CNIM Final Exam with all Correct & 100% Verified
Answers |Actual Complete Exam |Already Graded A+
You're scheduled to monitor an ACDF C6-7 and when you see your patient in pre-op you see
that they have an amputated right wrist. What is the most appropriate stimulation site for the
right upper extremity? ✔Correct Answer-Ulnar Notch
If the MN or UM at the wrist are to available, you'll want to stim more proximal. You can stim
MN at the antecubital fossa in the arm and you can stim UN at the Ulnar Notch. Remember,
above C5=MN; below C6=UN
In EEG, what might focal slowing indicate? ✔Correct Answer-infarct or lesion
The technical setup for tEMG for direct nerve stimulation includes placing a monopolar
stimulating probe in which output? ✔Correct Answer-negative output of the stim box with
"low" maximum intensity.
The highest intensity stim required for a Cranial Nerve ✔Correct Answer-0.5mA
Which organization sets the standards and initiatives for the National Patient Safety Goals in the
US? ✔Correct Answer-The Joint Commission
Sublaminar wires will aid in which type of spinal cord manipulation? ✔Correct Answer-
Translation
All of the following are true about The Notch Filter except:
-It is acceptable to use the notch filter on free running EMG
-Using a notch filter on EMG or EEG will cause a ringing artifact
-A notch filter uses a band to eliminate signals at the specific frequency
-Using a notch filter on an evoked potential will cause a ringing artifact ✔Correct Answer-
Using a notch filter on EMG of EEG will cause a ringing artifact (this is FALSE)
A notch filter will only cause ringing artifact on evoked potential recordings
During an XLIF Procedure, what is at risk? ✔Correct Answer-Lumbar Plexus is at risk
Which derivation is optimal for isolating brainstem potentials following median nerve
stimulation? ✔Correct Answer-CPi-EPc
To eliminate crossover, ACNS guidelines suggest masking noise be set to______. ✔Correct
Answer-60 dB SPL
, REMEMBER SPL(sound pressure level)
What is the generator and vascular supply for the waveform labeled N13? ✔Correct Answer-
Spinal Cord Presynaptic activity from the cervicomedullary junction with blood supply from the
posterior spinal artery.
What might be a patient's pre-Op diagnosis with an increased interval in right ear waveforms
between waves I and III? ✔Correct Answer-Right Acoustic Neuroma
How can you differentiate Wave I from the CM (cochlear microphonic) when doing Ecoch?
✔Correct Answer-Use alternating clicks
Clonus is an abnormal reflex indicating: ✔Correct Answer-spinal cord injury only
Clonus is involuntary and rhythmic muscle contractions caused by a permanent lesion in
descending motor neurons.
What component of the BAER is the most diagnostic? ✔Correct Answer-Wave I-V interpeak
interval
Axonotmesis ✔Correct Answer-When the nerve sheath remains intact but the axons may be
divided following traction of crush injury. The condition can result in complete loss of muscle
(motor) function, sensations and autonomic functions transmitted by the affected nerve. The
recovery usually takes several months to years.
Neurapraxia ✔Correct Answer-The least severe type of nerve injury, resulting in complete
block of nerve transmission despite intact nerve fibers. Neither the axon not the sheath are cut.
Can by caused by sudden stretching of nerves in fractures and dislocations. It can also occur
with blunt injuries and sometimes after prolonger pressure on the nerve. The condition usually
recovers spontaneously over a few hours.
Neurotmesis ✔Correct Answer-Partial or complete severance of the axons and the sheath. It
is the most severe form of nerve injury. However, a clean cut has potential for immediate repair
and faster recovery
If you're doing IONM during a case that uses IntraOperative MRI, what might happen if you use
electrodes that aren't MRI conditional? ✔Correct Answer-Thermal burns
Extreme cerebellar retraction during CPA tumor will likely result in: ✔Correct Answer-Loss of
all waveforms due to vascular compromise
Key word is EXTREME
Answers |Actual Complete Exam |Already Graded A+
You're scheduled to monitor an ACDF C6-7 and when you see your patient in pre-op you see
that they have an amputated right wrist. What is the most appropriate stimulation site for the
right upper extremity? ✔Correct Answer-Ulnar Notch
If the MN or UM at the wrist are to available, you'll want to stim more proximal. You can stim
MN at the antecubital fossa in the arm and you can stim UN at the Ulnar Notch. Remember,
above C5=MN; below C6=UN
In EEG, what might focal slowing indicate? ✔Correct Answer-infarct or lesion
The technical setup for tEMG for direct nerve stimulation includes placing a monopolar
stimulating probe in which output? ✔Correct Answer-negative output of the stim box with
"low" maximum intensity.
The highest intensity stim required for a Cranial Nerve ✔Correct Answer-0.5mA
Which organization sets the standards and initiatives for the National Patient Safety Goals in the
US? ✔Correct Answer-The Joint Commission
Sublaminar wires will aid in which type of spinal cord manipulation? ✔Correct Answer-
Translation
All of the following are true about The Notch Filter except:
-It is acceptable to use the notch filter on free running EMG
-Using a notch filter on EMG or EEG will cause a ringing artifact
-A notch filter uses a band to eliminate signals at the specific frequency
-Using a notch filter on an evoked potential will cause a ringing artifact ✔Correct Answer-
Using a notch filter on EMG of EEG will cause a ringing artifact (this is FALSE)
A notch filter will only cause ringing artifact on evoked potential recordings
During an XLIF Procedure, what is at risk? ✔Correct Answer-Lumbar Plexus is at risk
Which derivation is optimal for isolating brainstem potentials following median nerve
stimulation? ✔Correct Answer-CPi-EPc
To eliminate crossover, ACNS guidelines suggest masking noise be set to______. ✔Correct
Answer-60 dB SPL
, REMEMBER SPL(sound pressure level)
What is the generator and vascular supply for the waveform labeled N13? ✔Correct Answer-
Spinal Cord Presynaptic activity from the cervicomedullary junction with blood supply from the
posterior spinal artery.
What might be a patient's pre-Op diagnosis with an increased interval in right ear waveforms
between waves I and III? ✔Correct Answer-Right Acoustic Neuroma
How can you differentiate Wave I from the CM (cochlear microphonic) when doing Ecoch?
✔Correct Answer-Use alternating clicks
Clonus is an abnormal reflex indicating: ✔Correct Answer-spinal cord injury only
Clonus is involuntary and rhythmic muscle contractions caused by a permanent lesion in
descending motor neurons.
What component of the BAER is the most diagnostic? ✔Correct Answer-Wave I-V interpeak
interval
Axonotmesis ✔Correct Answer-When the nerve sheath remains intact but the axons may be
divided following traction of crush injury. The condition can result in complete loss of muscle
(motor) function, sensations and autonomic functions transmitted by the affected nerve. The
recovery usually takes several months to years.
Neurapraxia ✔Correct Answer-The least severe type of nerve injury, resulting in complete
block of nerve transmission despite intact nerve fibers. Neither the axon not the sheath are cut.
Can by caused by sudden stretching of nerves in fractures and dislocations. It can also occur
with blunt injuries and sometimes after prolonger pressure on the nerve. The condition usually
recovers spontaneously over a few hours.
Neurotmesis ✔Correct Answer-Partial or complete severance of the axons and the sheath. It
is the most severe form of nerve injury. However, a clean cut has potential for immediate repair
and faster recovery
If you're doing IONM during a case that uses IntraOperative MRI, what might happen if you use
electrodes that aren't MRI conditional? ✔Correct Answer-Thermal burns
Extreme cerebellar retraction during CPA tumor will likely result in: ✔Correct Answer-Loss of
all waveforms due to vascular compromise
Key word is EXTREME
