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Neurology 2 > 2.1 Neurophysiology Diagnostics > Flashcards

2.1 Neurophysiology Diagnostics Flashcards

1
Q

Electrodes in EEG are connected from the head to the recording system, which are attached to the scalp according to a standardized system of electrode placement

A

Ten Twenty Placement

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2
Q

Where does the electrical signals come from?

A

Pyramidal cells of cerebral cortex

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3
Q

What type of EEG has standard 30 minute recording of awake and sleep EEG activity that can extend to 24 hrs recording video?

A

Surface/ scalp EEG

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4
Q

An EEG can determine changes in brain activity that may be useful in diagnosing brain disorders like:

A 
Epilepsy or other seizure disorder
Brain tumor
Head injury
Brain dysfunction
Brain death in a persistent coma
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5
Q

Procedure: Pt will be ask not to sleep at night before the procedure or to stay up late or wake up early

A

Sleep deprivation test

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6
Q

Occurs often during sleep and are seizures originating in front of the brain that produces unusual symptoms that appear to be related to psychiatric problem or sleep disorder

A

Frontal lobe seizure

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7
Q

3Ps of frontal lobe seizure:

A

Pedaling motion
Pelvic thrusting
Profanity screams

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8
Q

How do you distinguished the left brain from right brain in an EEG?

A

RELO
Right side Even numbers
Left side Odd numbers

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9
Q

A test that detects electrical activity in the brain using small discs attached to the scalp.

A

Electroencephalography (EEG)

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10
Q

Different EEG activation procedures

A 
S- leep deprivation
H- yperventilation
E- ye opening/ E-ye closure
P- hotic stimulation
S- ensory stimuli
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11
Q

Characteristics of normal sleep EEG

A

P- POST
S- Spindle
V- Vertex wave

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12
Q

Commonly seen on EEG and have been said to be more common during daytime naps than nocturnal sleep. Commonly seen in adolescents and middle aged adults

A

Positive Occipital Sharp Transient of Sleep

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13
Q

Powerful strobe of light is placed about 15 in from pt’s eyes and fleshed at frequencies of 1 to 20 per sec with the pt’s eyes open and close

A

Photic stimulation

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14
Q

Common procedure used in the EEG lab in children and adults using strobe of flashing lights at different frequencies to detect abnormal epileptogenic sensitivity to flickering light

A

Intermittent photic stimulation (IPS)

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15
Q

Patient is asked to breathe in and out deeply and rapidly 20x for 3 to 5 minutes

A

Hyperventilation

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16
Q

Considered most specific and sensitive test confirming a diagnosis of absence seizures

A

Generalized spike and wave pattern

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17
Q

Hyperventilation brings out seizures called

A

Staring spells or abscence

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18
Q

The pt is instructed to open and close his eyes. Then determine whether there are certain responses during closure or opening of the eye

A

Eye opening/ eye closure

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19
Q

Closing of the eyes indicate:

Opening of the eyes indicate:

A

Closed: negative wave deflection
Open: positive wave deflection

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20
Q

During EEG, the pt is instructed to raise his hands during the procedure or the pt is instructed to close and open his fists

A

Sensory stimuli

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21
Q

Abnormal EEG pattern seen in sensory stimuli

A

Spike and polyspike wave pattern or sharp transient of waves

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22
Q

Is used to evaluate the function esp. the ability of electrical conduction of the motor and sensory nerve. It also determine nerve damage and destruction

A

Nerve conduction studies (NCS)

23
Q

How many electrodes are placed on the skin over the nerve in NCS

A

2; 1 electrode stimulates the nerve with a very mild electrical impulse and the second electrode records it

24
Q

Is calculated by measuring the distance between electrodes and the time it takes for electrical impulses to travel between electrodes in NCS

A

Nerve conduction velocity

25
Q

Usual nerves tested in NCS all have motor and sensory function except

A

Sural nerve (only sensory)

26
Q

Develops after injury to axon and myelin, as in transection of the nerve. Muscle atrophy is seen

A

Wallerian degeneration

27
Q

Develops after damage to the myelin sheath or schwann cell. Muscle is not denervated therefore no atrophy develops, with poor nerve conduction velocity

A

Segmental demyelination

28
Q

Develops when damage to cell body of the neuron results in distal dying of the axon and subsequent loss of myelin. Muscle is denervated, muscle atrophy develops

A

Neuronal (axonal) degeneration

29
Q

Follow segmental demyelination

A

Segmental remyelination

30
Q

Associated with formation of clusters of small and thin myelinated fibers

A

Axonal regeneration

31
Q

Decrease amplitude of CMAP/ SNAP and normal conduction velocity

A

Axonal nerve damage

32
Q

Normal amplitude and slower conduction velocity

A

Demyelinating nerve damage

33
Q

Result of damage to a single nerve or nerve group by trauma, injury, local compression, prolonged pressure or inflammation

A

Mononeuropathy

34
Q

Damage to multiple nerves in roughly the same areas on both sides of the body. E.g is GBS

A

Poly neuropathy

35
Q

Used in the presence of unexplained weakness based on the defect of neuromuscular transmission (sarcolemmal membrane or nerve terminal abnormality). CMAPs are recorded during repetitive stimulation of motor nerve.

A

Repetitive nerve stimulation

36
Q

10% decremental response confirms:

A

Myasthenia gravis

37
Q

10% incremental response after exercise confirms:

A

Lambert Eaton Syndrome

38
Q

Usually performed in pts with bell’s palsy

A

Facial nerve or blink reflex

39
Q

Assess the health of muscles and nerve cells that control them. Motor neurons transmit electrical signals that cause muscles to contract. Contraction can be recorded by needle electrodes

A

Electromyography

40
Q

Four things to remember about EMG:

A 
ISMR
I: insertional activity
S: spontaneous activity
M: motor unit action potentials
R:recruitment
41
Q

_________ insertional activity is seen in denervated muscle or muscle that is being reinnervated

A

Increased

42
Q

_______ of insertion activity found after prolonged denervation when muscle fibers have been replaced by connective tissue with fibrosis

A

Reduced

43
Q

To view waveforms and to listen to muscular activity use an:

A

Ocsilloscope

44
Q 
EMG: ISMR
I: increased
S: fibrillation positive wave
M: large unit limited recruitment
R: reduced fast firing rate
A

Lower motor neurogenic lesion

45
Q

Measure the electrophysiologic responses of the nervous system to a variety of stimuli. Study the more proximal segments of sensory pathway

A

Evoked potential

46
Q

Electrophysiologic assessment of large fiber sensory pathways of peripheral nerves, spinal cord and brain (AL system and dorsal column).

Used to judge conduction velocity and demyelination in the posterior funiculus or to predict outcome for coma pt

A

Somatosensory evoked potentials

47
Q

Used in the assessment of the clinical state of the cochlea, auditory nerve and the middle portion of the brainstem. Has 8 peaks generated on click stimulation

A

Brainstem auditory evoked potentials

48
Q

Peaks I-V are clinically useful such as:

A 
I auditory nerve
II cochlear nucleus
III superior olivary nucleus
IV lateral lemniscus
V inferior colliculus
Others: VI medial geniculate VII thalamocortical connection
49
Q

Lesions in the upper to middle pons tend to lead to _______ BAEP abnormalities

A

Ipsilateral

50
Q

Measures cognitive factors such as attention, memory, language and others. Use in the diagnosis of dementia.

A

Cognitive event related potentials

51
Q

Event related potential component elicited in the process of decision making.

A

P300 wave

52
Q

____________ = cognitive slowing

A

Prolonged P300 latency

53
Q

Test the function of the visual pathway from the retina to the occipital cortex. Most useful for testing optic nerve function

A

Visual evoked potentials

54
Q

VEP usually measure the amplitude and latency of:

A

P100 wave

Neurology 2 (5 decks)

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