CNIM - ABRET Practice Exam Questions 2023/
285 Questions and Answers/ Graded A+
Cavities inside the skull - -Anterior/middle/posterior fossa
-Cranial bones - -Frontal, occipital, sphenoid, ethmoid (unpaired). Parietal & temporal
(paired).
-Mental protuberance - -chin bone
-MCA supply of the cerebral cortex - -Hand + face/mouth/auditory
-Cranial nerves - --12 pairs (Mixed fibers: sensory/motor/both).
-Emerge @ irregular intervals from the brain.
-Nuclei displacement:
Motor = medial Sensory = lateral
-Meckle's Cave - -Depression in the medial middle fossa where CN V ganglion sits
-Low frequency sounds - -@ apex of cochlea
-Area of spine w/ small pedicles, long spinous process, large inter-vertebral foramen - -
Thoracic
-Neuroforamen - -Opening w/in the spinal canal for nerve roots to enter the SC
-Firm outer layer of the disc - -Annulus fibrosis
-Syrinx - -Fluid-filled cavity @ center of the SC
-Spinal cord ends @ the level btwn: - -L1-L2 vertebrae (Conus Medullaris)
-Blood supply to the SC consists of: - -1 ASA for both MEP tracts
-Hydrostatic pressure - -Depends on body position
-Structural functional anatomy may be altered by: - -Previous lesions, current,
plasticity, pressure
-Glia cell - -Comes from the Greek word "glue"
, -Large diameter nerve fiber (vs. small diameter) - --Recruited 1st w/ INC'd stim
intensity
-Higher conduction velocity
-More vulnerable to hypoxia & pressure Δ's
-Synaptic transmission, and/or Δ's in thalamocortical projections, produce - -Cortical
potentials
-Peripheral nerve sensitivity - -Least sensitive to injury (more sensitive = SC
grey/white mater, cortical grey matter)
-Cavernous angiomas - -Multi-lobulated lesions containing hemorrhage
-Geriatric population: prevalence of temporal bone hyperostosis - -10-15%
-Presbycusis - -High freq hearing loss; gradually occurs in older individuals
-Most commonly injured CN - -Facial nerve (VII)
-Burst fracture - --Break in the vertebra
-Failure of anterior & middle vertebral columns
-Caused by violent compressive event (fall, MVA)
-Excessive neck flexion in sitting position - -Quadraparesis (due to ischemia in upper
T-spine)
-Lhermittes Sign - -Shocking sensation that occurs throughout the body during neck
flexion
-Central Cord Syndrome (CCS) - --Sacral sparing
-Loss of sensory/motor fx @ level of injury
-Disruption of grey matter
-(+) Babinski Sign could indicate - --severe [UMN] SC trauma
-abnml PTN SSEPs
-Hoffman's Reflex (1918) - -Palmar flexion of the thumb when the distal phalanx of the
middle finger (of the same hand) is rapidly stroked
-A nml curve of the lumbar spine taking place @ 1-2 y/o - -Kyphosis
, -Scoliosis progression in peds - -More likely in girls > boys
-Apraxia - -Difficulty w/ skilled mvmnts
-Neurapraxia - -PNS disorder: blockage of sensory + motor nerve conduction (w/o
axonal damage)
-INC venous pressure leads to - --venous congestion; DEC drainage of nml veins;
chronic hypoxia
-NOT hypotension
-common source of air embolism introduction into the blood supply - -Superior sagittal
sinus
-MAC is approximated by the effect of anesthesia on - -H-reflex (mvmnt when
stimulated)
-Sevo/Des/N2O - -DO NOT act on the same neuronal receptors
-On an equi-MAC basis (w/ equivalent doses of anes), which has the greatest effect on
MEPs of recorded mm's? - -N2O
-N2O - --synergistic IONM effects when mixed w/ Iso --> depressed IONM
-weak anesthetic agent
-causes ~75% DEC in SSEP amplitudes
-Desflurane - --affects NMJ --> enhances effect of NMBs
-no effect on MEP CMAPs
-eliminates most rapidly
-Isoflurane 1.7% - -may result in burst suppression
-TIVA MoA on pt mvmnt - -Glycine receptor blocking in the SC
-Which is not a major MoA of the usual anesthetic agents that affect IONM? - -
Inhibition of nerve conduction velocity
-EP modality most affected by propofol - -Mid-latency auditory response
-Ketamine - -(NMDA antagonist)
285 Questions and Answers/ Graded A+
Cavities inside the skull - -Anterior/middle/posterior fossa
-Cranial bones - -Frontal, occipital, sphenoid, ethmoid (unpaired). Parietal & temporal
(paired).
-Mental protuberance - -chin bone
-MCA supply of the cerebral cortex - -Hand + face/mouth/auditory
-Cranial nerves - --12 pairs (Mixed fibers: sensory/motor/both).
-Emerge @ irregular intervals from the brain.
-Nuclei displacement:
Motor = medial Sensory = lateral
-Meckle's Cave - -Depression in the medial middle fossa where CN V ganglion sits
-Low frequency sounds - -@ apex of cochlea
-Area of spine w/ small pedicles, long spinous process, large inter-vertebral foramen - -
Thoracic
-Neuroforamen - -Opening w/in the spinal canal for nerve roots to enter the SC
-Firm outer layer of the disc - -Annulus fibrosis
-Syrinx - -Fluid-filled cavity @ center of the SC
-Spinal cord ends @ the level btwn: - -L1-L2 vertebrae (Conus Medullaris)
-Blood supply to the SC consists of: - -1 ASA for both MEP tracts
-Hydrostatic pressure - -Depends on body position
-Structural functional anatomy may be altered by: - -Previous lesions, current,
plasticity, pressure
-Glia cell - -Comes from the Greek word "glue"
, -Large diameter nerve fiber (vs. small diameter) - --Recruited 1st w/ INC'd stim
intensity
-Higher conduction velocity
-More vulnerable to hypoxia & pressure Δ's
-Synaptic transmission, and/or Δ's in thalamocortical projections, produce - -Cortical
potentials
-Peripheral nerve sensitivity - -Least sensitive to injury (more sensitive = SC
grey/white mater, cortical grey matter)
-Cavernous angiomas - -Multi-lobulated lesions containing hemorrhage
-Geriatric population: prevalence of temporal bone hyperostosis - -10-15%
-Presbycusis - -High freq hearing loss; gradually occurs in older individuals
-Most commonly injured CN - -Facial nerve (VII)
-Burst fracture - --Break in the vertebra
-Failure of anterior & middle vertebral columns
-Caused by violent compressive event (fall, MVA)
-Excessive neck flexion in sitting position - -Quadraparesis (due to ischemia in upper
T-spine)
-Lhermittes Sign - -Shocking sensation that occurs throughout the body during neck
flexion
-Central Cord Syndrome (CCS) - --Sacral sparing
-Loss of sensory/motor fx @ level of injury
-Disruption of grey matter
-(+) Babinski Sign could indicate - --severe [UMN] SC trauma
-abnml PTN SSEPs
-Hoffman's Reflex (1918) - -Palmar flexion of the thumb when the distal phalanx of the
middle finger (of the same hand) is rapidly stroked
-A nml curve of the lumbar spine taking place @ 1-2 y/o - -Kyphosis
, -Scoliosis progression in peds - -More likely in girls > boys
-Apraxia - -Difficulty w/ skilled mvmnts
-Neurapraxia - -PNS disorder: blockage of sensory + motor nerve conduction (w/o
axonal damage)
-INC venous pressure leads to - --venous congestion; DEC drainage of nml veins;
chronic hypoxia
-NOT hypotension
-common source of air embolism introduction into the blood supply - -Superior sagittal
sinus
-MAC is approximated by the effect of anesthesia on - -H-reflex (mvmnt when
stimulated)
-Sevo/Des/N2O - -DO NOT act on the same neuronal receptors
-On an equi-MAC basis (w/ equivalent doses of anes), which has the greatest effect on
MEPs of recorded mm's? - -N2O
-N2O - --synergistic IONM effects when mixed w/ Iso --> depressed IONM
-weak anesthetic agent
-causes ~75% DEC in SSEP amplitudes
-Desflurane - --affects NMJ --> enhances effect of NMBs
-no effect on MEP CMAPs
-eliminates most rapidly
-Isoflurane 1.7% - -may result in burst suppression
-TIVA MoA on pt mvmnt - -Glycine receptor blocking in the SC
-Which is not a major MoA of the usual anesthetic agents that affect IONM? - -
Inhibition of nerve conduction velocity
-EP modality most affected by propofol - -Mid-latency auditory response
-Ketamine - -(NMDA antagonist)
