Sensory
This SafeOp modality monitors the integrity of the sensory nervous system pathway.
What are SSEPs?
This anesthetic leads to an inability to get muscle responses and is why we test Train of Four.
What are paralytics?
This modality monitors the integrity of a patients motor pathway.
What are MEPs?
A 50% drop in amplitude or a 10% increase in latency.
Ends at L1/L2 and then turns into the cauda equina.
What is the spinal cord?
The recording locations for the SSEP modality are called.
What is cortical and transcortical, or Cpz/Fpz and Cp3/Cp4.
Decrease in patient blood pressure can cause this during SSEP and MEP monitoring.
The motor pathway travels in this direction.
What is proximal to distal?
In order to monitor MEP and SSEP changes over time, SafeOp needs to respectively set this at the very beginning of the case.
What are baselines?
Largest nerve of the lumbar plexus.
What is the femoral nerve?
Travels up the spinal cord and to the brain stem.
What is the somatosensory pathway?
TIVA is preferred for these 2 SafeOp modalities
What is SSEP and MEP
MEPs provide instantaneous information on the health of this major neural structure.
What is the spinal cord?
A global change is most likely attributed to.
What is anesthesia?
Stimulating electrodes are placed at the cranium in this monitoring modality.
What are MEPs?
The saphenous nerve and the posterior tibial nerve.
New item that will come in SafeOp electrode kits that must be placed prior to MEP monitoring.
What are bite blocks?
Intrusive to workflow, patient movement, false positive results
What are challenges with MEPs today?
At time based intervals or after major surgical manipulation.
When should MEPs be run?
This root (ventral or dorsal) supplies motor function.
What is the ventral root?
This root (ventral or dorsal) supplies sensory function.
What is the dorsal root?
Gas, (inhaled anesthetics), blood pressure, temperature, opioid injection.
What are changes to anesthetic regimen that can cause global alerts during SSEP?
The montage that calls for placing 4 stimulating electrodes in the head rather than 2.
What is quadripolar stimulation?
If the maneuvers in the case could compromise the integrity of the spinal cord, such as in cases that involve spinal derotation, reduction maneuvers, kyphosis correction, or implant insertion.
What are indications that MEPs should be run in the case?
Stimulated at the motor cortex of the brain.
What are upper motor neurons.