CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…///, Exams of Health sciences

Download CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// and more Exams Health sciences in PDF only on Docsity! CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// Lower motors neurons primarily exit the cord through the: 1 dorsal nerve roots 2 ventral nerve roots 3 dorsal columns 4 dorsal root ganglia - Correct Answer ✅Ventral Nerve Roots Which one of the following is an excitatory neurotransmitter? 1 GABA 2 Glutamate 3 Glycine 4 Phenylalanine - Correct Answer ✅Glutamate Which one of the following is an inhibitory neurotransmitter? 1 GABA 2 Serotonin 3 Dopamine 4 Phenlalanine - Correct Answer ✅GABA CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// The layers of protective tissue which surround the CNS are called: 1 the ventricles 2 the meninges 3 Cerebrospinal fluid 4 The Skull - Correct Answer ✅the meninges What separates the motor and sensory strips? 1 Sylvian Fissure 2 Central Sulcus 3 Frontal Sulcus 4 Sagittal Fissure - Correct Answer ✅Central Sulcus The interconnecting blood vessels at the base of the brain make up: 1 the circle of Willis 2 the Carotid exchange 3 the circle of Milford 4 the Perfect circle - Correct Answer ✅The Carotid Exchange CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 3 Filum Terminale 4 Conus Medularis - Correct Answer ✅cauda equina The nerve root entry levels for the ulnar nerve are: 1 C1-4 2 C5-T1 3 C5-6 4 C8-T1 - Correct Answer ✅C8-T1 The nerve root entry levels for posterior tibial nerve are: 1 C5-T1 2 L1-4 3 L4-S3 4 S1-S5 - Correct Answer ✅L4-S3 The tibial and common peroneal nerves form from what nerve? 1 Sural 2 Saphenous CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 3 Femora 4 Sciatic - Correct Answer ✅Sciatic Stimulation of the MN at the wrist will activate which muscle? 1 Abductor digiti minimi 2 Abductor pollicis brevis 3 Biceps 4 Deltoid - Correct Answer ✅Abductor pollicis brevis Stimulation of the peroneal nerve is performed: 1 across the medial malleolus 2 across the lateral malleolus 3 across the head of the fibula 4 in the medial third of the antecubital space - Correct Answer ✅Across the head of the fibula The resting membrane potential of a neuron is primarily maintained by: 1 passive diffusion of charged ions CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 2 the sodium-potassium pump 3 action potentials 4 the opening of sodium channels - Correct Answer ✅the Sodium-Potassium pump A typical resting membrane potential of a neuron is: 1 +20 mV inside the cell 2 -20 mV inside the cell 3 +70 mV inside the cell 4 -70 mV inside the cell - Correct Answer ✅-70mV inside the cell What is the initial event that occurs when the action potential threshold of a neuron is reached? 1 The ATP pump shuts down 2 Voltage-gated Sodium channels open 3 Voltage-gated Sodium channels close 4 Sodium rapidly diffuses out of the cell - Correct Answer ✅Voltage-gated Sodium channels open CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 2 Diazepam 3 Pavulon 4 Sevoflurane - Correct Answer ✅Diazepam MAC stands for: 1 minimum anesthetic consciousness 2 maximum alveolar compromise 3 minimum alveolar concentration 4 minimum anesthetic concentration - Correct Answer ✅minimum alveolar concentration Opioids are used primarily for: 1 Analgesia 2 Neuromuscular blockade 3 amnesia 4 anesthesia - Correct Answer ✅Analgesia Midazolam is what type of drug? CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 1 Opioid 2 neuromuscular blocker 3 halogenated gas 4 benzodiazepine - Correct Answer ✅Benzodiazepine Which of the following drugs has an appreciable effect on peripheral nerve APs? 1 Sufentanil 2 Vecuronium 3 Desflurane 4 none of the above - Correct Answer ✅none of the above Which of the following is a barbiturate? 1 Remifentanyl 2 Methohexital 3 Curare 4 Nitrous Oxide - Correct Answer ✅Methohexital CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// Desflurane has a more rapid onset and recovery than Isoflurane bc: 1 Des has a lower blood solubility than Iso 2 Des has a higher blood solubility than Iso 3 Des is injected directly into the blood stream 4 a MAC of Des is several times that of Iso - Correct Answer ✅Desflurane has a higher blood solubility than Isoflurane Which of the following is consistent with increasing depth of anesthesia? 1 Bilateral reduction of all SSEPs 2 Unilateral reduction of SSEPs on the dominant side 3 Bilateral reduction of cortical SSEPs only 4 Inc latencies of all SSEPs - Correct Answer ✅bilateral reduction of cortical SSEPs only Which of the following is most affected by halogenated agents? 1 BAEPs 2 MN subcortical response 3 Lumbar response to tibial nerve stimulation CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// For spontaneous EMG monitoring, which is the most appropriate drug to use at induction? 1 Curare 2 Pavulon 3 Succinylcholine 4 Norcuron - Correct Answer ✅Succinylcholine Which of the following are known to increase evoked potential amplitudes? 1 Nitrous Oxide 2 Ketamine 3 Halothane 4 Sufentanil - Correct Answer ✅Ketamine Fentanyl infusion will: 1 have no effect on amplitude or latency 2 decrease amplitude only 3 increase amplitude and increase latency CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 4 increase latency and decrease amplitude - Correct Answer ✅increase latency and decrease amplitude Which of the following can increase SSEPs amplitude? 1 Fentanyl 2 Etomidate 3 Isoflurane 4 0.5 MAC of halothane - Correct Answer ✅0.5 MAC of halothane What is the most important step to seting up BAEPs? 1 Cleaning the ear canal with Betadine 2 Placing the foam inserts 3 Sealing the ear closed 4 Filling the tubing with saline - Correct Answer ✅Placing the foam inserts If you have a lot of high freq. noise in your BAEPs, you can: 1 change your filter from 10 to 30 Hz 2 change your filter from 10 to 200 Hz CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 3 change your filter from 2500 to 150 Hz 4 change your filter from 2500 to 1500 Hz - Correct Answer ✅Change your filter from 2500 to 1500 Hz If a sound intensity is increased from 20 dB to 40 dB, then the sound pressure has increased by a factor of: 1 20 2 2 3 10 4 100 - Correct Answer ✅10 Loss of BAEPs during drilling of the internal auditory canal is most likely due to: 1 Compression of the brainstem 2 Disruption of the blood supply 3 Excessive noise 4 Transection of the auditory nerve - Correct Answer ✅Excessive Noise CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 1 Medulla 2 Midbrain 3 Thalamus 4 Temporal lobe - Correct Answer ✅Midbrain What is the very large amplitude potential following the BAEP waves I-V at approx. 15 ms? 1 Large latency potential 2 Postauricular myogenic response 3 Middle latency potential 4 Wave VI - Correct Answer ✅Postauricular myogenic response BAEPs can no longer be successfully performed after resection of the: 1 Tympanic Membrane 2 Ossicles 3 Acoustic Nerve 4 Vestibular Nerve - Correct Answer ✅Acoustic Nerve CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// CNS depressants cause: 1 minimal effects in BAEPs 2 Prolonged I-V latencies 3 Prolonged III-V latencies 4 Inc absolute latencies with no change in interpeaks. - Correct Answer ✅Minimal effects in BAEPs BAEPs are appropriate for monitoring: 1 Spinal Cord function 2 Brainstem function 3 Facial Nerve 4 Motor Function - Correct Answer ✅Brainstem function The Brainstem Auditory EPs (BAEPs) typically involves what type of stimulus? 1 Tone burst 2 Electrical pulse 3 Click sound 4 White noise - Correct Answer ✅Click Sound CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// During a posterior fossa resection of an acoustic neuroma, you observe the loss of wave II only in the BAEP. You should: 1 Inform the surgeon. This indicates significant damage to the VIIIth Nerve 2 Check the contralateral BAEP to confirm a lesion in the pons. 3 Continue to monitor without alarm 4 Check anesthetic levels - Correct Answer ✅Continue to monitor without alarm Excessive cerumen may cause: 1 Absence of the BAEP 2 Inc I-V interpeak latencies 3 Inc I-III interpeak latencies 4 Absence of wave V - Correct Answer ✅Absence of the BAEP Which of the following is most consistent with a discrete lesion of the medial geniculate body? 1 Loss of wave V 2 Loss of waves III-V CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 1 Inc I-III latency 2 Loss of wave V only 3 Absence of waves III-V 4 No change - Correct Answer ✅Absence of waves III-V Of the choices below, the optimal repetition rate for BAEPs is: 1 11.4 Hz 2 30 Hz 3 56 Hz 4 122 Hz - Correct Answer ✅56 Hz According to the Guidelines, what is the acceptable sweep for BAEPs? 1 25 msec 2 20-30 msec 3 10-15 msec 4 5 msec - Correct Answer ✅10-15 msec To eliminate crossover, the Guidelines suggest a masking level of: CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 1 60 dB SPL 2 60 dB HL 3 60 dB SL 4 60 dB nHL - Correct Answer ✅60 dB HL Of the choices below, the most appropriate BAEP interstimulus interval is: 1 10-20 mS 2 33-90 mS 3 0.02 mS 4 1-5 mS - Correct Answer ✅33-90 mS What is the most common reason for loss of BAEPs during retromastoid microvascular decompression? 1 Cut the cochlear nerve 2 Injury to the facial nerve 3 Opening of the dura 4 Compromise vascular supply - Correct Answer ✅Compromise vascular supply CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// You would expect a loss of BAEPs in which surgery? 1 Temporal resection 2 Foramen magnum decompression 3 Pontine glioma 4 Parotidectomy - Correct Answer ✅Pontine glioma Reversible loss of BAEPs indicates: 1 Complete neurological recovery 2 Permanent post-op deficits 3 Hypothermia 4 Inc in Isoflurane - Correct Answer ✅Complete neurological recovery The appropriate analysis time for BAEPs is: 1 15 mS 2 20 mS 3 50 mS 4 100 mS - Correct Answer ✅15 mS CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// What is the advantage of using bipolar recording pairs for monitoring of CN spontaneous EMG? 1 Avoids far-field recording of nearby muscle activity 2 Is more sensitive to irritation of cranial nerves 3 Maximizes amplitude of recorded EMG 4 Less affected by neuromuscular blockade - Correct Answer ✅Avoids far- field recording of nearby muscle activity The facial nerve CMAP response has a latency of apprx.: 1 3 msec 2 5 msec 3 7 msec 4 10 msec - Correct Answer ✅7 msec The trigeminal nerve EMG response has a latency of approx.: 1 1-2 msec 2 3-5 msec CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 3 6-8 msec 4 9-11 msec - Correct Answer ✅3-5 msec Random spike discharges can be heard from a speaker during facial nerve dissection in all of the following, except: 1 Irrigation 2 heating effects 3 traction on the nerve 4 during electrocautery - Correct Answer ✅During electrocautery CN XII can be monitored using electrodes inserted into the: 1 Vocalis muscle 2 Trapezius muscle 3 Tongue 4 Soft palate - Correct Answer ✅Tongue Neurotonic discharges of facial nerve indicate: 1 Possible compromise of facial nerve CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 2 Presence of CMAP 3 Presence of CNAP 4 Cold irrigation - Correct Answer ✅Possible compromise of facial nerve What might be monitored for a jugular bulb tumor Sx? 1 Flash VEP 2 CN III-Vi 3 CN VII-XII 4 BAEP only - Correct Answer ✅CN VII-XII CN X can be monitored using electrodes inserted into the: 1 Vocalis muscle 2 Trapezius muscle 3 Tongue 4 Soft palate - Correct Answer ✅Vocalis muscle Visual observation of the facial nerve muscles during facial nerve electrical stimulation may be misleading b/c: CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 3 Prevent current shunting to other cranial nerves 4 Required by JCAHO - Correct Answer ✅Prevent current shunting to other cranial nerves What type of electrode is recommended for monitoring facial nerve? 1 Needle 2 Surface 3 Ring electrode 4 Gold electrode - Correct Answer ✅Needle Which of the following could be used to monitor facial nerve EMG? 1 Temporalis 2 Mentalis 3 Stylopharyngeus 4 Streptococcus - Correct Answer ✅Mentalis The integrity of the facial nerve in acoustic neuroma Sx is determined by: 1 Spontaneous EMG CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 2 Proximal CMAP 3 Distal CMAP 4 Stagnara wake-up test - Correct Answer ✅Proximal CMAP What CNs should be ideally monitored for Cerebellopontine (CP) angle tumors? 1 V and VII 2 VII and VIII 3 VIII and IX 4 VII, VIII, and XII - Correct Answer ✅VII and VIII Microvascular decompression involves: 1 Clampinng off the blood supply to a nerve 2 Eliminating an arteriovenous malformation 3 Lifting an artery off of the nerve 4 Placing an arteriovenous shunt - Correct Answer ✅Lifting an artery off of the nerve CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// What is the advantage of using bipolar recording pairs for monitoring of CN spontaneous EMG? 1 Avoids far-field recording of nearby muscle activity 2 Is more sensitive to irritation of CNs 3 Maximizes amplitude of recorded EMG 4 Loss affected by neuromuscular blockade - Correct Answer ✅Avoids far- field recordinng of nearby muscle activity Fast Fourier Transformation: 1 Determines the time domain of the rew EEG 2 Uses the zero-crossing frequency 3 Is the mathematical transformation of a complex waveform into simpler, more uniform waves 4 Separates EEG amplitude by time - Correct Answer ✅Is the mathematical transformation of a complex waveform into simpler, more uniform waves If you cannot replace an electrode that has come out during Sx, you: 1 Ask the surgeon to stop and replace it 2 Ignore the missing recording channel and continue to monitor CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// Processed EEG: Spectral Edge is a function of: 1 Beta and alpha vs. time 2 Amplitude and latency vs. time 3 Power and frequency vs. time 4 Radiographic interpretation - Correct Answer ✅Power and frequency vs. time EEG will most likely disappear at what body temp? 1 36' C 2 28' C 3 16' C 4 23' C - Correct Answer ✅16' C What is the max. time in which to expect EEG changes, following cross clamping of the carotid? 1 30 sec 2 1 min CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 3 2 min 4 5 min - Correct Answer ✅2 minutes All of the following are benefits of EEG monitoring during CEA, except: 1 Detection of occlusion-associated ischemia 2 Selective shunting 3 Detection of heparin dosage 4 Detection of hypoxia - Correct Answer ✅Detection of herparin dosage Cardiac activity appears on the CSA/DSA display as: 1 Delta Activity 2 Alpha Activity 3 Beta Activity 4 Burst Suppression - Correct Answer ✅Delta Activity Epileptiform discharges can be localized by: 1 A Mu rhythm 2 A phase reversal between two channels CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 3 The use of gold electrodes 4 The activation of specific muscle groups - Correct Answer ✅A phase reversal between two channels What EEG changes would you expect after intra-carotid sodium amytal? 1 Diffuse dec 2 Discharges 3 Contralateral dec in high freq EEG 4 Ipsilateral dec in high freq EEG - Correct Answer ✅Ipsilateral dec in high freq EEG According to the nurses guidelines, how far do you need to be from the sterile field? 1 6 in 2 12 in 3 18 in 4 24 in - Correct Answer ✅18 in When preparing the patient for IOM, you want to make sure that: CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 3 The machine might not function properly 4 It may affect other electrical equipment that have connections to Earth ground - Correct Answer ✅Any current leaking to the chassis may find a path to ground through your body How should needle electrodes be discarded? 1 It doesn't matter as long as they are not contaminated with blood 2 Carefully discarded in a plastic or metal trash can 3 Only in a red puncture proof sharps container 4 Toss onto the OR floor so Housekeeping can sweep them up - Correct Answer ✅Only is a red puncture proof sharps container How is TB transmitted? 1 It is sexually transmitted 2 By airborne droplets 3 By contact with blood 4 Via skin to skin contact - Correct Answer ✅By airborne droplets What is the most important means of preventing the spread of infections? CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 1 Wearing gloves 2 Hand washing 3 Using a condom 4 Wearing a mask - Correct Answer ✅Hand washing Personal Protective Devices (PPDs) consist of: 1 Gloves 2 Masks 3 Gowns 4 All of the above - Correct Answer ✅All of the above Which would not be considered contamination of the sterile field? 1 Reaching your arm over the sterile table 2 Brushing your bouffant cap against the microscope drape 3 Reaching underneath the surgeon's gown to grab his pager 4 Dropping a junior mint into the wound - Correct Answer ✅Reaching underneath the surgeon's gown to grab his pager CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// The most frequent source of patient infection in the OR derives from: 1 The patient's own endogenous flora 2 Non sterile instruments 3 Bacteria from the surgical staff 4 Bacteria from the OR environment - Correct Answer ✅The patient's own endogenous flora The main source of airborne bacteria in the OR is from: 1 Plume resulting from electrocautery 2 OR personnel talking, laughing, and coughing 3 Exfoliated skin particles from the OR staff 4 Flies in the OR - Correct Answer ✅Exfoliated skin particles from the OR staff You do not want to use a power extension cord bc: 1 It is a fire hazard 2 It will inc your risk of ground leakage 3 It will mean that more current could be delivered to the patient if the ground fails CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 4 9 cm medial to the right pre-auricular point - Correct Answer ✅9 cm medial to the left pre-auricular point You want to have matching impedances so that: 1 Vertical resolution will be optimized 2 Horizontal resolution will be optimized 3 You can maximize your common mode rejection 4 You can minimize your common mode rejection - Correct Answer ✅You can maximize your common mode rejection When doing a C5 decompression involving the axillary nerve, which muscle should you record form? 1 Trapezius 2 Biceps 3 Deltoid 4 Triceps - Correct Answer ✅Deltoid If you have a small signal with a lot of noise, what should you do to help resolve your signal? CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 1 Inc your duration 2 Inc your averages 3 Inc your stimulus rate 4 Inc your trigger delay - Correct Answer ✅Increase your averages If you have a 5 uV signal in 20 uV of noise, how many averages would you need to get a signal to noise ratio of 2:1? 1 16 2 20 3 64 4 100 - Correct Answer ✅64 During electrocautery, we should: 1 Pause recording 2 Continue to average and watch raw traces 3 Run impedances to let the amp desaturate 4 Request the surgeon to stop - Correct Answer ✅Pause recording CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// The gain of a differential amp is defined as: 1 Output voltage minus input voltage 2 The voltage difference between the inputs 3 Input voltage divided by output voltage 4 Output voltage divided by input voltage - Correct Answer ✅Output voltage divided by input voltage The positive input of a differential amplifier is also called the: 1 Input voltage 2 Non-inverting input 3 Inverting input 4 Active input - Correct Answer ✅Non-inverting input If you get artifact in your subcortical channel, you: 1 Ask anesthesia to inc gases 2 Ask the surgeon to move retractors 3 Disable the subcortical channel 4 Use a spare CS5 electrode - Correct Answer ✅Use a spare CS5 electrode CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 2 They require digitization of the analog signal 3 They operate faster than analog filters 4 They impose no phase effects on the recorded signal - Correct Answer ✅They impose no phase effects on the recorded signal Why is platinum used in epidural electrodes? 1 Other metals become toxic when they contact the spinal cord. 2 Platinum is cost effective 3 Other metals become toxic when current is applied to them, due to the ionic dissolution. 4 All of the above - Correct Answer ✅Other metals become toxic when current is applied to them due to the ionic dissolution Lowering the SSEPs hi-cut filter from 500 Hz to 200 Hz may cause the cortical peaks to: 1 Appear larger in amplitude 2 Appear shorter in latency 3 Become insensitive to anesthesia 4 Appear longer in latency - Correct Answer ✅Appear longer in latency CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// Which time constant would be most effective for cutting out low frequency noise from your signal? 1 10 ms 2 100 ms 3 1 s 4 10 s - Correct Answer ✅10 ms What is the required horizontal resolution of an evoked potential system? 1 At least 8 bits per data point 2 20 uS per data point or less 3 At least 20 uS per data point 4 At least twice the Nyquist frequency - Correct Answer ✅20 uS per data point or less The vertical resolution of an evoked potential system depends primarily on: 1 The analysis period 2 The sampling rate CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 3 The filter settings 4 The number of bits in the A/D Converter - Correct Answer ✅The number of bits in the A/D converter A 10-bit A/D converter has how many discrete V values in its range? 1 256 2 512 3 1024 4 2048 - Correct Answer ✅1024 What is the minimum required vertical resolution of an EP system? 1 8 bits 2 16 bits 3 80 bits 4 256 bits - Correct Answer ✅8 bits A match must be made between the size of the recorded signal and the range of the A/D converter to: CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 3 Stimulus intensity 4 Nerve conduction velocity - Correct Answer ✅Analysis time A 60 Hz notch filter should not be used for EP recording bc of: 1 The ringing artifact that comes from distortion of the stimulus artifact 2 Aliasing of the signal by the filter 3 60 Hz interference coming from various OR equipment 4 Common Mode Rejection of 60 Hz prior to filtering - Correct Answer ✅The ringing artifact that comes from distortion of the stimulus artifact You want your vertical resolution to: 1 Be 10% of you input 2 Match the amplitude of your input to maximize the signal 3 Match the horizontal resolution to maximize the signal 4 Be 1% of your input - Correct Answer ✅Match the amplitude of your input to maximize the signal When you have a salt bridge, you will: CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 1 Max out your impedances 2 Be able to stimulate the underlying nerve better 3 Have difficulty stimulating the underlying nerve 4 Create a lethal pathway for current - Correct Answer ✅Have difficulty stimulating the underlying nerve Brown-Sequard: 1 Peripheral Nerve 2 Spinal Cord 3 Brainstem 4 Cortex - Correct Answer ✅Spinal Cord Meniere's disease: 1 Polyneuropathy 2 Spinal deformity 3 Inner ear disturbance 4 Brainstem dysfunction - Correct Answer ✅Inner ear disturbance CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// A shocking sensation that occurs throughout the body during neck flexion is called: 1 Tinel's sign 2 L'hermittes sign 3 Fubar syndrome 4 Gullaime-Barre syndrome - Correct Answer ✅L'hermittes sign Brown-Sequard syndrome: 1 Degeneration of cortical neurons 2 Myopathy 3 Vascular disease 4 Hemi-spinal cord lesion - Correct Answer ✅Hemi-spinal cord lesion Which of the following is most likely assoc. with abnormal tibial nerve SSEPs? 1 Romberg sign 2 Anterior cord syndrome 3 Meniere's disease CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 4 Seizures - Correct Answer ✅Abnormal movement Cortel-Dubousset instrumentation involves which of the following? 1 Sublaminar wires 2 De-rotation 3 Distraction 4 Intervertebral discectomy - Correct Answer ✅De-rotation The primary risk to the spinal cord during Lugue instrumentation is: 1 Placement of bone graft 2 Insertion of pedicle screws 3 Placement of wires 4 De-rotation of the rod - Correct Answer ✅Placement of wires Harrington rod instrumentation uses: 1 Hooks and a rod 2 Rods and screws 3 Wires and rods CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 4 Rods, hooks, and screws - Correct Answer ✅Hooks and a rod The primary risk assoc. with sublaminar wire placement is: 1 Nerve root damage 2 Subluxation 3 Dorsal column injury 4 Blood loss - Correct Answer ✅Dorsal column injury During a median nerve preoperative study, a patient has discomfort at the wrist. Stimiulation electrodes are 10 mm gold disk, stimulus intensity is 20 mA, and stimulus duration is 100 usec. Which of the following would most likely reduce the patient's discomfort while maintaining adequate stimulation? 1 Inc stimulus duration 2 Dec number of repetitions 3 Use smaller stimulating electrodes 4 Dec stimulus intensity below motor threshold - Correct Answer ✅Dec number of repetitions CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// If you are doing a C6 decompression, which should you monitor? 1 Ulnar nerve and median nerve 2 Tibial nerve and peroneal nerve 3 Sural and radial 4 Ulnar and tibial nerve only - Correct Answer ✅Ulnar and tibial nerve only If you cannot evaluate motor twitch, you: 1 Inc intensity until the peripheral response no longer increases 2 Inc pulse duration 3 Leave intensity at 20 mA 4 Inc intensity until any discernible response is present - Correct Answer ✅Inc intensity until the peripheral response no longer increases What are IOM techs NOT to do? 1 Record critical surgical events 2 Tell surgeon of changes 3 Check electrode impedances 4 Interpret the changes - Correct Answer ✅Interpret the changes CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 1 Run median nerve and check anesthetic levels. 2 Inform the surgeon immediately and indicate that the changes are consistent with a right hemi-cord injury. 3 Check the right stimulator output with a bar electrode. 4 Reset the amplifier, check your recording parameters, and wait to see if the responses return - Correct Answer ✅Inform the surgeon immediately and indicate that the changes are consistent with a right hemi-cord injury. What will most likely affect SSEPs? 1 Spinal cord tumor 2 Degenerative motor condition 3 Anterior spinal hypoperfusion 4 Scoliosis - Correct Answer ✅Spinal cord tumor During an anterior lumbar fusion (L4-5), a loss of all right tbial nerve SSEPs responses occurs over the course of about 5 min. What should you do? 1 Inform the surgeon the right stimulator has failed, but that you will continue to diligently monitor the left side. CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 2 Check the current output and stimulator connections quickly. Then inform the surgeons you are seeing changes consistent with ischemia of the right leg. 3 Inform the surgeon there may be spinal cord changes. 4 Check median nerve responses for possible anesthetic changes. - Correct Answer ✅Check the current output and stimulator connections quickly. Then inform the surgeons you are seeing changes consistent with ischemia of the right leg. Electrical amplitude of the SSEPs is: 1 0.1 to 10 uV 2 10 to 100 uV 3 100 to 1000 uV 4 1000 to 10,000 uV - Correct Answer ✅0.1 to 10 uV For peroneal nerve stim, the ground should be placed: 1 Foot 2 Calf 3 Ankle CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 4 Thigh - Correct Answer ✅Thigh When testing SSEPs from the upper extremity, an electrode placed at Erb's point will record activity generated from: 1 Brachial plexus 2 Lumbar plexus 3 Cauda Equina 4 Thalamocortical radiations - Correct Answer ✅Brachial plexus SSEPs recordings are thought to be generated by which of the following sensory tracts? 1 Corticospinal tract 2 Lateral spinothalamic tract 3 Posterior columns and medial lemniscus 4 Lateral geniculate - Correct Answer ✅Posterior columns and medial lemniscus Which montage would you use to confirm a change in the Cz'-Fz cortical response to tibial nerve stimulation? CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 4 All waveforms - Correct Answer ✅All waveforms The median nerve is an excellent measure of: 1 Cerebral blood flow 2 Central spinal cord function 3 Lower motor neuron function 4 Lateral lemniscus function - Correct Answer ✅Cerebral blood flow Pre-operative baseline evaluation is not indicated for which of the following modalities? 1 Median nerve somatosensory 2 Brainstem evoked potentials 3 Facial nerve EMG 4 Peroneal nerve somatosensory - Correct Answer ✅Facial nerve EMG Nerve fibers activated during SSEPs recording carry what type of info.? 1 Proprioception and vibro-tactile sensation 2 Pain and temp sensation CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 3 Efferent motor signals 4 Visceral sensation - Correct Answer ✅Proprioception and vibro-tactile sensation Which of the following is not an advantage of epidural recording? 1 Reproducible morphology 2 Absence of significant artifact 3 Resistant to anesthesia 4 Stability of responses - Correct Answer ✅Absence of significant artifact A loss of SSEPs responses would most likely occur ______ to the surgical site. 1 Rostral 2 Caudal 3 Anterior 4 Posterior - Correct Answer ✅Rostral Why are SSEPs and TCeMEPs used simultaneously? CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 1 Spinal cord damage can occur in only one tract causing loss of MEP but not SSEP. 2 Because MEPs indicate spinothalamic tract function 3 Because SSEPs monitoring alone is not very sensitive to changes in spinal cord function 4 All of the above - Correct Answer ✅Spinal cord damage can occur in only one tract causing loss of MEP but not SSEP When placing the tibial nerve stimulator, you should not: 1 Use paste and conducting gel 2 Secure the tape and bands around the whole ankle 3 Place the electrodes an inch apart 4 Place the cathode behind the medial malleolus - Correct Answer ✅Secure the tape and bands around the whole ankle Which procedure would require intraoperative spinal cord monitoring? 1 Cerebellar mass 2 Kyphoscoliosis 3 Abdominal hernia CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 1 Provide proof of stimulation 2 Monitor for positional limb problems 3 Assess temp effects 4 Establish an AP - Correct Answer ✅Establish an AP If you have a loss of responses, what is most important in determining it is not artifact, but a real change? 1 Impedances are good and electrodes appear secure 2 It is sudden and occurs during a critical surgical event 3 Anesthesia values have not changed 4 Stimulus intensity has not changed - Correct Answer ✅It is sudden and occurs during a critical surgical event The P31 response to posterior tibial nerve stimulation: 1 Reflects post-synaptic activity in the cervical spinal cord 2 Is generated by the thalamus 3 Is recordable over a generalized region of scalp 4 Is best recorded by an electrode placed at CS5 - Correct Answer ✅Is recordable over a generalized region of scalp CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// Which of the following responses increases linearly, with an inc in stimulus intensity? 1 Popliteal Fossa 2 P31 3 Tibial nerve cortical 4 Median nerve cortical - Correct Answer ✅Popliteal Fossa The central conduction time for median nerve SSEPs is: 1 N9-N20 2 P14-P23 3 P14-N20 4 N13-N18 - Correct Answer ✅P14-N20 A patient with a body temp of 30 degrees C will have: 1 Inc latencies 2 Inc latencies, dec amps 3 Dec latencies CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 4 Dec latencies, dec amps - Correct Answer ✅Increased latencies What is the preferred alternate when the tibial nerve is unavailable? 1 Peroneal 2 Sciatic 3 Femoral 4 Ulnar - Correct Answer ✅Peroneal In an epidural response, what is the advantage of the bipolar response? 1 Presence of myogenic activity 2 Improved in-phase cancellation of noise components 3 Needles are far apart 4 Large cardiac artifact - Correct Answer ✅Improved in-phase cancellation of noise components There were epidural recordings to tibial nerve stimulation from T5 and from C7. The T5 had a stable response throughout the tumor surgery, while the C7 had no response and then a great one after the tumor removal. Where was the tumor? CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// Which of the following drugs significantly affect the transcranial motor D- wave amplitude? 1 Isoflurane 2 Pavulon 3 Propofol 4 None of the above - Correct Answer ✅None of the above Compound muscle action potentials (CMAPs) to transcranial electric stimulation are susceptible to: 1 Isoflurane 2 Pavulon 3 Propofol 4 All of the above - Correct Answer ✅All of the above Train stimuli are used for TCeMEPs in order to: 1 Charge the patient more 2 Overcome anesthetic suppression of synaptic transmission in the motor pathway 3 Activate D-waves in the peripheral muscles CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 4 Negate the effects of neuromuscular blockade - Correct Answer ✅Overcome anesthetic suppression of synaptic transmission in the motor pathway The D-wave is recorded from the: 1 Peripheral nerve 2 Peripheral limb muscle 3 Spinal cord 4 Cerebral cortex - Correct Answer ✅Spinal Cord Which of the following is NOT a safety concern regarding the use of TCeMEPs? 1 Patient's history of seizure disorder 2 Patient has a pacemaker 3 Patient history of cerebral palsy 4 Activation of biting muscles during stim - Correct Answer ✅Patient history of cerebral palsy Which of the following is true of transcranial magnetic stim? CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers…/// 1 Stim is painful 2 The technique is invasive 3 The myogenic response is resistant to anesthetic effects 4 Responses are sensitive to positioning of the magnetic coils - Correct Answer ✅Responses are sensitive to positioning of the magnetic coils One of the risks of a wake up test is: 1 Dec blood pressure 2 Accidental extubation 3 Cardiac problems 4 Muscle fatigue - Correct Answer ✅Accidental extubation What is the period of a 200Hz signal? 1 200 mS 2 50 mS 3 5 mS 4 2 mS - Correct Answer ✅5 mS