Download 1. What are the 2 types of nervous tissue? 2. What are types of

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What are the 2 types of nervous tissue?
What are types of neuroglia?
What are the 3 main parts of a neuron?
What are afferent and efferent messages in the
nervous system?
5. What’s the difference b/t white and grey matter?
6. What’s ortho- vs. antidromic
7. Why are receptors called selective transducers?
8. Memorize conduction speed with receptors.
a. What does myelin have to do with conduction speed?
9. At rest, what is the intra- and extracellular makeup of
sodium and potassium?
a. What is resting membrane potential?
b. What happens with a strong depolarization?
10. What are the steps from a cell at rest through
hyperpolarization?
11. How is an action potential conducted in a neuron?
12. What’s the all-or-none law when talking about AP’s?
a. What is the purpose of refractory period?
b. What’s the difference between absolute and relative
refractory period?
13. What’s the difference between contiguous conduction
and saltatory conduction?
14. What happens in action potentials when we stimulate
at 110% threshold?
a. How is this different in receptors?
15. Explain movement through a graded potential.
16. What’s the difference b/t graded and action
potentials?
17. How do graded responses affection action potentials?
18. Why should we stimulate at supramax intensity?
19. What are the general function of glutamate, GABA
and Ach in the nervous system?
20. Review how a neuron goes from “quiet” to active.
21. Describe synaptic transmission.
22. What’s the difference b/t spatial and temporal
summation?
23. Example
24. Describe saltatory conduction
25. Describe how myelin speeds up conduction.
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26. Describe how myelin lowers resistance to increase
conduction velocity.
27. Example of continuous vs. saltatory
a. What is the conduction speed of the PNS vs. the
auditory system?
28. What electrodes are needed to record a potential?
29. How is an electrode like ½ a battery?
a. What metals are good to use for recording?
30. Why do you need to use the same electrodes for
recording?
31. What’s the purpose of an electrode?
a. Why is Ag-AgCl a good choice as an electrode
b. What direction does current and electrons flow?
32. How should the anode and cathode be placed for
SSEP?
a. What is the relationship of electrode surface area and
impedance?
b. If threshold of a nerve fiber is reached, why might
there be an increase in amplitude if you increase the
stim intensity?
33. What is anodal blocking?
34. Where should MN and UN electrodes be placed?
35. What are some alternative places?
36. What are the abbreviations of the 10-20 system?
a. What side has odd #’s?
b. What does the 10 and 20 of the 10-20 system stand
for?
37. What’s the difference b/t a bipolar and referential
setup?
38. Example
39. List the 5 different ways waves are recorded in SSEP
from generator points.
40. What’s the difference b/t a traveling and a stationary
wave?
41. Is each generator point from 1 source?
42. How Is A Potential Is Recorded That Causes Polarity
Change In A Near-Field Response In White Matter?
43. What’s the difference b/t near and far-field?
44. Example
45. Are there any differences in near and far-field
potentials in white and gray matter?
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46. Describe a negative and positive peak.
47. What are the UE SSEP generator points?
48. What are the obligate peaks?
49. Erb’s point
50. Cervical response
51. P14 response
52. What does different electrode positions do to the P14
response?
53. N18
54. N20
55. P22
56. Can there be recording issues in people with phantom
limb pain, aside from part of the limb missing to
stimulate?
57. Summarize UE SSEP pathway.
58. Summarize UE SSEP stimulation from nerve to
recording in the cortex.
59. What’s the alarm criterion for a significant change in
UE SSEP?
60. What are some parts of the ACDF that might be
problematic for the nervous system?
61. What do SSEP look like in pts with severe sensory
neuropathies?
a. Why does this happen?
62. Examples of lesions and SSEP recordings
63. How does conduction velocity change as we age?
64. How does temperature affect SSEP?
65. Example
66. When would you consider MEP or EMG for ACDF
cases?
67. MEPs and ACDF
68. Describe the setup for dermatonal SSEPs
69. What is the stimulating and recording parameter for
DSSEP?
a. Should we use these more often?
b. Are they reliable?
70. For LE SSEP, what is the # of trials, analysis time,
pulse width, stim rate, stim intensity, impedance, and
bandpass?
71. Where should you stimulate the posterior tibial nerve
for LE SSEP?
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72. How can you stimulate the peroneal nerve?
73. What’s the blood supply to the lumbosacral plexus?
74. What supplies blood to the cauda equina?
75. What’s the first, second and third order neuron in the
SSEP pathway?
76. What is the orientation of the LE DCML compared to
the UE DCML?
77. What are the generator points of the LE SSEP?
78. What is the montage recommended for LE SSEP?
79. PF
80.LP
81. P31
82. N34
83. P31 and N34 vs. P14 and N18?
84. Where are MEPs produced?
a. Where does anesthesia affect MEPs?
85. Describe the difference b/t D-waves and I-waves.
86. Does anes affect D or I-waves?
87. Does Sevo affect MEP at the neuromuscular junction?
88. What meds can cause changes to SSEP and MEP
89. If you can’t use Prop/Remi TIVA what else might
work?
90. Should you use Dex with tcMEP?
91. Where does tcMEP start after stimulation?
92. How many neurons fire with tcMEP?
93. What is the blood supply to the lobes of the brain?
94. What is the pathway of the corticospinal tract?
95. What’s the blood supply to the internal capsule?
96. Where does the DCML and LCST decussate in relation
to each other?
97. Describe the supply of blood to the spinal cord in a as
a whole
a. What is the major feed of the lower 2/3 of the
cord?
98. Describe the blood supply within the spinal cord.
99. Where are the watershed zones in the spinal cord?
100.
How does the motor output from the LCST go
from the white tract in the cord to the muscle?
101.
Describe a muscle from bundle to myofibril.
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102.
Describe the patient presentation with motor
lesions to the cortex, internal capsule, midbrain, pons,
medulla, cervical cord, thoracic cord.
103.
Where is the synapsing site from stimulation of
the cortex with tcMEP and recording with epidural
electrodes?
104.
What are the volleys following D-wave?
a. Why is it later than D-wave?
105.
How do I-waves assist in CMAP production
with tcMEP?
106.
For tcMEP, what is the electrode position, head
lead locations, number of trains used, inter-pulse
interval, pulse duration, max stimulation intensity,
impedance of stimulating and recording electrodes,
bandpass and analysis time?
107.
Do you stimulate with cathode or anode for
cortical tcMEP.
a. What about subcortical?
108.
What are the different head lead setups and
when would you consider using or not using each one?
109.
How many trains till I-waves?
110.
What inter-pulse interval allows for complete
recovery of D-wave amplitude?
111.
What inter-pulse interval may not elicit a
response in the LE?
112.
What are the latencies in the UE and LE, and
what are the typical amplitudes of tcMEP?
113.
What’s the problem with longer pulse
durations?
114.
What does an increase in intensity mean for
areas stimulated under the anode?
115.
What causes only a small fraction of current to
actually stimulate the brain matter?
116.
If you stimulate one cortex, can you get
recordings on both sides?
117.
How does impedance relate to intensity needed
to stimulate the cortex?
118.
What history is needed before deciding to
perform tcMEP?
119.
What are the alarm criteria for tcMEP?
120.
What is fade?
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121.
Why is all-or-none a popular alarm criteria in
the OR?
122.
How can temperature affect tcMEP?
123.
What are some things you can do to get better
tcMEP recordings?
124.
What’s the youngest you can record a tcMEP
on?
125.
What muscle strength do you need in order to
get reliable tcMEP?
126.
Are tcMEP predictive of a LMNL?
127.
Are tcMEP good for cord ischemia
128.
What are some weaknesses of tcMEP?
129.
Is TMS reliable in the OR?
130.
Is neurogenic MEP reliable for monitoring the
motor system?
131.
What is a common finding in BAER with
acoustic neuroma testing?
132.
What’s the difference b/t weber’s and rinne’s
test?
133.
When would a surgeon choose a retrosigmoid,
translabyrinthine, or medial fossa approach for an
acoustic neuroma?
134.
What anesthesia works with BAER?
135.
What portion of the BAER is peripheral?
a. What cases are intraoperative BAER used for?
136.
What sound is used in the OR for BAER?
137.
What structure first absorbs sounds vibrations?
138.
How is an ear like a microphone?
139.
Describe the difference in amplitude of sound
and frequency of sound.
140.
What is “loudness?”
a. How is it measure?
141.
How many bels in 1 dB?
142.
What’s the audible range of humans?
143.
How does hearing change with age?
144.
What are the 3 small bones in the ear, and what
purpose do they serve?
145.
That muscles of the ear affect hearing, and
what innervates them?
146.
What’s the difference in the oval vs. round
window?
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147.
What’s does vibration of the basilar membrane
cause?
148.
What’s the purpose of the hair cells?
149.
What part of the cochlea does fast frequency
sounds go?
150.
What membranes separate the cochlea?
151.
How is mechanical energy of sound
transformed into electrical signals?
152.
What are the major relay structures in the
auditory pathway?
153.
What’s the difference in conductive and
sensorineural hearing loss?
154.
Example audiograms
155.
What are the following settings for BAER:
stimulator, sound type, duration, polarity, delivery,
rep rate, intensity, masking, filters, analysis time,
sensitivity, head leads, notch filter?
156.
What kind of clicks are used?
a. What time is added for the tube connected to
the ear bud inserts?
157.
What’s the difference b/t condensation and
rarefaction?
158.
What is alternating clicks and is it of benefit?
159.
How are the clicks delivered?
160.
What range of rep rate is best, and what should
you stay below?
161.
When is damage to hearing begin with ear bud
stimulation?
a. What’s the difference in dB pe SPL and dB HL?
162.
Filter settings?
163.
What is the latency of wave V, and what is the
analysis time?
164.
Are BAER waves large or smaller waves?
165.
What does size of the wave mean for the # of
sweeps needed?
166.
Why do BAER have a poor signal-to-noise?
167.
Why does averaging work?
168.
Which BAER is a negative wave?
a. What causes post-auricular muscle artifact?
169.
What is the anatomical areas for the generator
points in BAER?
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170.
What is the blood supply to the inner ear?
171.
What is the blood supply to the cochlear nerve?
172.
What are the more upstream blood vessels seen
around the brainstem?
173.
What artery supplies the cochlear nucleus?
174.
What artery supplies the superior olivary
nucleus and lateral lemniscus?
175.
What artery supplies the inferior colliculus?
176.
What artery supplies the medial geniculate
body?
177.
How are the electrodes set up on the head?
178.
How is wave I different from the way wave III
and V are generated?
179.
What is volume conduction and how does that
assist BAER potentials?
180.
What 3 rules does conduction through the body
follow?
181.
Wave I?
182.
Wave II?
183.
Wave III?
184.
Wave IV?
185.
Wave V?
186.
Wave V?
187.
Wave VI and VII?
188.
What’s measured in BAER?
189.
Alarm criteria for BAER?
190.
What can temperature change, blood pressure
change, conductive loss, drilling the skull, and
opening dura do to BAER recordings.
191.
What are known causes of artifact in BAER?
192.
Which wave is the last to disappear with
decreased intensity?
193.
What procedures are BAER better for, which is
not as sensitive?
194.
What makes up that atom?
195.
How does an atom have a charge, and what’s
its measurement?
a. What’s the difference b/t resistors and
conductors?
196.
What is Coulomb’s Law?
a. What’s a current of 1 coulomb per second?
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197.
How is electromotive force similar to a
hydraulic system?
198.
What is resistance of current?
a. What’s it measured in?
199.
What is Ohm’s Law?
a. What happens to the current if the resistance is
double?
200.
What does an ohmmeter, ammeter and
voltmeter measure?
201.
What’s the difference b/t direct and alternating
current?
202.
What does electroencephalography measure?
203.
What causes the cortical activity monitored?
204.
How does volume conductance enable EEG
recordings?
205.
A radial dipole has what orientation, while a
tangential has what orientation?
206.
What does the frequency of the waveforms
indicate about the cortical activity?
207.
Image
208.
How does background electrical fields
contaminate the recordings/
209.
What are the positions the patient may be
placed in?
a. What are the name of the tables?
210.
What in the OR gives off noise at 60 Hz?
211.
What are the sizes of the amplitudes of our
recordings vs. noise?
212.
What’s the difference b/t physiological and
non-physiological artifact?
213.
What are things you can do to fight noise?
214.
What’s the appropriate way to apply head
electrodes and keep noise in the lead to a minimum?
215.
You can affect the resistance of the skull, but
you can affect what to keep recordings optimal?
216.
Why are twisted electrodes better?
217.
What is parasitic capacitive coupling?
218.
Where should you place the ground?
a. How does it help reduce noise?
219.
What does a signal go through before it pops
up on your screen?
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220.
What inputs come into the amplifier that it has
to sort out?
221.
How does a differential amplifier work?
222.
What is common mode rejection?
223.
How do you figure out the CMRR in decibels?
224.
What is the formula for the amplifier gain?
a. What’s a common amplification of signals after
225.
What is the difference b/t analog and digital
processing?
226.
What does a digital converter do?
227.
What happens if the digitizing rate is set too
slow?
228.
What is epoch/analysis period/sweep length?
a. What is dwell time/bin width/intersample
interval?
b. What is the relationship of dwell time to
sampling rate?
c. How many points per channel is
recommended?
229.
A decrease in dwell time with a constant
analysis time does what to the resolution?
230.
How many points are needed for the dwell time
to sufficiently resolve the highest frequency collected?
a. What’s that called?
231.
What is the least sample required during
collection of EEGs?
232.
Shortening the dwell time does what to the # of
addresses?
233.
What’s it called if sampling is done too
infrequently?
234.
What does vertical resolution define?
a. What is a bit?
b. What’s the minimum bits required for IOM?
c. How do you find the resolution when the
amount of bits is given?
235.
Given the range and resolution, how do you
find the smallest voltage detected (precision)?
236.
How many bits of resolution is recommended?
237.
Why is that many bits recommended?
238.
What is quantization errors?
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239.
How does resolution and range relate to
quantization errors?
240.
What’s the purpose of an isolation box?
241.
Analog filters are made up of what?
a. What advantages does digital filters have over
analog filters?
242.
For LFF, how are capacitors and resistors
aligned?
a. For HFF, how are capacitors and resistors
aligned?
243.
Memorize
244.
What are the electrical quantities associated
with circuits?
245.
What is voltage?
246.
What is amperage?
247.
What is resistance?
248.
What is conductance?
249.
What is power?
250.
What is inductance?
251.
Describe a circuit in series and a circuit in
parallels.
252.
What is the difference in high pass and low
pass filters output potential?
253.
What is the reciprocal of resistance?
254.
How does Ohm’s law apply to resistors?
255.
What is the equation to find the power
dissipated by the resistor?
256.
What are inductors?
257.
Inductors behave like what?
258.
What does a transistor do?
259.
What frequencies is a notch filter around?
260.
What does smoothing do to your plotted data?
261.
Signal averaging review
262.
What reject levels should you be set at?
263.
What is Amaurosis fugax?
264.
How does EEG progress with inhalational
agents?
265.
What are the 7 stages of EEG during anesthesia
(assuming it makes it all the way)?
266.
What is WAR and FIRDA patterns?
267.
What is AIS and WPS patterns?
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268.
What EEG is present in moderate anesthesia?
269.
How do barbiturates differ from opioids in
EEG suppression?
270.
In EEG, what is the head lead setup,
impedance, bandpass, paper speed, and sensitivity?
271.
How do you find CP3, M1 and M3 in the 10-20
system?
272.
10-20
273.
What’s the difference in a referential setup vs.
bipolar?
a. Which is recommended for the OR?
274.
Which is more likely to pick up artifact?
275.
How many channels should you use for IOM
CEA?
276.
What are the frequencies of EEG monitored?
277.
How are the waves classified?
278.
What frequencies dominate the frontal and
occipital regions
a. What frequencies are more prominent during
sleep?
279.
What does awake EEG look like?
a. What artifact is common?
280.
What does a sedated patient’s EEG look like?
281.
What is burst suppression?
282.
What is the goal of anesthesia for CEA?
a. What is the goal of anesthesia during an
aneurysm clipping?
283.
What should the filter settings be for EEG?
284.
What areas should the EEG cover?
285.
What are the watershed zones of the cortex?
286.
What alarm criteria is recommended for EEG
on CEA?
287.
Tips on looking at EEG on the test
288.
Explain how the Circle Of Willis is a big shunt
289.
How does the posterior circulation help during
clamping?
290.
Image
291.
When should you see sleep spindles in a patient
under anesthesia?
292.
How do resting EEG differ from awake EEG?
293.
When are changes in EEG seen during CEA?
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294.
What are recommended practices when
watching EEG during CEA?
295.
When should signals return after shunt
placement?
a. What are gradual changes vs. abrupt changes
attributed to?
296.
What is ischemic penumbra?
297.
What is penlucida?
298.
How long can the brain go without blood flow?
299.
What blood flow levels are the critical levels
needed to maintain adequate blood flow?
300.
What level of BF is consistent with ischemia?
301.
What is the Fast Fourier Transform?
302.
What’s the difference b/t CSA and DSA?
303.
What are peak power frequency and spectral
edge frequency?
304.
What happens if the power spectral edge shift
to the left?
305.
What is burst suppression ratio and what is it
used for?
306.
What is the alarm criteria for CEA using SSEP?
307.
What are weaknesses of EEG?
308.
Which will go first, SSEP or EEG?
309.
Why doesn’t stimulation of the MN SSEP alter
the EEG recordings?
310.
Which is better for EEG for CEA, SSEP or
EEG?
311.
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