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Electromyography (EMG) and Nerve Monitoring Flashcards

6 cards from real CNIM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. During thyroid or parathyroid surgery, intraoperative EMG monitoring of the recurrent laryngeal nerve (RLN) is achieved by recording from:

    Answer: Vocalis muscle via endotracheal tube electrodes

    Specialized endotracheal tubes with surface electrodes record EMG from the vocalis (thyroarytenoid) muscle innervated by the RLN, providing real-time monitoring of laryngeal nerve integrity.

  2. During spinal cord stimulator lead placement, EMG is used to:

    Answer: Confirm lead position by recording paresthesia-mapping responses from stimulated myotomes

    EMG can confirm spinal cord stimulator lead position by verifying that electrical stimulation activates the intended myotomes corresponding to the patient's pain distribution.

  3. The H-reflex recorded during intraoperative monitoring represents:

    Answer: An electrically elicited monosynaptic reflex assessing sensory-motor arc integrity

    The H-reflex is an electrically elicited monosynaptic spinal reflex analogous to the Achilles tendon reflex, testing the integrity of the S1 afferent and efferent arc.

  4. When monitoring cranial nerve XI (spinal accessory nerve) during posterior fossa surgery, EMG is recorded from which muscle?

    Answer: Trapezius and sternocleidomastoid

    The trapezius and sternocleidomastoid muscles are innervated by cranial nerve XI and are the appropriate recording sites for monitoring spinal accessory nerve integrity.

  5. Why is the ulnar nerve-innervated abductor digiti minimi (ADM) commonly used as an upper extremity EMG electrode site during cervical spine surgery?

    Answer: It monitors C8-T1 nerve root function and is sensitive to ulnar nerve injury

    The ADM is innervated by C8-T1 nerve roots via the ulnar nerve, making it sensitive to lower cervical nerve root injury and ulnar nerve traction during cervical surgery.

  6. The absence of EMG activity in all monitored muscles during intraoperative free-running recording most likely indicates:

    Answer: Possible residual neuromuscular blockade preventing reliable monitoring

    Complete absence of any EMG activity, including no spontaneous potentials in a quiet field, may indicate residual NMB is blocking neuromuscular transmission and rendering EMG monitoring unreliable.

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