What has to be removed in order to place an epidural electrode?
lamina
pedicle
Stimulation of the cortex on an AWAKE patient is to test for:
identity
language
If a patient is unable to move at the end of the surgery, it is consistent with damage to the:
cortical spinal tracts
spinal thalamic
Isola:
rods and hooks
sublaminal wires
The best muscle to record lower TCeMEPs is:
ATB
FHL
The best time for a wake-up test during scoliosis surgery is after:
distraction
induction
The risk of the wake-up test includes:
derotation
extubation
What monitoring is best for a scoliosis surgery?
TCeMEP, SSEP, s-EMG, t-EMG
EEG, EMG
If you have to select only one modality during a scoliosis surgery, which one will you choose?
TCeMEP
SSEP
Vertebral arteries run from:
C2-C7
the basilar artery rostrally
What is the conduction time from stimulation at the lower thoracic spinal cord to a recording at the upper thoracic spinal cord?
less than 10 msec
more than 30 msec
What is the most likely outcome with an occlusion of the anterior spinal artery
loss of N13
lower extremity paralysis
After a thoracolumbar case, the patient wakes up with intact lower sensation and motor function, but left upper extremity weakness. What is the likely cause?
brachial plexopathy
thrombosis
The effects of Harrington rod distraction on the spinal cord can be tested by the following except:
the Stagnara wake-up test
dorsal root stimulation
Stimulation of the motor pathway can be achieved with little movement in the surgical field by:
slowing the stimulation rate
increasing the stimulation rate enough to produce muscle tetany
Following the final application of corrective forces to the spinal column, the spinal cord should typically be monitored for at least:
5 minutes
30 minutes
A contraindication for the use of transcranial electrical stimulation is
craniotomy
a cardiac pacemaker in place
The Luque type of spinal instrumentation usually involves:
the sublaminal wires
rods and screws
Luque rods would best be used for:
posterior spinal fixation
anterior cervical fusion stabilization
A "false negative" test means that the test results:
do not show an abnormality when a clinical abnormality is present
show an abnormality when no clinical abnormality exits
During scoliosis surgery, the spinal cord is most at risk for injury during:
hypotension induced by the anesthesiologist
spinal distraction and sublaminar wiring
For transcortical magnetic stimulation, it is not true that:
an electrical stimulator is required to pace the stimulus
the stimulation is not perceived as painful
Changing the inter stimulus interval (lSI) from 3.7 to 2.1 will:
increase the frequency of stimulation
decrease the frequency of stimulation
Motor evoked potentials are also known as:
cathodal stimulation
anodal stimulation
Motor evoked potentials can be recorded from the:
dermatomes
epidural space
Motor evoked potentials responses are affected by the:
rocuronium
ativan
The ideal anesthesia regimen for TCeMEP recording is:
65% N20
TIVA
The epidural responses are also known as:
D and I waves
F and H waves
The motor evoked response in hand muscles (arrow) is referred as:
robust
clipping
The latency of the response in foot muscles is approximately:
40 ms
22 ms
The responses in channel2 are classified as:
biphasic
polyphasic
When recording motor evoked potentials, the artifact reject should always be
turned off
turned on
The latency of D-wave responses in the upper cervical area is about:
3 ms
6 ms
D-wave responses are:
abolished at 1.2 MAC of anesthesia
not effected by anesthesia
An increase in anesthesia will result in a loss of the ___ response before the ____
I4, I3
I1, I2
The recommended range of inter stimulus interval for motor evoked potentials is:
1.1 - 8.8
1.9 - 3.9
The band pass setting for motor evoked potential should be set to:
10-5000 Hz
1 -1000Hz
The latency of D-wave responses in the lower cervical area is about:
12 ms
The latency of D-wave responses in the lower thoracic area is about:
9 ms
15 ms
A response recorded at 15 ms from an epidural spinal electrode arises from:
the lower thoracic spine
para-spinal muscles
A motor unit originates from:
anterior horn cells
neuromuscular junction
The inter-peak latency between I-waves is:
2.0 ms
1.0 ms
The lowest spinal level for epidural recordings is:
T10
L2
Bite blocks must be used during motor evoked potential recordings to prevent
tongue bites
burns
When monitoring motor evoked potentials during spinal surgeries, the muscles selected must be ___ to the site of the surgery.
proximal
distal
Motor evoked potentials monitor the integrity of dorsal column pathways.
True
False
Ischemia of anterior spinal artery will result in loss of TCeMEP responses.
A pulse width of 1000 us is used for TCeMEP stimulation.
I-waves are epidural responses due to indirect stimulation of spinothalamic pathways.
Motor evoked potentials are generated from which type of summation?
Temporal
Spatial