SSEP Flashcards

1
Q

SSEPs follow an Ascending/Sensory pathway, called the _____ Pathway.

A

Dorsal Column

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2
Q

Flexion

A

Bending

decrease angle

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3
Q

Extension

A

Straightening

increase angle

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4
Q

Abduction

A

Lateral movement of the limbs away from the median

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5
Q

Adduction

A

Movement of a limb or eye toward the median

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6
Q

Pronantion

A

Palm/stomach down

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7
Q

Supination

A

Palm/stomach up

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8
Q

The DRG contains cell bodies of stimulated _____

A

Peripheral sensory axons

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9
Q

_____ contains axons carrying evoked signals from lower extremities

A

Fasciculus Gracilis

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10
Q

_____ contains axons carrying evoked signals from upper extremities

A

Fasciculus Cuneatus

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11
Q

Fasciculus Cuneatus starts and ascends at _____

A

T6

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12
Q

Anterior CST passes through the _____

A

Anterior Funiculus

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13
Q

Lateral CST passes through the _____

A

Lateral Funiculus

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14
Q

The cervical spinal cord does not have a _____ horn

A

lateral

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15
Q

The end of the spinal cord is called the _____

A

conus medularis

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16
Q

The collection of spinal roots at the end of the spinal cord is called the _____

A

cauda equina

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17
Q

The brainstem consists of the _____, _____, and _____.

A

Midbrain
Pons
Medulla

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18
Q

1st order neurons synapse at the _____.

A

Caudal medulla

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19
Q

1st order synapse for lower extremities is the _____

A

nucleus gracilis

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20
Q

1st order synapse for upper extremities is the _____

A

nucleus cuneatus

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21
Q

NC and NG decussate via the _____

A

internal arcuate fibers

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22
Q

Internal arcuate fibers from the NC and NG for the _____ on the contralateral side

A

medial lemniscus

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23
Q

The medial lemniscal tracts ascend to the _____

A

VPL of the thalamus

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24
Q

The _____ is the site of the 2nd synapse

A

VPL of the thalamus

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25
Q

From the VPL, axons pass through the _____ to S1

A

posterior limb of the internal capsule

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26
Q

_____ is the site of the 3rd synapse

A

S1, Area 3b of layer IV

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27
Q

Surface electrodes use _____ as a binding agent

A

Hydrogel on Ag/Ag-Cl

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28
Q

Surface electrodes should be placed _____cm apart

A

2-3cm

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29
Q

The anode (+) is always placed _____

A

distal

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30
Q

The cathode (-) is always placed _____

A

proximal

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31
Q

Current moves from the _____ to the _____

A

positive (anode)

cathode (negative)

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32
Q

The cathode is where _____ occurs

A

depolarization

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33
Q

the anode is where _____ occurs

A

hyperpolarization

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34
Q

The resting membrane potential is at _____

A

-70mV

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35
Q

If the cathode/anode are placed too close together, you’ll get a _____ amplitude

A

small

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36
Q

If the cathode/anode are placed too far apart, you’ll get a _____

A

large stimulus artifact

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37
Q

The stim boxes are _____ current stimulators.

A

constant

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38
Q

If current is fixed, the machine must provide a higher _____ to compensate for higher resistance. higher _____ = larger _____.

A

voltage
voltage
stimulus artifact

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39
Q

Cathode placement of median nerve stimulation is between the tendons of the _____ and _____

A

palmaris longus

flexor carpi radialis

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40
Q

An alternative site for median stimulation is _____, at the _____.

A

medial to the biceps brachii tendon

cubital fossa

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41
Q

Ulnar nerve stimulation is between the _____ and _____.

A

flexor carpi ulnaris
ulnar artery
proximal wrist crease

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42
Q

An alternative site for ulnar nerve stimulation is the _____.

A

medial epicondyle of the humerus

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43
Q

Radial nerve stimulation is just proximal to the _____

A

lateral epicondyl at the elbow

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44
Q

Posterior tibial nerve stimulation is midway between the _____ and _____.

A

medial malleolus

achilles tendon

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45
Q

Alternative PTN stimulation is at the _____

A

popliteal fossa

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46
Q

Peroneal nerve stimulation at the _____, medial to the tendon of the _____.

A

knee

biceps femoris

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47
Q

Peroneal nerve alternative sites are _____ and _____

A

medial/lateral malleolus

popliteal space

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48
Q

Femoral nerve stimulation _____

A

lateral to the femoral artery

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49
Q

Ulnar nerve should be used if at level of _____

A

5th cervical vertebrae or below

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50
Q

vertebral column is _____ bones

A

26

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51
Q

_____ cervical vertibrae

A

7

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52
Q

_____ thoracic vertebrae

A

12

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53
Q

_____ lumbar vertebrae

A

5

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54
Q

_____ sacral verebrae

A

5

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55
Q

_____ coccygeal vertebrae

A

4

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56
Q

cervical vertebrae have a _____ foramen for the _____.

A

transverse

vertebral arteries

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57
Q

Cervical vertebrae (-C_) have a _____ spinous process

A

bifid

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58
Q

cervical plexus is at

A

c1-4

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59
Q

brachial plexus is at

A

c5-8

t1

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60
Q

lumbar plexus is at

A

l1-4

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61
Q

sacral plexus is at

A

l4-5

s1-4

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62
Q

supraclavicular nerve is at

A

c3-4

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63
Q

transverse cutaneous nerve is at

A

c2-3

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64
Q

greater auricular nerve is at

A

c2-3

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65
Q

lesser occipital nerve is at

A

c2-3

66
Q

greater occipital nerve is at

A

c2

67
Q

phrenic nerve is at

A

c3-5

68
Q

musculocutaneous nerve is at

A

c5-7

69
Q

axillary nerve is at

A

c5-6

70
Q

radial nerve is at

A

c5-t1

71
Q

medial nerve is at

A

c5-t1

72
Q

ulnar nerve is at

A

c8-t1

73
Q

iliohypogastric nerve is at

A

l1

74
Q

illioinguinal nerve is at

A

l1

75
Q

genitofemoral nerve is at

A

l1-2

76
Q

lateral femoral cutaneous nerve is at

A

l2-3

77
Q

obturator nerve is at

A

l2-4

78
Q

femoral nerve is at

A

l2-4

79
Q

sciatic nerve is at

A

l4-s3

80
Q

tibial nerve is at

A

l4-s3

81
Q

common peroneal nerve is at

A

l4-s2

82
Q

pudendal nerve is at

A

s2-4

83
Q

upper stim intensity

A

15-25mA

84
Q

lower stim intensity

A

30-50mA

85
Q

Upper/Lower pulse width

A

0.2ms

86
Q

Upper/lower rep rate

A

4.7Hz

87
Q

If SSEPs have low amplitude, you could…

A

 Increase the intensity
 Increase the pulse width
 Decrease the RR

88
Q

HFF filters are analagous to ___

A

LPF

89
Q

LFF filters are analagous to ___

A

HPF

90
Q

Peripheral and cervical responses should be filtered by HFF of ___

A

1500Hz

91
Q

Cortical responses should be filtered by HFF of ___

A

250Hz

92
Q

Peripheral, cervical, and cortical responses should be filtered by LFF of ___

A

30Hz

93
Q

Peripheral and cervical responses should go through a band pass filter of ___

A

30-1500Hz

94
Q

Cortical responses should go through a band pass filter of ___

A

30-250Hz

95
Q

Notch filters are not recommended for ____

A

SSEPs

96
Q

If you are getting a lot of noise in cervical or peripheral responses, you could lower HFF from ___ to ___

A

1500

1000

97
Q

Time base for uppers is _

A

5ms per divison *10

50ms total

98
Q

Time base for lowers is _

A

10ms per division *10

100ms total

99
Q

Recommended trials for recording SSEP average

A

300 runs

100
Q

UE N9 is analogous to

A

erb’s point

101
Q

UE Obligates (5)

A
N9
N13
P14
N18
N20
102
Q

LE Obligates (4)

A

LP
P31
N34
P37

103
Q

N20 is the _ response from stimulating UE

A

cortical

104
Q

N20 is a _ field response

A

near

105
Q

P14 is a _ field response

A

far

106
Q

N18 UE is a _ field response

A

far

107
Q

N34 LE is a _ field response

A

far

108
Q

Stationary potentials have a _, irrespective of their position

A

constant latency

109
Q

Propagating potentials have _ depending on electrode position

A

shifting latencies

110
Q

N9 (_) is a _ potential

A

UE propagated

111
Q

N13 (_) is a _ potential

A

UE stationary

112
Q

N13 (_) generator

A

UE cervical cord

113
Q

P14 (_) generator

A

UE Caudal ML

114
Q

N18 (_) generator

A

UE Brainstem/Thalamus

115
Q

N20 (_) generator

A

UE S1

116
Q

N9 (_) generator

A

LE Pop Fossa

117
Q

LP Generator

A

Lumbar cord

118
Q

P31 (_) generator

A

LE

subcortical

119
Q

N34 (_) generator

A

LE

BS

120
Q

P37 (_) generator

A

LE

S1

121
Q

N9 UE channel

active vs ref

A

EPI vs EPC

122
Q

N13 UE channel

active vs ref

A

C5S vs EPC

123
Q

P14/N18 UE channel

active vs ref

A

CPI vs EPC

124
Q

N20 UE channel

active vs ref

A

CPC vs CPI/Fz

125
Q

N9 LE channel

active vs ref

A

PFI vs PFC

126
Q

P31/N34 LE channel

active vs ref

A

FPZ vs C5S

127
Q

P37 LE channel

active vs ref

A

CPZ vs Fpz

128
Q

Central conduction time (CCT)

A

dif in time between 2 points in the CNS

129
Q

Peripheral conduction time (PCT)

A

dif in time between 2 points in the PNS

130
Q

Median SSEP will have a larger or smaller amplitude than ulnar?

A

larger

131
Q

Median nerve root levels

A

C5-T1

132
Q

Ulnar nerve root levels

A

C8-T1

133
Q

supplies ant 2/3 of sc

A

ASA

134
Q

supplies post 1/3 of SC

A

PSA

135
Q

ASA and PSA arise from

A

vertebral arteries

136
Q

supplies blood to structures in and around spinal canal and each level

A

segmental arteries

137
Q

segmental arteries arise directly from the

A

aorta

138
Q

segmental arteries are called _ in the thoracic region

A

intercostal arteries

139
Q

segmental arteries are called _ in the lumbar region

A

lumbar arteries

140
Q

branch from the intercostal or lumbar arteries

A

radicular arteries

141
Q

PSA radicular arteries are called

A

radiculopial arteries

142
Q

ASA radicular arteries are called

A

radiculomedullary arteries

143
Q

One radicular artery that connects to ASA forms the _

A

artery of adamkiewicz

144
Q

Artery of adamkiewicz arises from _ or _

A

left inferior intercostal artery

first lumbar artery

145
Q

Branches of ASA form

A

sulcal arteries

146
Q

vessels from both the asa and psa encircle the spinal cord forming a _

A

pial plexus

147
Q

vessels of the pial plexus constitute the _

A

vasocorona

148
Q

vasocorona provides a _ between ASA and PSA

A

limited anastomosis

connection

149
Q

outer disc is called the

A

annulus fibrosus

150
Q

inner disc is called the

A

nucleus pulposus

151
Q

HNP

A

herniated nucleus pulposus

152
Q

removal of softer structers use a

A

putuitary rongeur

153
Q

corpectomy

A

removal of the vertebral body to decrompress

154
Q

Map

A

60mmHg

155
Q

MAP =

A

DP + 1/3 Pulse Pressure

156
Q

Pulse pressure =

A

SP - DP

157
Q

decadron is a _

A

steroid

158
Q

decadron is used to _

A

suppress inflamatory response

159
Q

pentobarbital is a _

A

barbituate

160
Q

hematocrit

A

percent of whole blood that is composed of rbc

161
Q

MAC

A

minimum alveolar concentration

162
Q

PAR for SSEP

A

.75 Mac inhalational agent
<=50%
muscle relaxants ok
narcotics ok