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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. Free-running (spontaneous) EMG monitoring during spine surgery is used primarily to detect:

    Answer: Nerve root irritation or injury from surgical manipulation

    Free-running EMG detects spontaneous electrical activity (trains of potentials) generated when nerve roots are mechanically irritated, stretched, or injured during surgery.

  2. Neurotonic discharges in free-running EMG during lumbar surgery are characterized by:

    Answer: Sustained high-frequency trains of motor unit potentials indicating nerve irritation

    Neurotonic discharges are sustained, high-frequency trains of motor unit activity that are highly significant for nerve root mechanical irritation and require surgical team notification.

  3. Triggered EMG (t-EMG) is used to assess pedicle screw placement by:

    Answer: Stimulating the screw and measuring the threshold current needed to elicit a muscle response

    Triggered EMG assesses pedicle screw integrity by stimulating the screw and determining the minimum current required to elicit a CMAP response; low thresholds suggest cortical wall breach.

  4. A triggered EMG threshold of less than 6–7 mA for a pedicle screw suggests:

    Answer: Possible medial wall breach with proximity to the nerve root

    Threshold values below 6–7 mA for pedicle screws are considered concerning for a medial cortical wall breach, placing the screw close to the adjacent nerve root.

  5. EMG monitoring of which muscle confirms the integrity of the facial nerve (CN VII) during parotid or posterior fossa surgery?

    Answer: Orbicularis oculi and orbicularis oris

    The orbicularis oculi (upper face) and orbicularis oris (lower face) are the primary muscles monitored for CN VII integrity, representing the upper and lower branches of the facial nerve.

  6. During spinal deformity surgery, the L5 nerve root is best monitored using EMG from which muscle?

    Answer: Tibialis anterior

    The tibialis anterior is primarily innervated by the L4-L5 nerve roots via the deep peroneal nerve and provides the most sensitive EMG monitoring of L5 root function.

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