IOM.txt

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IOM.txt
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2010-02-10 13:16:48
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IOM
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  1. XII Hypoglossal - what muscle is used for EMG monitoring?
    Tongue
  2. X Vagus - what muscle is used for EMG monitoring?
    Crycothyroid
  3. IX Glossopharyngeal - what muscle is used for EMG monitoring?
    Stylopharyngeus
  4. VII Facial - what muscle(s) is/are used for EMG monitoring?
    • • Orbicularis Oris
    • • Orbicularis Oculi
  5. VI Abducens - what muscle is used for EMG monitoring?
    Lateral rectus
  6. V Trigeminal- what muscle is used for EMG monitoring?
    Masseter
  7. IV Trochlear - what muscle is used for EMG monitoring?
    Superior Oblique
  8. III Oculomotor - what muscle is used for EMG monitoring?
    Inferior Rectus
  9. What is the number of the Spinal Accessory cranial nerve?
    XI
  10. What are the functions of the Spinal Accessory nerve?
    • •Motor - trapezius
    • •Motor - sternocleidomastoid
  11. What is the name of the 11th cranial nerve (XI)?
    Spinal accessory
  12. What are the functions of the 11th (XI) cranial nerve?
    • •Motor - trapezius
    • •Motor - sternocleidomastoid
  13. What is the number of the Hypoglossal cranial nerve?
    XII
  14. What is the name of the twelfth (XII) cranial nerve?
    Hypoglossal
  15. What is the function of the Hypoglossal cranial nerve?
    Motor - tongue
  16. What is the function of the twelfth (XII) cranial nerve?
    Motor - tongue
  17. What is the number of the Vagus cranial nerve?
    X
  18. What is the name of the tenth (X) cranial nerve?
    Vagus
  19. What are the functions of the Vagus cranial nerve?
    • •Sensory - pharynx and larynx
    • •Sensory - thorax
    • •Sensory - abdomen
    • •Motor - soft palate, pharynx and larynx
    • •Autonomic - heart, blood vessels, trachea, bronchi, esophagus, stomach, intestines
  20. What are the functions of the tenth (X) cranial nerve?
    • •Sensory - pharynx and larynx
    • •Sensory - thorax
    • •Sensory - abdomen
    • •Motor - soft palate, pharynx and larynx
    • •Autonomic - heart, blood vessels, trachea, bronchi, esophagus, stomach, intestines
  21. What is the name of the ninth (IX) cranial nerve?
    Glossopharyngeal
  22. What is the number of the Glossopharyngeal cranial nerve?
    IX
  23. What is the function of the ninth (IX) cranial nerve?
    • •Sensory - Taste
    • •Sensory - Palate
    • •Sensory - Posterior 1/3 of tongue
    • •Motor - Posterior throat
    • •Autonomic - Parotid gland
  24. What is the function of the Glossopharyngeal cranial nerve?
    • •Sensory - Taste
    • •Sensory - Palate
    • •Sensory - Posterior 1/3 of tongue
    • •Motor - Posterior throat
    • •Autonomic - Parotid gland
  25. What is the name of the eighth (VIII) cranial nerve?
    Vestibulocochlear
  26. What is the number of the Vestibulocochlear cranial nerve?
    VIII
  27. What is the function of the eighth (VIII) cranial nerve?
    Sensory - hearing and equilibrium
  28. What is the function of the Vestibulocochlear cranial nerve?
    Sensory - hearing and equilibrium
  29. What is the name of the seventh (VII) cranial nerve?
    Facial
  30. What is the number of the Facial cranial nerve?
    VII
  31. What is the function of the seventh (VII) cranial nerve?
    • •Motor - facial expression
    • •Sensory - taste
    • •Autonomic - salivary and lacrimal
  32. What is the function of the Facial cranial nerve?
    • •Motor - facial expression
    • •Sensory - taste
    • •Autonomic - salivary and lacrimal
  33. What is the name of the sixth (VI) cranial nerve?
    Abducens
  34. What is the number of the Abducens cranial nerve?
    VI
  35. What is the function of the sixth (VI) cranial nerve?
    Motor - eye movement
  36. What is the function of the Abducens cranial nerve?
    Motor - eye movement
  37. What is the name of the fifth (V) cranial nerve?
    Trigeminal
  38. What is the number of the Trigeminal cranial nerve?
    V
  39. What is the function of the fifth (V) cranial nerve?
    • •Sensory - face, mouth, teeth, front 2/3 of tongue
    • •Motor - mastication
  40. What is the function of the Trigeminal cranial nerve?
    • •Sensory - face, mouth, teeth, front 2/3 of tongue
    • •Motor - mastication
  41. What is the name of the fourth (IV) cranial nerve?
    Trochlear
  42. What is the number of the Trochlear cranial nerve?
    IV
  43. What is the function of the fourth (IV) cranial nerve?
    Motor - eye movement
  44. What is the function of the Trochlear cranial nerve?
    Motor - eye movement
  45. What is the name of the third (III) cranial nerve?
    Oculomotor
  46. What is the number of the Oculomotor cranial nerve?
    III
  47. What is the function of the Oculomotor cranial nerve?
    • •Motor - eye movement, eyelids
    • •Autonomic - pupil constriction
  48. What is the function of the third (III) cranial nerve?
    • •Motor - eye movement, eyelids
    • •Autonomic - pupil constriction
  49. What is the name of the second (II) cranial nerve?
    Optic
  50. What is the number of the Optic cranial nerve?
    II
  51. What is the function of the second (II) cranial nerve?
    Sensory - vision
  52. What is the function of the Optic cranial nerve?
    Sensory - vision
  53. What is the name of the first (I) cranial nerve?
    Olfactory
  54. What is the number of the Olfactory cranial nerve?
    I
  55. What is the function of the first cranial nerve?
    Sensory - smell
  56. What is the function of the Olfactory cranial nerve?
    Sensory - smell
  57. Which spinal nerve roots innervate the Trapezius?
    C3, C4
  58. Which muscle is preferred for EMG monitoring of the C3 and C4 nerve roots?
    Trapezius
  59. Which spinal nerve root innervates the Deltoid?
    C5
  60. Which muscle is preferred for EMG monitoring of the C5 nerve root?
    Deltoid
  61. Which spinal nerve root innervates the Biceps?
    C6
  62. Which muscle is preferred for EMG monitoring of the C6 nerve root?
    Biceps
  63. Which spinal nerve root innervates the Triceps?
    C7
  64. Which muscle is preferred for EMG monitoring of the C7 nerve root?
    Triceps
  65. Which spinal nerve root innervates the Flexor carpi ulnaris?
    C8
  66. Which muscle is preferred for EMG monitoring of the C8 nerve root?
    Flexor carpi ulnaris
  67. Which spinal nerve root innervates the Sartorius?
    L1
  68. Which spinal nerve root innervates the Iliopsoas?
    L1
  69. Which muscles are preferred for EMG monitoring of the L1 nerve root?
    • •Sartorius
    • •Iliopsoas
  70. Which spinal nerve roots innervate the Rectus femoris?
    L2, L3, L4
  71. Which spinal nerve roots innervate the Vastus lateralis?
    L2, L3
  72. Which muscles are preferred for EMG monitoring of the L2-L3 nerve roots?
    • •Rectus femoris
    • •Vastus lateralis
  73. Which spinal nerve roots innervate the Tibialis anterior?
    L4, L5
  74. Which spinal nerve roots innervate the Biceps femoris?
    L5, S1, S2
  75. Which muscles are preferred for EMG monitoring of the L4 nerve root?
    • •Tibialis anterior
    • •Rectus femoris
  76. Which muscles are preferred for EMG monitoring of the L5 nerve root?
    • •Tibialis anterior
    • •Biceps femoris
  77. Which muscle is preferred for EMG monitoring of the S1 nerve root?
    Biceps femoris
  78. Which spinal nerve root innervates the Gastrocnemius?
    S2
  79. Which muscles are preferred for EMG monitoring of the S2 nerve root?
    • •Gastrocnemius
    • •Biceps femoris
  80. Which spinal nerve roots innervate the Anal sphincter?
    S3, S4
  81. Which muscle is preferred for EMG monitoring of the S3 - S4 nerve roots?
    Anal sphincter
  82. Impedance can be defined as the opposition to what?
    Alternating current
  83. Resistance can be described as the opposition to what?
    Direct current
  84. What range of impedance is considered acceptable for EEG scalp electrodes?
    1000 - 5000 ohms (1 - 5 kiloohms)
  85. What is the generator of Wave I of the BAEP?
    The distal VIII cranial nerve.
  86. What is the generartor of Wave II of the BAEP?
    The cochlear nucleus.
  87. What is the generator of Wave III of the BAEP?
    The superior olivary nucleus.
  88. What is the generator of Wave IV of the BAEP?
    Lateral lemnisus.
  89. What is the generator of Wave V of the BAEP?
    Inferior colliculus.
  90. How often should IOM equipment undergo electrical safety checks?
    Every 6 months.
  91. What is a typical filter setting for BAEPs?
    • LFF = 30 Hz
    • HFF = 3000 Hz
  92. What is a typical stimulation rate for BAEPs?
    11 Hz.
  93. What is the frequency range of delta activity?
    <4 Hz
  94. What is the frequency range of theta activity?
    4 to 7 Hz
  95. What is the frequency range of alpha activity?
    8 - 12 Hz
  96. What is the frequency range of beta activity?
    13 - 30 Hz
  97. In the event of occlusion of either the internal carotid artery (ICA) or middle cerebral artery (MCA), where are SEP changes likely to occur?
    Cortical Median SEPs (ipsilateral hand)
  98. In the event of occlusion of the posterior cerebral artery (PCA), where are SEP changes likely to occur?
    • Loss of Median Cervical SEP signals (according to practice test)
    • Cortical Median SEPs (contralateral hand)
  99. What EP is used as an indicator of occlusion of the anterior cerebral artery (ACA)?
    Cortical posterior tibial SEP from the contralateral leg.
  100. What EPs should be employed for procedures involving the superior cerebellar artery (SuCA) or the anterior inferior cerebellar artery (AICA)?
    Median SEPs to the contralateral hand.
  101. What EPs should be employed for procedures involving the posterior inferior cerebellar artery (PICA)?
    Median SEPs to the ipsilateral hand.
  102. What is the likely effect of occlusion of the basilar artery on SEPs?
    Bilateral loss of cortical and cervical signals.
  103. Which arteries supply the brainstem?
    • Basilar artery (BA)
    • Posterior inferior cerebellar artery (PICA)
    • Anterior inferior cerebellar artery (AICA)
    • Superior cerebellar artery (SuCA)
    • Posterior cerebral artery (PCA)
  104. What monitoring modalities are recommended for procedures in the area of the posterior fossa?
    • BAEPs
    • SEPs
    • Cranial EMGs/tEMGs
  105. What monitoring modalities are recommended for procedures in the area of the supratentorium?
    • EEG
    • SEPs
  106. What arteries are at risk during procedures in the supratentorium region?
    • Anterior cerebral artery(ACA)
    • Anterior communicating artery(ACom)
    • (MCA)
    • (PCA)
    • (BA)
  107. What artery may be paritally obstructed if the temporal lobe is retracted during surgical procedure?
    Middle cerebral artery (MCA)
  108. Which artery is the main blood supply for the hand area of the medial somatosensory cortex?
    Middle cerebral artery (MCA)
  109. What artery is the main source of blood supply to the leg area of the somatosensory cortex?
    Anterior cerebral artery (ACA)
  110. What artery is most commonly linked to trigeminal neuralgia?
    Anterior cerebral artery (ACA)
  111. What artery is most commonly linked to hemifacial spasm?
    Posterior inferior cerebellar artery (PICA)
  112. What modalities should be used if blood vessels supplying the brainstem are involved in a surgical procedure?
    SEPs and BAEPs.
  113. What modality should be used for procedures involving the ICA, MCA, PCA, PCom or BA arteries?
    Median SEPs.
  114. What modality should be employed for surgical procedures involving teh ACA or ACom arteries?
    Posterior tibial nerve SEPs.
  115. What cortical signal might a newborn infant show after stimulation of the median nerve?
    N30.
  116. What cortical signal might a newborn infant show after stimulation of the posterior tibial nerve?
    P50.
  117. At what age to SEPs normally reach adult form?
    3 - 10 years.
  118. What effect will inhalational anesthetics have on SEPs?
    • Significant amplitude decrease
    • Significant increase in latency
  119. What effect will Propofol have on SEPs?
    • No change in amplitude
    • Moderate increase in latency
  120. What effects will Barbituates have on SEPs?
    • Moderate decrease in amplitude
    • Significant increase in latency
  121. What effect will Etomidate have on SEPs?
    • Increase in amplitude by 200-600%
    • Moderate decrease in latency
  122. What effect does Ketamine have on SEPs?
    • Increase in amplitude by 200-600%
    • Moderate decrease in latency
  123. What effect do opiates have on SEPs?
    • No change in amplitude
    • Moderate increase in latency
  124. What effects do Benzodiazepines have on SEPs?
    • Significant decrease in amplitude
    • Significan increase in latency
  125. What effect do muscle relaxants have on SEPs?
    No direct effects
  126. What effects do hypotensive agents have on SEPs?
    • Moderate decrease in amplitude
    • Moderate increase in latency
  127. What effects does Nitrous Oxide have on BAEPs?
    • Moderate decrease in amplitude
    • No change in latency
  128. What effects do inhalational anesthetics (other than Nitrous Oxide) have on BAEPs?isi
    • No change in amplitude
    • Moderate increase in latency
  129. What is Ohm's Law?
    I = V/R
  130. Define microshock.
    Shock as low as 100 uA
  131. What is the maximum allowable leakage current through patient leads?
    10 uA
  132. With ground open, what is the maximum acceptable chassis leakage?
    300 uA
  133. The brachial plexus is innervated by which spinal root levels?
    C5 through T1
  134. The median nerve is innervated by which spinal roots?
    C5 - T1
  135. What nerve of the brachial plexus innervates the abductor poolicis brevis?
    Median nerve
  136. What spinal roots innervate the abductor pollicis brevis?
    C8 - T1
  137. What brachial plexus nerve innervates the pronator teres?
    Medial nerve
  138. What spinal root levels innervate the pronator teres?
    C6 - C7
  139. What spinal root levels innervate the ulnar nerve?
    C8 - T1
  140. What brachial nerve innervates the Adductor Pollicis?
    Ulnar nerve
  141. What spinal nerve roots innervate the Adductor pollicis?
    C8 - T1
  142. What brachial plexus nerve innervates the first dorsal interosseous?
    Ulnar nerve
  143. What spinal nerve roots innervate the First Dorsal Interosseous?
    C8 - T1
  144. What brachial plexus nerve innervates the abductor digiti minimi?
    Ulnar nerve
  145. What spinal nerve roots innervate the abductor digiti minimi?
    C8 - T1
  146. What brachial plexus nerve innervates the Flexor Carpi Ulnaris?
    Ulnar nerve
  147. What spinal nerve root levels innervate the Flexor Carpi Ulnaris?
    C8 - T1
  148. What nerve root levels innervate the radial nerve?
    C5- T1
  149. What brachial plexus nerve innervates the brachioradialis?
    Radial nerve
  150. What spinal nerve root levels innervate the brachioradialis?
    C5 -C6
  151. What brachial plexus nerve innervates the triceps?
    Radial nerve
  152. What spinal nerve root levels innervate the triceps?
    C6 - C8
  153. What spinal nerve roots innervate the axillary nerve?
    C5 - C6
  154. What brachial plexus nerve innervates the deltoid?
    Axillary nerve
  155. What spinal nerve root innervates the musculocutaneous nerve?
    C5 - C6
  156. What brachial plexus nerve innervates the biceps?
    C5 - C6
  157. What muscle is innervated by the accessory cranial nerve (XI) and spinal roots C2 - C3?
    Sternocleidomastoid
  158. What muscle is innervated by C2 - C3 and the XI cranial nerve (Accessory)?
    Sternocleidomastoid
  159. What muscle is innervated by C3-C4 and the XI cranial nerve (Accessory)?
    Trapezius
  160. What is a reasonable rate of stimulation to obtain transient signals for pattern-reversal VEPs?
    4/sec or less
  161. What is the formula for obtaining visual angle for pattern-reversal VEPs in minutes of arc?
    3438 x W/D
  162. What can a change in contrast in stimulus do to pattern shift VEPs?
    Latency shift
  163. What level of contrast is acceptable for visual stimulus in pattern-shift VEPs?
    >50%
  164. What are acceptable field size and check size ranges for stimulating central vision in pattern-shift VEPs?
    12-16' check size and 2-4 degree field size
  165. What are acceptable field size and check size ranges for stimulating the peripheral vision in pattern-shift VEPs?
    40-50' check size and 16-32 degree field size
  166. What are acceptable field size and check size ranges for initial pattern-shift VEP testing?
    24-32' check size and 6-12 degree field size
  167. What bandpass is used for pattern-shift VEPs?
    1-100 Hz
  168. What analysis time is used for pattern-shift VEPs?
    250 msec
  169. If P100 appears excessively delayed, what changes can be made to VEP recording parameters?
    • Extend analysis time to 500 msec
    • Reduce stimulation rate to 2/msec or less
  170. How many averaged responses should be acquired for pattern-shift VEPs?
    At least 2
  171. In VEPs, where is N100 generated?
    Midfrontal region (MF)
  172. What 3 criteria are used to determine abnormal VEPs?
    • Intraocular latency difference
    • Intraocular amplitude ratio
    • Interhemispheric amplitude ratio

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