FREE CNIM Neurosurgery Questions and Answers
During a spine surgery, what is the purpose of monitoring free-running EMG?
Free-running EMG monitors spontaneous muscle activity to detect potential nerve irritation or damage during surgery.
Which neural structures are typically monitored using brainstem auditory evoked potentials (BAEPs)?
BAEPs are used to monitor the integrity of the auditory pathways and brainstem function.
What is the primary goal of continuous EEG monitoring during neurosurgery?
Continuous EEG monitoring helps detect changes in cortical activity that may indicate ischemia or other complications.
In the context of IONM, what does the term "baseline" refer to?
Baseline recordings are taken before any surgical intervention to provide a reference for detecting changes during surgery.
What action should be taken if there is a sudden loss of TcMEPs during surgery?
A sudden loss of TcMEPs could indicate potential neural injury, requiring immediate attention from the surgical team.
What does a significant drop in somatosensory evoked potentials (SSEPs) during surgery typically indicate?
A significant drop in SSEPs can indicate potential damage or compromise to the neural pathways being monitored.
What type of anesthesia is preferred for optimal IONM results?
TIVA is preferred as it has less impact on neurophysiological signals compared to inhalational anesthetics.
Which of the following is a contraindication for using transcranial electrical stimulation in TcMEP monitoring?
These conditions may contraindicate the use of transcranial electrical stimulation due to the risk of adverse effects.
Which factor can most significantly affect the quality of IONM signals?
The type of anesthesia can significantly influence the quality of neurophysiological monitoring signals.
Which modality of IONM is commonly used to assess the integrity of motor pathways?
TcMEPs are used to monitor motor pathways by stimulating the motor cortex and recording responses from muscles.
What is the primary purpose of intraoperative neurophysiological monitoring (IONM) during neurosurgery?
IONM is used to continuously monitor the functional integrity of neural pathways during surgery to prevent iatrogenic damage.