MONITORING: CNS sidenotes Flashcards

1
Q

Ideal cerebral function monitor measuring the

A

electrical pattern of electrical activity from the depolarization of cortical neurons.

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2
Q

Motor evoked potentials monitor

A

electrical activity produced by skeletal muscles when directly stimulated.

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3
Q

SSEP monitor the _____Column

A

Dorsal column (sensory)

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4
Q

SSEP are stimulated ________and recorded _____

A

peripherally ; centrally

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5
Q

MEP assess the integrity of the

A

descending motor pathway in the ventral spinal cord

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6
Q

MEP monitor the _____Column

A

Ventral column (motor)

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7
Q

With MEP what is stimulated

A

Peripheral muscles are stimulated.

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8
Q

The MEP is usually detected at what two muscles?

A

THENAR EMINENCE and ABDUCTOR HALLUCIS MUSCLE

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9
Q

EP Least affected by VA

A

BAEPs

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10
Q

EP most Affected by VA

A

VEP

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11
Q

Correct order from MOST TO LEAST SENSITIVE TO VA

A

VEP>SSEP>BAEP

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12
Q

Nerves that be stimulated to elicit SSEPs are

A

Posterial tibial
Medial
Peroneal
Ulnar

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13
Q

SSEPs evaluated the integrity of the brain or spinal cord during certain types of surgery by monitoring

A

Gracilis and cuneatis tracts of the posterior spinal cord.

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14
Q

Burst suppression is a

A

reversible decrease in cortical neuronal metabolic function (CMRO2)

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15
Q

Characteristic signal often recognized with deepening of anesthesia levels

A

Burst suppression

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16
Q

Burst suppression is caused by

A

Barbiturates and propofol

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17
Q

Complete EEG suppression occurs at what temperature

A

15-18C

18
Q

BURST SUPPRESSION occurs at what MAC of VA?

A

~1.5 Iso, DES, sevo

19
Q

Burst of those agents can turn into epileptic seizures

A

Sevo and enflurane

20
Q

Barbiturates on EEG

A

Reduces EEG electrical activity as much as 50%, dose dependent

21
Q

In normothermic patient, CBF volume of 20-50 ml/100g/min been associated with

A

Slowing on the EEG

22
Q

Normal CBF is

A

50ml/100g/min

23
Q

CBF associated with significant neurologic impairment

A

<18 ml/100g/min

24
Q

CBF where EEG waveforms are completely abolished

A

<12 ml/100g/min

25
Q

CBF is irreversible at

A

< 6 ml/100g/min

26
Q

List 4 EEG waveforms from LOW to HIGH frequencies

DTAB

A

Dela < Theta < Alpha < Beta

27
Q

Delta frequency

A

1-4 Hz

28
Q

Theta Frequency

A

4-8 Hz

29
Q

Alpha Frequency

A

9-14 Hz

30
Q

Beta Frequency

A

15-40 Hz

31
Q

Most feared complications of spinal surgery

A

Paraplegia

32
Q

2 methods to detect intraoperative spinal cord function compromise?

A

Wake-up test

SSEPs

33
Q

SSEP and wake up monitor the ______column pathways

A

Dorsal

34
Q

If acute alterations in SSEP amplitude or latency occur what does it signify?

A

spinal cord compromise, ischemia, compression or hematoma

35
Q

If acute alterations in SSEP amplitude or latency occur and there is possible spinal cord compromise what should be done?

A

Surgery be discontinued, and BP return to normal or 20% above normal.

36
Q

What is EMG

A

It is a technique for evaluating and recording the electrical activity produced by skeletal muscles.

37
Q

What is the GOLD STANDARD for monitoring patients undergoing CAROTID ENDARTERECTOMY under GA?

A

12-lead EEG

38
Q

Beside the GOLD STANDARD Of 12-lead EEG for patients undergoing CEA what other pressures can be used?

A

TCD

Stump pressures.

39
Q

Shivering cause O2 consumption to increase by

A

200%

40
Q

An opioid agonist commonly used to stop shivering is

A

Meperidine

41
Q

Best sensors when comparing accuracy, safety and cost

A

ESOPHAGEAL (should be placed in the lower half or third of the esophagus behind the heart )

42
Q

What prevents phase I hypothermia and How?

A

Prewarming a surgical patient in the preoperative area for at least 30 minutes effectively prevents phase I hypothermia by eliminating the CENTRAL-PERIPHERAL temperature gradient.