IIA10 - Setup for EDX

Question 1

What is the following recording parameter for an electromyogram (EMG)?

Gain (amplitude, Y-axis):

Answer 1

50 - 100 uv/cm

Question 2

What is the following recording parameter for an electromyogram (EMG)?

Sweep Speed (x-axis):

Answer 2

2 - 10 ms/cm

Question 3

What are the following recording parameters for an electromyogram (EMG)?

High Freq Filter:
Low Freq Filter:

Answer 3

High Freq Filter: 10 kHz
Low Freq Filter: 20 kHz

Question 4

Where should the reference electrode be placed in setup for an electromyogram (EMG)?

Answer 4

Placed over connective tissue, or a bony prominence

Question 5

What is the most common type of needle used for the recording electrode during an electromyogram (EMG)?

Answer 5

A concentric needle

Question 6

How many regions for each muscle should be tested during an electromyogram (EMG)?

Why test this many regions?

Answer 6

5 - 10

Changes in the muscle can be focal or patchy and may be missed if only a few sites are tested

Question 7

What is the following recording parameter for a motor nerve conduction velocity (MNCV) test?

Gain (amplitude, Y-axis):

Answer 7

2 - 5 mV/cm

Question 8

When should be taken into consideration when selecting a muscle for biopsy after doing an electromyogram (EMG)?

Answer 8

Insertion of the EMG needle results in minor muscle injury.

Try to avoid this by doing EMG on one side and biopsies from the other if possible

Question 9

What is the following recording parameter for a motor nerve conduction velocity (MNCV) test?

Sweep Speed (x-axis):

Answer 9

2 - 10 ms/cm

Question 10

What are the following recording parameters for a motor nerve conduction velocity (MNCV) test?

High Freq Filter:
Low Freq Filter:

Answer 10

High Freq Filter: 10 kHz
Low Freq Filter: 20 Hz

Question 11

What are the stimulation parameters for a motor nerve conduction velocity (MNCV) test?

Duration:
Rate:
Intensity:

Answer 11

Duration: 0.2 - 2 ms
Rate: 1 - 2 Hz
Intensity: 10 - 50 V

Question 12

What type of needle is typically used for motor nerve conduction velocity (MNCV) testing?

Answer 12

Two monopolar needles placed about 2-3cm apart

Question 13

How should the cathode and anode be placed in relation to each other and the recording site when setting up a motor nerve conduction velocity (MNCV) test. What happens if this is swapped?

Answer 13

The active electrode (cathode) should always be placed closer to the recording site than the anode

Anodal block and loss of output can occur if the cathode and anode location are swapped

Question 14

What is the minimum distance between the recording and stimulating sites that is considered optimal for performing an motor nerve conduction velocity (MNCV) test?

Answer 14

Ideally at least 10cm in between the two sites

Question 15

What is supramaximal stimulation when performing a motor nerve conduction velocity (MNCV) test?

Answer 15

The stimulation current at which no further increase in the size (amplitude) of the compound muscle action potential (CMAP) is achieve

The CMAP is maximized

Question 16

Where are the recording electrodes placed (generally) when setting up a motor nerve conduction velocity (MNCV) test?

Answer 16

The recording electrodes are placed within the belly of the muscle that is associated with the nerve being stimulated

The cathode (active electrode) is placed in the center of the muscle belly and the anode is placed in an electrically inactive site

Question 17

Where should the reference electrode be placed when performing a motor nerve conduction velocity (MNCV) test?

Answer 17

Placed on a bony prominence between the stimulating and recording electrodes

Question 18

How should the recording electrode be adjusted after first inserted when setting up for a motor nerve conduction velocity test?

Answer 18

The needle should be readjusted until the initial deflection measured is in the upwards (negative) direction

This indicates the needle is near the motor point

Question 19

How should the stimulating electrode be adjusted after first insertion when setting up for a motor nerve conduction velocity test?

Answer 19

The needle should be adjusted until the largest response is observed - the closer the needle is to the nerve the larger the CMAP will be

Question 20

Which nerve in particular is recommended for motor nerve conduction velocity (MNCV) fin the pelvic limb for its ease?

Answer 20

Sciatic nerve and its branches (tibial or peroneal)

Question 21

What is the following recording parameter for a Brainstem Auditory Evoked Response (BAER)?

Gain (amplitude, Y-axis):

Answer 21

5 - 10 mV/ div

Question 22

What is the following recording parameter for a Brainstem Auditory Evoked Response (BAER)?

Sweep Speed (x-axis):

Answer 22

0.5 - 1 msec/ div

Question 23

What are the following recording parameters for a Brainstem Auditory Evoked Response (BAER)?

High Freq Filter:
Low Freq Filter:

Answer 23

High Freq Filter: 10 kHz
Low Freq Filter: 1.5 - 2 Hz

Question 24

What is the stimulating parameters for a Brainstem Auditory Evoked Response (BAER)?

Stimulus Rate:

Answer 24

10 stimuli / sec

Question 25

What are the two types of conductive devices that can be used for a Brainstem Auditory Evoked Response (BAER)?

Answer 25

Air-conducted (headphone or earphones) Bone-conducted

Question 26

How does bone conducted stimulus work when used for Brainstem Auditory Evoked Response (BAER)?

Answer 26

The stimulation creates vibrations that are applied to the ipsilateral mastoid process of the temporal bone and bypasses the conductive structures of the outer and middle ear

Question 27

What can bone-conducted stimulus help you to distinguish when performing a Brainstem Auditory Evoked Response (BAER)?

Answer 27

It can help to distinguish conductive from sensorineural deafness

Question 28

Where are the electrodes placed when performing a mastoid-vertex montage for a brainstem auditory evoked response (BAER) test?

Answer 28

Anode is placed at the vertex Cathode is placed at the mastoid area of the stimulated ear Reference placed at the nuchal crest, base of the neck, or opposite mastoid

Question 29

Where are the electrodes placed when performing a T1-vertex montage for a brainstem auditory evoked response (BAER) test?

Answer 29

Anode is placed at the vertex Cathode is placed at T1 Reference is placed at the nuchal crest, base of the neck, or opposite mastoid

Question 30

What needs to happen with the output from a brainstem auditory evoked potential (BAER) in order to achieve a readable tracing?

Answer 30

Since the amplitude of the signal achieved is so tiny, hundreds to thousands of responses need to be averaged to exclude random artifact

Question 31

What is the purpose of the automatic rejection system used during a brainstem auditory evoked response (BAER) test?

Answer 31

To automatically reject traces that contain massive amplitude signals (outside a predetermined threshold) which are clearly not from the BAER recording and would otherwise destroy the tracing average (waveforms from muscle or artifact)

Question 32

What are the most common types of electrodes used for electroencephalogram (EEG) studies?

Answer 32

Subdermal electrodes (wires or monopolar needle)

Question 33

How should recording electrodes be ideally spaced when performing an electroencephalogram (EEG)?

Answer 33

Ideally recording (active) electrodes are spaced evenly across the head to allow for recording of all different regions of the cortex

Question 34

Where should the reference electrode be placed when performing an electroencephalogram (EEG)?

Answer 34

Please the reference electrode on a portion of the head that would not pick up on electrical activity from the brain (e.g. nose, mastoid, pinna)

Question 35

Where should the ground electrode be placed when performing an electroencephalogram (EEG)?

Answer 35

Somewhere on the patient but the exact location does not matter

Question 36

Why is the ground electrode important when performing an electroencephalogram (EEG)?

Answer 36

It helps to prevent electrical charges from causing burn or more serious injuries to the patient and also helps to reject large changes in electrical potential from interference from instruments and power lines (50-60Hz interference)

Question 37

When using electroencephalogram (EEG) nomenclature, what region of the skull is denoted by "Fp"?

Answer 37

Prefrontal

Question 38

When using electroencephalogram (EEG) nomenclature, what region of the skull is denoted by "C"?

Answer 38

Central

Question 39

When using electroencephalogram (EEG) nomenclature, what region of the skull is denoted by "F"?

Answer 39

Frontal

Question 40

When using electroencephalogram (EEG) nomenclature, what region of the skull is denoted by "T"?

Answer 40

Temporal

Question 41

When using electroencephalogram (EEG) nomenclature, what region of the skull is denoted by "P"?

Answer 41

Parietal

Question 42

When using electroencephalogram (EEG) nomenclature, what region of the skull is denoted by "O"?

Answer 42

Occipital

Question 43

When using electroencephalogram (EEG) nomenclature, what region of the skull is denoted by odd numbers?

Answer 43

The left side of the skull

Question 44

When using electroencephalogram (EEG) nomenclature, what region of the skull is denoted by event numbers?

Answer 44

The right side of the skull

Question 45

When using electroencephalogram (EEG) nomenclature, what region of the skull is denoted by "Z"?

Answer 45

Midline

Question 46

When setting up for an electroencephalogram (EEG) what is impedance and what range is aimed for?

Answer 46

Impedance is the amount of resistance for alternating currents Should aim for 0.1 - 5 ohms but up to 10 ohms may be acceptable for continuous recordings

Question 47

What are the two most common types of montages used for an electroencephalogram (EEG)?

Answer 47

1) Referential montage 2) Bipolar montage

Question 48

How is a referential montage for an electroencephalogram (EEG) arranged?

Answer 48

Each individual active electrode is paired with a common reference electrode The reference electrode is the same for all active electrodes

Question 49

How is a bipolar montage for an electroencephalogram (EEG) arranged?

Answer 49

Each active electrode is paired with an adjacent electrodes to form chains of electrodes with each active electrode represented in two channels

Question 50

What type of montage is shown in the electroencephalogram (EEG) below?

Answer 50

A bipolar montage

Question 51

When performing an electroencephalogram (EEG) what would a common average montage be?

Answer 51

Where each electrode is compared to a reference that is made up of all active electrodes

Question 52

When performing an electroencephalogram (EEG), what would a laplacian montage be?

Answer 52

Where each active electrode is compared to the average of its surrounding electrode

Question 53

What are the pros and cons of a reference montage when evaluating an electroencephalogram (EEG)?

Answer 53

A reference montage will accurately display the shape and amplitude of waveforms but will show more artifacts and abnormalities will appear in multiple channels

Question 54

What are the pros and cons of a bipolar montage when evaluating an electroencephalogram (EEG)?

Answer 54

A bipolar montage will display less artifact and be more useful for localizing an abnormality; however, the shape and amplitude of waveforms will be distorted If both electrodes are equidistant to an abnormality, the electrodes will cancel each other out and the abnormality will not be displayed

Question 55

Within what frequency range are most of the important signals on an electroencephalogram (EEG) found?

Answer 55

Between 0.5 and 30 Hz

Question 56

What is the typical settings for a band pass filter on electroencephalogram (EEG) and what is its purpose?

Answer 56

A band pass filter of 0.5 to 70 Hz is most common Is used to eliminate signals with frequencies outside this range as they are unlikely to be of clinical significance

Question 57

What is a 50/60 Hz notch filter typically used for on an electroencephalogram (EEG)?

Answer 57

To remove artifact arising from alternating current (i.e. electrical interference)

Question 58

What is the benefit of coupling an electroencephalogram (EEG) recording with video?

Answer 58

Any abnormal electrical activity can be paired with video of what the animal was doing at the time to better understand if the activity is an artifact (animal moving or other incidence) or if related to a paroxysm

Question 59

What are **activation procedures** which may be performed during an electroencephalogram (EEG) recording?

Answer 59

Stimulation which can be sent to the animal to try to trigger epileptiform discharges Hyperventilation (20 bpm for 3-5 minutes) Intermittent photic stimulation (flashes of light over 5-7 seconds with increasing frequency)

Question 60

What is the following recording parameter for a sensory nerve conduction velocity (SNCV) test? Gain (amplitude or y-axis):

Answer 60

1 - 5 mV/ cm

Question 61

What is the following recording parameter for a sensory nerve conduction velocity (SNCV) test? Sweep Speed (y-axis):

Answer 61

1 ms/cm

Question 62

What are the following recording parameters for a sensory nerve conduction velocity (SNCV) test? Low Freq Filter: High Freq Filter:

Answer 62

**Low Freq Filter:** 5 kHz **High Freq Filter:** 2 Hz

Question 63

For a sensory nerve conduction velocity (SNCV) test, what types of nerves can the signals be obtained from?

Answer 63

Sensory or mixed (motor and sensory) nerves

Question 64

What are the following settings for stimulating parameters for a sensory nerve conduction velocity (SNCV) test? Stimulation duration:

Answer 64

0.2 msec

Question 65

What are the following settings for stimulating parameters for a sensory nerve conduction velocity (SNCV) test? Stimulation rate:

Answer 65

10 Hz

Question 66

What are the following settings for stimulating parameters for a sensory nerve conduction velocity (SNCV) test? Number of stimulations:

Answer 66

an average of 250-500 impulses

Question 67

What are the following settings for stimulating parameters for a sensory nerve conduction velocity (SNCV) test? Stimulatory intensity:

Answer 67

Supramaximal

Question 68

Stimulation is most commonly of what region when performing a sensory nerve conduction velocity (SNCV) test?

Answer 68

Stimulation of the skin/SQ that is innervated by the nerve being recorded The stimulation occurs distally with the recording more proximally since a sensory (afferent nerve) is being evaluated

Question 69

How many locations need to be recorded in order to properly calculate sensory nerve conduction velocity?

Answer 69

Only one site needs to be measured since you do not have to correct for the NMJ

Question 70

How many locations need to be recorded in order to properly calculate motor nerve conduction velocity?

Answer 70

At least two sites, due to needed to remove the time at the NMJ from the total time

Question 71

What type of wave is produced when performing a sensory nerve conduction velocity (SNCV) test?

Answer 71

A sensory nerve action potential (SNAP)

Question 72

Which of the motor nerve conduction velocity (MNCV) electrodes can be repurposed for use during a sensory nerve conduction velocity (SNCV) test?

Answer 72

The recording electrodes for the SNCV can come from the stimulating electrodes used during the MNCV (as those electrons should be near to the nerve)

Question 73

Where should the ground be placed during a sensory nerve conduction velocity (SNCV) test?

Answer 73

In between the stimulating and recording electrodes in order to reduce stimulus artifact

Question 74

What is the most common thoracic limb nerve used for performing a repetitive nerve stimulation (RNS) test?

Answer 74

Ulnar nerve with the palmar intraosseous muscle

Question 75

What are the two most common pelvic limb nerves used for performing a repetitive nerve stimulation (RNS) test?

Answer 75

1) Sciatic-tibial nerve with the plantar interosseous muscle 2) Sciatic-peroneal nerve with the tibialis cranialis muscle

Question 76

Why is a more distal muscle recommended for use when performing a repetitive nerve stimulation (RNS) test?

Answer 76

To reduced movement artegact

Question 77

How many stimulation are performed in order to review a repetitive nerve stimulation (RNS) test?

Answer 77

10

Question 78

What are the recommended stimulation rates for a repetitive nerve stimulation (RNS) test?

Answer 78

2 - 3 Hz

Question 79

What happens when using stimulation rates higher than 10 Hz during a repetitive nerve stimulation (RNS) test?

Answer 79

A decremental response will be seen even in **normal** muscle

Question 80

How many times should you repeat the train of 10 stimulations to ensure repeatability of results on a repetitive nerve stimulation (RNS) test?

Answer 80

Repeat the test at least once to confirm repeatability of results

Question 81

How long should you wait between trains of tests when performing a repetitive nerve stimulation test and why?

Answer 81

At least 30 seconds should pass between tests to allow for recovery of neuromuscular transmission

Question 82

What type of setup (needle arrangement) is used to evaluate an F-wave on electrodiagnostic testing?

Answer 82

The same setup as with a motor nerve conduction velocity (MNCV) test

Question 83

What type of setup (needle arrangement) is used to evaluate an H-wave on electrodiagnostic testing?

Answer 83

The same setup as with a motor nerve conduction velocity (MNCV) test