ASET CNIM EVALUATION SET ANSWERS AND
QUESTIONS SET A+
✔✔Monitoring procedures during CEA include
1. monitoring both hemispheres
2. cessation of monitoring following clamp removal
3. monitoring from the compromised hemisphere only
4. recording a full minute of EEG basline - ✔✔monitoring both hemispheres
✔✔Preoperative baselines, SSEP values are essential to IONM because
1. latencies and amplitudes are highly variable
2. it is necessary to compare IONM values with laboratory normative data
3. absolute boundaries for EPs obtained intra-op are not available
4. they help to establish the appropriate level of anesthesia - ✔✔absolute boundaries
for EPs obtained intra-op are not available
✔✔A patient is admitted to the operating room diagnosed with a herniated C5/6 disc.
Most appropriate nerve(s) to monitor during the resulting surgical procedure would be
the
1. tibial and ulnar nerves
2. median and posterior tibial nerves
3. median and auditory nerves
4. ulnar nerve - ✔✔median and posterior tibial nerves
✔✔The median nerve SSEP can be helpful as a measure of
1. cerebral blood flow
2. lower spinal cord function
3. blood pressure variability4
4. anesthetic sensitivity - ✔✔Cerebral blood flow
,✔✔In the OR, the stim intensity for activating a sensory nerve
1. should be set at double the sensory threshold
2. should be set for two to three times the motor threshold
3. does not have an established boundary
4. is set to slightly above motor threshold - ✔✔does not have an established boundary
✔✔The suggested rate of stimulation for intraoperative posterior tibial nerve evoked
potential monitoring is:
1. 30 to 40 per second
2. 20 to 30 per second
3. 10 to 20 per second
4. 2 to 10 per second - ✔✔2 to 10 per second
✔✔When stimulating the posterior tibial at the ankle, stimulation can be confirmed by
1. turning the stimulator up to read 20mA
2. recording a cortical response at Cp4
3. reducing the impedance of the stimulating electrodes to less than 5k ohms
4. recording a response from the popliteal fossa - ✔✔Recording a response from the
popliteal fossa
✔✔To record cortical SSEPs during intraoperative monitoring of cervical spinal cord
surgery, electrodes should be placed
1. 2cm anterior to C3 and C4
2. 2cm posterior to C3 and C4
3. in the C3 and C4 positions of the 10-20 system
4. between Cz and Pz and between Pz and Oz - ✔✔2 cm posterior to C3 and C4
✔✔"Hearing level" (HL) is defined as the
1. average threshold intensity of normally hearing young adults
2. intensity of along duration sound that has the same amplitude as the peak SPL of a
short duration sound
3. lowest intensity that an average ear drum can her
4. inverse of the sound pressure level - ✔✔average threshold intensity of normally
hearing young adults
✔✔In order to record cortical SSEPs during intraoperative monitoring of the
thoracolumbar spinal cord (BLE SSEP), an electrode should be placed
1. 2cm posterior to Pz
2. 2cm anterior to Cz
, 3. 2cm posterior to Cz
4. 2cm posterior to C3 and C4 - ✔✔2 cm posterior to Cz
✔✔The recommended location for recording the cervical cord response to median
nerve stimulation
1. C1
2. C2
3. C5
4. C8 - ✔✔C5
✔✔A secure method for applying surface cup electrodes requires
1. application the day before surgery
2. a conductive paste and tape
3. water resistant tape
4. collodion and compressed air - ✔✔collodion and compressed air
✔✔The amplitude of the cortical response to posterior tibial SSEP stim is at least 80%
attenuated by
1. stimulation rates of 15 per second or higher
2. large doses of muscle relaxant
3. a HLF of 5,000 Hz
4. a stimulation duration greater than 150 usec - ✔✔stimulation rates of 15 per second
or higher
✔✔It is recommended that while recording intra-op BAERs, electrodes be sealed with
tape in order to
1. keep the impedances high
2. prevent drying and to protect from fluids
3. keep stimulation artifact to a minimum
4. prevent them from oxidizing - ✔✔prevent drying and to protect from fluids
✔✔When using a bipolar montage during EEG recording, the localizing sign is
1. phase reversal between adjacent channels having a common electrode
2. the maximum amplitude activity is replicated in all channels displayed
3. the highest amplitude in the electrode referred to a common reference
4. at the end of the chain of electrode selections - ✔✔phase reversal between adjacent
channels having a common electrode
✔✔A patient is admitted to the OR diagnosed with a burst fracture of the first lumbar
vertebra. The most appropriate nerve(s) to monitor would be
QUESTIONS SET A+
✔✔Monitoring procedures during CEA include
1. monitoring both hemispheres
2. cessation of monitoring following clamp removal
3. monitoring from the compromised hemisphere only
4. recording a full minute of EEG basline - ✔✔monitoring both hemispheres
✔✔Preoperative baselines, SSEP values are essential to IONM because
1. latencies and amplitudes are highly variable
2. it is necessary to compare IONM values with laboratory normative data
3. absolute boundaries for EPs obtained intra-op are not available
4. they help to establish the appropriate level of anesthesia - ✔✔absolute boundaries
for EPs obtained intra-op are not available
✔✔A patient is admitted to the operating room diagnosed with a herniated C5/6 disc.
Most appropriate nerve(s) to monitor during the resulting surgical procedure would be
the
1. tibial and ulnar nerves
2. median and posterior tibial nerves
3. median and auditory nerves
4. ulnar nerve - ✔✔median and posterior tibial nerves
✔✔The median nerve SSEP can be helpful as a measure of
1. cerebral blood flow
2. lower spinal cord function
3. blood pressure variability4
4. anesthetic sensitivity - ✔✔Cerebral blood flow
,✔✔In the OR, the stim intensity for activating a sensory nerve
1. should be set at double the sensory threshold
2. should be set for two to three times the motor threshold
3. does not have an established boundary
4. is set to slightly above motor threshold - ✔✔does not have an established boundary
✔✔The suggested rate of stimulation for intraoperative posterior tibial nerve evoked
potential monitoring is:
1. 30 to 40 per second
2. 20 to 30 per second
3. 10 to 20 per second
4. 2 to 10 per second - ✔✔2 to 10 per second
✔✔When stimulating the posterior tibial at the ankle, stimulation can be confirmed by
1. turning the stimulator up to read 20mA
2. recording a cortical response at Cp4
3. reducing the impedance of the stimulating electrodes to less than 5k ohms
4. recording a response from the popliteal fossa - ✔✔Recording a response from the
popliteal fossa
✔✔To record cortical SSEPs during intraoperative monitoring of cervical spinal cord
surgery, electrodes should be placed
1. 2cm anterior to C3 and C4
2. 2cm posterior to C3 and C4
3. in the C3 and C4 positions of the 10-20 system
4. between Cz and Pz and between Pz and Oz - ✔✔2 cm posterior to C3 and C4
✔✔"Hearing level" (HL) is defined as the
1. average threshold intensity of normally hearing young adults
2. intensity of along duration sound that has the same amplitude as the peak SPL of a
short duration sound
3. lowest intensity that an average ear drum can her
4. inverse of the sound pressure level - ✔✔average threshold intensity of normally
hearing young adults
✔✔In order to record cortical SSEPs during intraoperative monitoring of the
thoracolumbar spinal cord (BLE SSEP), an electrode should be placed
1. 2cm posterior to Pz
2. 2cm anterior to Cz
, 3. 2cm posterior to Cz
4. 2cm posterior to C3 and C4 - ✔✔2 cm posterior to Cz
✔✔The recommended location for recording the cervical cord response to median
nerve stimulation
1. C1
2. C2
3. C5
4. C8 - ✔✔C5
✔✔A secure method for applying surface cup electrodes requires
1. application the day before surgery
2. a conductive paste and tape
3. water resistant tape
4. collodion and compressed air - ✔✔collodion and compressed air
✔✔The amplitude of the cortical response to posterior tibial SSEP stim is at least 80%
attenuated by
1. stimulation rates of 15 per second or higher
2. large doses of muscle relaxant
3. a HLF of 5,000 Hz
4. a stimulation duration greater than 150 usec - ✔✔stimulation rates of 15 per second
or higher
✔✔It is recommended that while recording intra-op BAERs, electrodes be sealed with
tape in order to
1. keep the impedances high
2. prevent drying and to protect from fluids
3. keep stimulation artifact to a minimum
4. prevent them from oxidizing - ✔✔prevent drying and to protect from fluids
✔✔When using a bipolar montage during EEG recording, the localizing sign is
1. phase reversal between adjacent channels having a common electrode
2. the maximum amplitude activity is replicated in all channels displayed
3. the highest amplitude in the electrode referred to a common reference
4. at the end of the chain of electrode selections - ✔✔phase reversal between adjacent
channels having a common electrode
✔✔A patient is admitted to the OR diagnosed with a burst fracture of the first lumbar
vertebra. The most appropriate nerve(s) to monitor would be
