     1. Ato check amplifier input impedances
     2. Bto depolarize the electrodes
     3. Cto calibrate the amplifiers
     4. Dto evaluate the electrode contact
185. 185The stimulus rate is determined by:

     1. ANerve conduction velocity
     2. Bstimulus intensity
     3. Canalysis time
     4. Dnumber of stimulations
186. 186you want to have matching impedances so that

     1. Ayou can minimize your common mode rejection
     2. Bvertical resolution will be optimized
     3. Cyou can maximize your common mode rejection
     4. Dhorizontal resolution will be optimized
187. 187Which of the following blood pressures is most likely to attenuate the evoked potential?

     1. A120 mm/Hg
     2. B130 mm/Hg
     3. C140 mm/Hg
     4. D150 mm/Hg
188. 188Horizontal Dipole

     1. AP14
     2. BN18
     3. CEP
     4. DN34
189. 189Which derivation is scalp to non-cephalic?

     1. AEPi - EPc
     2. BFz - C5S
     3. CCPc - CPi
     4. DCPz - Fz
190. 190During WADA testing, what should you expect after injection of sodium amytal?

     1. AContralateral cortex slow wave activity increase
     2. BBilateral cortex slow wave activity increase
     3. CIpsilateral cortex slow wave activity increase
     4. DBilateral fast wave activity increase
191. 191What is the suggested IOM auditory stimulation according to ACNS guidelines?

     1. A100 dB pe SPL with masking
     2. B100 dB pe SPL without masking
     3. C90 dB pe SPL with masking
     4. D90 dB pe SPL without masking
192. 192Which of the following can decrease horizontal resolution?

     1. AIncreasing the stim rate
     2. Bincreasing the HFF
     3. Cdecreasing the analysis time
     4. Ddecreasing the number of data points
193. 193Most sensitive predictor of post - op deafness in BAER?

     1. ALoss of wave I
     2. BLoss of wave II
     3. CLoss of wave III
     4. DLoss of wave V

Description

Quiz on CNIM WRONG/ NEED TO KNOW, created by Suzanne Picciurro on 12/08/2019.

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Suzanne Picciurro

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