Viewing a Polysomnogram (pre-final) Flashcards
The term ______ is
derived from Greek and Latin
roots.
polysomnogram
indicates many and
represents the many channels of
data collected.
Poly
____ refers to sleep.
Somno
______ refers to the
writing or display of the data.
Gram or graphy
The ___ are viewed
simultaneously to show activity
from several parts of the body at
one time during wake and sleep.
channels
Some of the channels portray ____ (electromyogram), whereas others collect _____ (respiratory channels).
fast frequency activity / slow-frequency activity
The data are displayed at a __, or __, of 10 mm/sec.
rate/ paper speed
For polysomnography, EEG, EOG,
chin EMG, and EKG activity is
optimally viewed as a 30-second
“ ___,” most often referred to as
an ___.
page / epoch
For slower-frequency
channels like airflow, ____ can be combined to display
windows of ____
several epochs / larger time segments.
Common window widths range
from ____ (4 epochs) to
____ (10 epochs).
120 seconds - 300 seconds
The first type of channel on a
polysomnograph is the
_____
electroencephalogram (EEG)
EEG leads are placed on the head to detect ___, or ___,
from specific areas of the ___.
impulses / brain waves / cortex
EEG data are used in sleep
primarily for determining
______ and to distinguish the various ____
wakefulness versus sleep / stages of sleep
The ___, ____, and
_____ (shape) of the waves
help the reader determine the
stage of sleep.
amplitude, frequency, and morphology
EEGs are also beneficial in
detecting other events such as
____ and _____.
seizure activity and beta spindles
The recommended EEG montage
for polysomnography is a
_____.
referential montage
Referential montages use ____ and ____ for each channel.
one active electrode /
one reference electrode
For EEG channels collected in a
standard diagnostic sleep study,
the electrodes on the left side of
the head— namely, ___ and
___ —are all referenced to the
opposite mastoid, ___.
F3, C3, and O1/ M2
the electrodes on the
Right side of the head —namely, ___ and ___ —are all referenced to ___
F4, C4, and O2 / M1
The signals derived at __ and __
should be similar because they lay over the same area of the ___ on each side.
F3 and F4 / frontal cortex
However, they will not be identical because they have different ___.
reference electrodes
The _____ is the display of eye movements.
electroocculogram (EOG)
Because the ___ is positively
charged with respect to the retina,
when a patient looks toward the
electrode, a _____ is sent
to the polysomnograph, resulting in a ___ pen deflection.
cornea / positive charge / downward
When a patient looks away from
the EOG electrode, a ____ results, creating an ___
pen deflection.
negative charge / upward
The _____
portrays the recording of muscle
activity and tone.
electromyogram (EMG)
Muscle tone, particularly of the
__ and ___ area, is an important
criterium used in determining sleep stages.
chin and jaw
____ decreases in
amplitude from wake to sleep, and it decreases further during rapid eye movement (REM) sleep.
Muscle tone
It is not necessary to identify
specific wave forms or shapes in
___ , but rather amplitude
changes.
EMGs
____ changes in
amplitude may indicate muscle
movement such as a ___ or
___ .
Sharp, abrupt / leg jerk / twitch
___ changes in EMG
amplitude may indicate a change
in muscle tone, such as when the
muscles in the ___ relax at sleep
onset.
Gradual, subtle / chin relax
The _____
sometimes spelled
(___) because
of its German roots,
is a recording of the heart’s electrical impulse
activity.
electrocardiogram (ECG), (EKG)
____ and ___
between the different waves are all important factors to consider when interpreting an ECG and can help identify abnormalities.
Rate, rhythm, and intervals
The normal adult heart rate while awake is ____
While asleep, the average heart
rate decreases by ____
60–100 beats per minute. / 10–20 beats per minute.
The normal ECG rhythm is made
up of a ____, a ____,
and a ___.
P wave / QRS complex / T wave
Each ___ corresponds to a
portion of the heart’s electrical and mechanical activity.
waveform
The ___ indicates the
contraction of the atria, or upper
chambers of the heart.
P wave
The ___ corresponds to the contraction of the ventricles, or lower chambers of the heart.
QRS complex
the ____ indicates the
repolarization of the ventricles.
T wave
___ and ___ of the
waveform can also provide
important information.
Segments and intervals
The ____ refers to the
distance from the beginning of the P wave to the beginning of the Q wave
PR interval
the ____ refers
to distance from the beginning of the QRS complex to the end of the T wave.
QT interval
The ____ refers to the
distance between the end of the P wave and the beginning of the QRS
PR segment
_____ refers to the distance from the end of the QRS complex to the beginning of the T wave.
ST segment
Respiratory parameters recorded in polysomnography include ____
and _____.
airflow and respiratory effort
(Respiratory Channels)
Most often this is accomplished via a ____ , a _____, and _____
thermal sensor / pressure
transducer / respiratory effort belts.
______ are the
slowest of the AC channels on the polysomnograph.
Respiratory channels
The waveform is
____ in nature, and the
____ is determined by the
speed of the breath.
sinusoidal / frequency
____is a measurement of the
saturation of oxygen in the
blood as read by a _____
SpO2 / Oxygen Saturation (SpO2)
/ pulse oximeter
In polysomnography, _____ allows a continuous
measure of oxygen saturation
throughout the night without
disturbing the patient’s sleep.
pulse oximetry
In sleepers without respiratory
disturbances, the ___
remains fairly constant
throughout the night.
saturation
Oxygen saturation decreases
with respiratory disturbances
such as ___ and ____.
apneas / hypopneas
An oxygen desaturation in
response to a respiratory
disturbance may vary
anywhere from ____ or
more.
1% to 40%
The ____ is a DC channel that displays the position in which the patient is laying determined by readings from the ___ sensor.
body position channel
The ____ is placed in the middle of the chest and typically displays the body position
as ____
body position sensor / supine, left, right, prone, or
upright.
The ____ is particularly
important in patients with sleep-
disordered breathing.
body position
Many patients with _____ have more severe symptoms while in the supine position.
obstructive sleep apnea
Therefore, it is important
to document information on body position during the diagnostic sleep study to identify ____.
positional trends
In addition, when titrating ___, it is important to correct the ___ while the patient is in the supine position.
PAP/ sleep- disordered breathing
