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Intraoperative Neurophysiologic Monitoring: Multi-modal Monitoring for Complex Cases

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1.  What mode of monitoring is a "diagnostic procedure to assess the health of muscles and the nerve cells that control them". Transcranial Motor Evoked Potentials Electromyography Pedicle Screw Stimulation Somatosensory Evoked Potentials

2.  What mode of monitoring is defined as "responses recorded over the limbs, spine, and scalp following the stimulation of peripheral nerves, trunks or cutaneous nerve." Somatosensory Evoked Potentials Visual Evoked Potentials Auditory Evoked Potentials Cochlear potentials

3.  Transcranial Motor Evoked Potentials are: one of the oldest forms of stimulation for monitoring of the motor pathways an excellent method of monitoring motor function if seizure history precludes EMG stimulation of the sensory cortex and recording over the limbs electrical signals recorded from neural tissue or muscle following activation of central motor pathways

4.  Upper limb SSEP, TcMEP, and single-sided EMG in the upper and lower limbs is an appropriate combination of IONM modes for monitoring which of the following surgeries? Carotid Endarterectomy Cortical Brain Tumor resection Spinal Cord De-tethering Lumbar Fusion

5.  In a thoracic procedure, which of the following is an uncommon mode of monitoring? Upper Limb SSEP Lower Limb SSEP EMG TcMEP

6.  For cervical procedures, which of the following is an appropriate mode of monitoring? Upper Limb SSEP EMG TcMEP All of the above

7.  In a lumbar procedure, which of the following modes is rarely performed? SSEP EMG TcMEP Direct Nerve Stimulation

8.  What types of equipment rarely introduce electrical noise artifact in the operating room? Fluid warmers Unplugged surgical beds Grounded extension cords Computers on wheels

9.  What position reduces the chances of stimulation and recording cords producing electrical noise? Closely spaced Parallel Perpendicular Overlaying

10.  When should you avoid stimulating to record TcMEP responses? When the surgeon is changing sides Between stages of the procedure While using a scalpel While cleaning the electrocautery