EEG

-y

(condition or process of)

15 mm/second, 1 page 15 seconds dpes what?

(enhances the appearance of slow waves I.e. sleep

-ic

(pertaining to)

-ium

(structure or tissue)

The computer boots up fine but the display is fuzzy, dark, discolored, or not the correct size

, the three components directly responsible for the display are the monitor, the monitor cable (attached to the computer), and the video card inside the computer. The easiest troubleshooting involves swapping a compatible monitor / cable to see if the problem resolves. If the problem does not resolve, then the video card should be reseated by an approved staff member. Failure after reseating may indicate a bad video card. In some cases, the display problem could be caused by incorrect software settings in the computer. Your manufacturer should know what the correct settings should be for your system and most of these settings are easy to find and reset over the phone. These settings need to be reset when the monitor is changed on the system. Incorrect software settings may have an impact on all programs or only on specific programs such as icon text size, resolution and color.

ex-

- out or away

ECG or EKG

-1.5 mV

Sensory Evoked Potentials

-10Vv

Motor Evoked Potentials

-2.5 mV

Electroencephalogram "EEG"Answer 4

-20 Uv

Electromyogram "EMG"

-3 mV

densely packed stellate cells; a few small pyramidal cells

-External Granular Layer

Benign Epileptiform Transients of Sleep (BETS) are often confused with spikes associated with complex partial seizures (CPS) because: (select all that apply)

-They have a very sharp morphology. -They are found in the temporal lobe -They are found in Stage II sleep.

Asymmetry in the EEG _____.

-may sometimes be caused by a poor electrode placement .-may be caused by a skull defect -refers to a difference in EEG amplitude between homologous areas

Digital EEG systems are generally set to record the widest possible band of frequencies within the recording spectrum, for example.

.1-100Hz

delta range is..

0 to less than 4 hz

EEG activity recorded at the scalp with conventional EEG instruments do not reliably observe frequencies below

0.5 Hz

1 Hz is equal to.... It is the number of complete cycles of repetitive waves or complexes in one second.

1 cycle per second Hertz

Tingling sensation: almost not perceptible

1 mA

Alpha appears around _____ after eye closure

1-1.5 seconds

The outermost cerebral cortex (neocortex) is made up of these layers of closely packed cells of in this order:

1-Molecular layer, 2-Multiform Layer, 3-External Pyramidal Layer, 4-Internal Granular Layer, 5- Internal Pyramidal Layer, 6-External Granular Layer

nervous )ssue is made up of two cell types:

1. Neurons: nerve cell 2. Neuroglia: nerve glue

Many neurotransmitter substances have been identified in the CNS and are divided into two general classes:

1. Substances of low molecular weight such as: noradrenaline, dopamine, serotonin, 5HTP, histamine, glutamate, GABA, glycine 2. Neuroactive peptides (which have large molecular weight): i.e. vasopressin, substance P, somatostatin

order of decevopment?

1. ectoderm 2. neural plate 3. neural groove 4.neural tubes

r. The first Grass Model I was completed in 1935 with new linear moving coil pen writers designed and installed in early 1936. The five stages of cascaded differential vacuum tube amplifiers, plus a power amplifier to drive the inkwriter, made this instrument a high-sensitivity amplifier with a frequency response from...

1.0 Hz to 10,000 Hz

6 things to remember for electrical safety in EMU:

1.avoid using extension cords 2. get to know biomed engineering staff 3. know dangers of ESU 4. biomed equipment checks up to date 5. learn equipment, isolated amps and grounds? 6. embrace electrical concepts Use isolated ground, not an earth ground Bundle and twist wires to avoid electrical burns

measuring just below, FP1 to T3 T3 to F7 F7 to T3 T3 to O1 same for Fp2 to F8 f8 to T6 T6 to O2

10 10 10

vertical marks left preauricular-T3 T3-C3 C3-CZ CZ-C4 C4-T4 T4-preauricular

10 20 20 20 20 10

Inter-electrode distances should be at least ______.

10 cm

nomenclature has ____ inferior to the "7 electrodes" and _____ innferior to "8 electrodes"

10%

horizontal marks nasion-fpz fpz-fz fz-cz cz-pz pz-oz oz-ionion

10% 20 20 20 20 10

Inter-electrode impedances should be under...

10,000 ohms but over 100 ohms

accomodate additional electrode placements needed to localize focal abnormalities or confirm

10-10 system

standard for symmetrical placement using 10% and 20% measurments from landmarks on skull, based on relationship between measured electrode site and underlying cortical structures

10-20 system

The minimum screen resolution to properly display a 10 second page of digital EEG would be:

1024 x 768 pixels

The vertical resolution of an A-D converter should be at least _____ bits per ACNS guidelines?

11 bits

The vertical resolution recommended in the ACNS Digital Medial Guidelines, is a _____. This would allow (as shown above) a representation of 4,096 discrete voltage values. Some current digital EEG systems offer 16 bit resolution. In general the more bits, within reason, the better. However there is often no reason in clinical EEG to resolve changes in voltage that are smaller than the inherent noise and precision of the amplifier system.

12 bit ADC

Positive Occipital Sharp Transients are typically found in the following age group:

13-25 year old

- benign variant F. 14 & 6 Hz; can be 14 Hz or 6 Hz only M. Positive spikes T. Posterior temporal regions; unilateral or bilateral R. Seen during drowsiness and light sleep; has a high incidence of occurring in normal individuals. rfacepositive spikes most prominent in the posterior-temporal regions occurring at 14 Hz, 6 Hz, or a mixture of 14 Hz and 6 Hz

14 and 6 positive spikes

Common household circuit breakers

15-30 Amps

Maximum current for a person to grasp and then let go

16 mA

Tetany of skeletal muscles

16-20 mA

what is the 1st, second, and newest generation of AEDs?

1st generation - PB/PRM, PHT, CBZ, VPA • 2nd generation - GBP, LTG, TPM, TGB - OXC, LEV, ZNS - PGB • Newest AEDs - RUF - LCS - GVG

One second is usually demonstrated by

2 bold lines or with a horizontal legend.

spikes have ___ or less of paper, with sharp waves more than ___

2 mm

2 bits =

2 to the second power voltage levels, which is the same as 2x2 voltage levels = 4 voltage levels

Paralysis of respiratory muscles: respiratory arrest

20-50 mA

spike duration=

20-70 msec

The ACNS recommendations for recording clinical EEG on digital media state that the sampling rate should be ____ and the resolution of the A to D converter should be ____.

200 or higher, 12

In the adult, the skull consists of ___ individual bones, ____ of which are immobile and united into a single unit

22 21

Maximal intensity of household current (US)

240 Amps

Typical sample rates for EEG A-D converters are:

256-512 Hz

the brain is ____ pounds

3

"Let go" current for an average child

3-5 mA

The first demonstration of the use of EEG to diagnose epilepsy was a recording by Gibbs, Davis, and Lennox of..

3/sec spike and wave from a patient with known petit mal epilepsy.

Beta rhythm is usually low voltage (less than _____) in adults. Often, during the awake EEG, beta is present in the anterior head area, but may be obscured by muscle artifact (EMG) and eye movement potentials from the frontal electrodes

30 microvolta

ECI studies should be recorded for at least ____.

30 minutes

standard chart speed

30 mm/second (standard chart speed), 10 seconds

EEG activity recorded at the scalp with routine EEG instruments rarely exceeds

30-40 Hz

30 mins of Digital EEG with video requires approximately ___ of disk space.

300 MB

An entire 30-minute EEG requires approximately _____ of disk space and may be stored on a hard drive, server or a portion of a CD or DVD. Storage on CD or DVD allow from 650 megabytes to 9.4 gigabytes. The low cost of the recording disk coupled with the large storage size makes this a good option for many labs who do not have large storage capacity on a network server

300 MB The Sampling rate and number of channels recorded will affect the number of megabytes required to store an EEG. If patient data is to be stored on the hard drive temporarily, then a large hard drive will increase the number of hours of recording that can be stored prior to archiving to a permanent storage medium.

Most systems have _____ channels of input, no less than 16 channels shown

32

mostly wired and assembled by Albert and Ellen Grass in the basement of their home, was widely used by the armed forces during WWII. Instruments in both the European and Pacific theaters as well as in the U.S. were used to study epilepsy, encephalopathy, penetrating wounds to the head, and other wartime neurological conditions.

4 channel Grass Model II

The minimum vertical screen display resolution for viewing EEG should be:

4 pixels per vertical mm or better, which most currently are

theta range is..

4 to less than 8 hz

The average voltage of the normal adult alpha rhythm is ___. It is more dominant in the ____ hemisphere

50 microvolts right

Threshold for ventricular fibrilation

50-100 mA

There are ______ layers of the cerebral cortex.

6

"Let go" current for an average woman

6-8 mA

Let go" current for an average man

7-9 mA

Sensitivity must be increased from _______ s of the recording with inclusion of appropriate calibrations.

7uv/mm to at least 2 uv/mm for at least 30 minutes

The clinical value of the test was wellestablished; instruments were introduced with 8 and then 16 channels after WW2

8 and 16 channels

alpha range is..

8 to 13 hz

Other EEG patterns may fall within the ____ range. They are described as being within the alpha frequency, but not called the alpha rhythm. Mu rhythm, for example, is within the alpha frequency range, but its' location and reactivity are different. M

8-13 Hz

The minimum allowable level of common mode rejection (according to ACNS) in a digital EEG system is:

80 dB (1:10,000)

Appropriate method of decontamination of noncritical items..

=low-intermediate level disinfection

Asystole (Heart stops beating)

>2 Amps

Five Basic Rules for Constructing Terms

A combining vowel is used to join root to root as well as to any suffix beginning with a consonant • A combining vowel is not used before a suffix that begins with a vowel • If the root ends in a vowel and the suffix begins with the same vowel, drop the final vowel from the root and do not use a combining vowel Most often, a combining vowel is inserted between two roots even when the second root begins with a vowel • Occasionally, when a prefix ends in a vowel and the root begins with a vowel, the final vowel is dropped from the prefix

What component is responsible for assigning numeric values to the Analog EEG signal?

A-D Converter

Using this equipment, ______ were able to record alpha waves from Davis in 1933

A. J. Derbyshire, Pauline Davis, and H. N. Simpson

acts to catalyze the acetylcholine and breaks it into acetate and choline which is reabsorbed into the presynaptic cell for re- synthesis. This series of events is demonstrated using the transmitter substance acetylcholine as a model.

ACh -ase

a digital EEG machine measures the EEG voltages and stores the voltage values as numbers. This is the central concept of digital EEG and it is called

ADC

is a process by which the computer measures the voltages of the EEG at specific time intervals and stores the values. Physically, the ADC is an array of computer chips mounted on a circuit board in the PC that has inputs to receive the amplified analog EEG signal.

ADC

The ability to record a patient's EEG over an extended period of time in almost any environment is called ____.

AEEG or ambEEG

Drugs that cause changes in EEG

Antiepileptic - EEG is a pivotal tool in PWE - AEDs may affect background & IED • Analgesic • Chemotherapeutic • Illicit • Psychotropic • Anesthetic

nerves that carry involuntary impulses to smooth muscle, cardiac muscle, and various glands

Autonomic nervous system (ANS)

where an axon of one neuron synapses onto an axon of another axon

Axo-axonic

where an axon of one neuron synapses onto a dendrite of another axon

Axo-dendritic

_____ represent the most common structure for synapses in the central nervous systems of the human

Axo-dendritic and axo-somatic synapses

Chemical synapses can be:

Axo-somatic Axo-dentritic Axo-axonic

the PC loads what when turned on..

BIOS Basic Input/Ouput System

what causes periodic triphasic waves?

Baclofen Lithium Metrizamide L-dopa Ifosfamide

Uncommon unilateral failure of the alpha to attenuate with eye opening. It may occur in lesions of the temporal or parietal lobes. Alpha does not consistently attenuation with eye closure

Bancaud phenomenon

Etiology - Structural lesions involving subcortical white matter, metabolic encephalopathies and effects of drugs • May be focal over localized area of abnormality • Associated with poor outcome when acute.

continuous high voltage delta

Time scale, Time Base, Display Time or epoch, are terms used in digital EEG that are similar to the term ______ , used with analog EEG.

Paper speed.

The thoracic cage includes the ___ pairs of ribs, and the sternum, the flattened bone of the anterior chest

The thoracic cage includes the 12 pairs of ribs, and the sternum, the flattened bone of the anterior chest

Current modern Neurodiagnostic instruments are usually optically isolated protecting the patient from injury when the patient is connected to the instrument.

True

allow you to use a computer for specific applications, such as word processors, digital EEG systems, games, etc

application software files

The iconic gray mantle of the human brain, which appears to make up most of the mass of the brain, is the _____

cerebrum

cerebr/o

cerebrum

The telecephalon will become the _____ The diencephalon gives rise to several adult structures; two that will be important are the _____

cerebrum thalamus and hypothalamus

What is the largest part of the brain?

cerebrum (makes up 3/4 of the brain's volume)

What are the 4 regions of the brain?

cerebrum, diencephalon, brainstem, cerebellum

The spinal cord is a single structure, whereas the adult brain is described in terms of four major regions:

cerebrum. diencephalon, brain stem, and cerebellum

of the neck region develops as the infant begins to hold their head upright when sitting

cervical curve

The ______ is composed of axons from spinal nerves C1 through C5 and branches into nerves in the posterior neck and head, as well as the phrenic nerve, which connects to the diaphragm at the base of the thoracic cavity.

cervical plexus

EEG patterns ____.

change during the transition from wakefulness to sleep

In EEG, one line/output of EEG activity derived from the input of 2 electrodes in a differential amplifier. Display of potential differences between a pair of electrodes

channel

One line of EEG activity derived from 2 electrode inputs into a differential amplifier.

channel

(formerly Paper Speed aka Epoch, Time Base, Analysis time)

chart speed

The _______ name is assigned to a drug in the laboratory at the time it is invented.

chemical

atoms bond to form molecules with three dimensional structures

chemical level

a chemical signal—namely, a neurotransmitter—is released from one cell and it affects the other cell.

chemical synapse

______ have more application to neural signals that produce the EEG, as we shall see, and for this reason we will not discuss electrical synapses at this time.

chemical synapses

ped/o

child, foot

pod/o

child, foot

is a layer of highly vascularized connective tissue that provides a blood supply to the eyeball.

choroid

The ______ in the four ventricles produce CSF, which is circulated through the ventricular system and then enters the subarachnoid space through the median and lateral apertures. The CSF is then reabsorbed into the blood at the arachnoid granulations, where the arachnoid membrane emerges into the dural sinuses.

choroid plexus

The _______ is a specialized structure in the ventricles where ependymal cells come in contact with blood vessels and filter and absorb components of the blood to produce cerebrospinal fluid.

choroid plexus

Developing slowly over time

chronic

Alcohol (ETOH) Chronic Use

chronic: low voltage fast, lower amplitude and decreased frequency alpha

Augmentin

chronic: low voltage fast, lower amplitude and decreased frequency alpha

The choroid is posterior to the ______, a muscular structure that is attached to the lens by zonule fibers. T

ciliary body

The perceived proportion of sunlight to darkness establishes the ______ of our bodies, allowing certain physiological events to occur at approximately the same time every day.

circadian rhythm

The left and right internal carotid arteries and branches of the basilar artery all become a confluence of arteries that can maintain perfusion of the brain even if narrowing or a blockage limits flow through one part

circle of willis

Mandatory 1st step before disinfection, requires water, friction or motion, and enzymatic detergents to remove soil and clean instruments according to manufacturer recommendations

cleaning

, the PCs are all connected to a central server, like the spokes in a wheel, so that they all have access to that computers resources.

client server model

Voltage and amplitude are terms that are...

closely linked but are not synonymous.

The inner ear is often described as a bony labyrinth, as it is composed of a series of canals embedded within the temporal bone. It has two separate regions, the _____ which are responsible for hearing and balance, respectively.

cochlea and vestibule

The scala vestibuli extends from the oval window, travelling above the ______ which is the central cavity of the cochlea that contains the sound-transducing neurons.

cochlear duct

col/o, colono

colon

white matter of the spinal column is separted into

columns

Rather than applying a specified electrode, some systems use multiple electrodes for their "system reference" Ie. C3, C4, A1, A2 & Ground or a common average reference. A common average reference is basically the electrical activity from each electrode, added together, and divided by the total number of electrodes.

common average reference

The very first branches off the aorta supply the heart with nutrients and oxygen. The next branches give rise to the ______

common carotid arteries

A differential amplifier by definition only amplifies the "difference" between the 2 inputs. Like signals (signals of the same amplitude, frequency and timing) are cancelled out or "rejected".that characteristic of a differential amplifier to reject "like" or common signals and read low amplitudes

common mode rejection

Since only the difference is recorded or stored, signals in common to both electrodes, such as environmental noise, cancel out.

common mode rejection

Serial ports are also called _____ or COM ports and are labeled COM1, COM2, etc.

communication

are small plastic disks with a reflecting metal coating, usually aluminum. The data is burned coating making tiny indentation

compact disks or CDs

A waveform made up of more than one frequency and morphology. one example is: Spike and Slow Wave Complexes the two waves form one pattern but the two components are very different in frequency and morphology

complex

CSA stand for _____.

compressed spectral array

A device or system that is capable of carrying out a sequence of operations in a distinctly and explicitly defined manner. The operations are frequently numeric computations or data manipulations, but also include data input and output

computer

performs all of the data processing operations. Inside the box of the computer is a microprocessor, a motherboard, memory (RAM chips and ROM chips), disk drives, and expansion slots.

computer

Each computer has attached to the motherboard, a number of chips where information is stored; these are referred to as memory. There are two types of memory - RAM and ROM.

computer memory

The latest development in EEG technology has been _____ and the ability to analyze the EEG pattern with a machine instead of with the human eye. Even this most modern advance is built on the past: in 1938 Fred Gibbs and Albert Grass developed a one-channel system for Fourier analysis.

computer technology

-mania

condition of abnormal impulse toward

white matter of spinal cord

conducts impulses

ma, mata

condyloma, condylomatama,

Infection transmitted through hand shaking is called _____.

contact trasnmission

Common vehicle transmission of infection is caused by ______.

contaminated food, water, medication or equipment

what is a requirement to maintain registry?

continued education through ASET

seen without interruption

continuous

Propagation along an unmyelinated axon is referred to as ______

continuous conduction

Another type of process that branches off from the soma, responsible for receiving most of the input from other neurons. multiple branching extensions (receptor) - transmit messages toward the cell body

dendrite

the frequency of EEG activity that occupies the greater part of the recording.

dominant frequency

Axons enter the posterior side through the ______, which marks the posterolateral sulcus on either side.

dorsal posterior nerve root

The most common type of sensory ganglion is a ______. These ganglia are the cell bodies of neurons with axons that are sensory endings in the periphery, such as in the skin, and that extend into the CNS through the dorsal nerve root.

dorsal posterior root ganglion

is a measure of the physical size of the smallest dot that can be fit on the display. A typical dot pitch specification is .25 mm.

dot pitch

doubles usal distances in electrode chains

double distance montage (longitudinal bipolar) FP1-C3 C3-O1

cata-

down

nfection transmitted by coughing, sneezing and talking is called

droplet trasnmission

Beta is enhanced by drowsiness and some medications, especially barbiturates. Beta activity seen bilaterally in the frontal and central areas, often with eyes open

drowsiness

is a thick fibrous layer and a strong protective sheath over the entire brain and spinal cord.

dura mater

After passing through the CNS, blood returns to the circulation through a series of ______ and veins

dural sinuses

the time an EEG wave persists. This waveform is usually expressed in milliseconds, although some waveforms may last longer (Ie. 1 second duration = 1 Hz). This term is useful when describing an event that is not part of a continuing pattern, and therefore may be difficult to describe in terms of frequency. Both frequency and duration may be used to describe patterns. For example, a 10 Hz sine wave would have 10 waves in one second, with each wave having a ____ of 100 milliseconds.

duration

The amount of time between each data point _____ is referred to as the dwell time (or intersample interval - ISI) and is expressed in milliseconds.

duration This can be stated as, an ADC sampling rate of 100 Hz will have 100 points of information stored per second, with each point separated by a dwell time of 10 milliseconds. It is easy to imagine that the more sample points available within the second, the better the representation of the waveform. Imagine recording a single sample point of EEG for each second; there would simply not be enough information to reconstruct the original signal. In fact, the reconstructed wave would appear as a very slow wave, regardless of the original data

Factors in electrical injury include: (select all that apply)

duration of exposure, current intensity, current pathway

condition of difficult articulation, group of related speech impairements affecting speed, range, direction, strengh, and timing

dysarthria

Developmental disability characterized by a difficulty understanding written or spoken words, sentences or paragraphs affecting reading spelling and self-expression

dyslexia

The nervous system develops from embryonic tissue called the ______

ectoderm

there is a direct connection between the two cells so that ions can pass directly from one cell to the next.

electrical synapse

an event causing sudden loss of amplitude with abrupt return to the previous pattern

electro decremental

ect

electroconvulsive therapy

An event causing sudden loss of amplitude with abrupt return to the previous pattern:

electrodecrimental

This word means the EEG recording itself. It can be printed or stored on digital media as a file

electroencephalogram

The instrument used to amplify and record the electrical potentials of the brain

electroencephalograph

The process of amplification, recording and analysis of the electrical potentials of the brain.

electroencephalography

was discovered in 1820 by Hans Christian Oersted (1777-1851).

electromagnetism

Caton used an early Thomson galvanometer for his initial work in _________. This instrument had a mirror on the galvanometer and reflected a beam of light from an oxyhydrogen lamp onto an 8 - 9 foot scale on the wall. Movement of the light beam showed electrical currents from biologic material

electrophysiology

Six electroencephalography experts in 1963 developed the first examination for EEG technologists, and in 1964 there were ____ registered EEG technologists

eleven

Depolarization in a postsynaptic potential is called an _____ because it causes the membrane potential to move toward threshold

excitatory postsynaptic potential (EPSP)

-ectasis means

expansion

(ear canal)—This is the large opening on the lateral side of the skull that is associated with the ear

external acoustic meatus

The auricle, ear canal, and tympanic membrane are often referred to as the _____.

external ear

. On its outside surface, at the posterior midline, is a small protrusion called the _________ which serves as an attachment site for a ligament of the posterior neck

external occipital protuberance

Movement of the eye within the orbit is accomplished by the contraction of six ______ that originate from the bones of the orbit and insert into the surface of the eyeball

extraocular muscles

acr/o

extremity, topmost

medial-lobe structures that, along with the adjacent cortex, are involved in long-term memory formation and emotional responses.

hippocampus and amygdala

the first document generated when a patient presents for care and that records the medical history and exam findings

history and physical (h and p)

how to do collodion glue method?

hold electrode, apply collodion and apply air

is the state of steady internal conditions maintained by living things

homeostasis

Areas sharing common function, the same area on the opposite side or the same area, having the same relative position, in another organism

homologous

opposite side of head electrodes, must make same adjustments to each

homologous electrodes ex: P3 and P4

loss of vision of a complete visual field or the nasal portion of one eye and the temporal portio

homonymous hemianopsia

studied in present-day neuroanatomy classes is the result of their functional mapping of the exposed cortex

homunculus

In EEG when surface electrodes are able to record both the negative and positive end of a generator.

horizontal dipole

The largest region of each of the palatine bone is the _____

horizontal plate

how often the EEG voltages are measured; The quality of a digitized signal is determined in part by the number of data points that are stored to record that signal in each second across time. In other words, there must be an adequate number of points in each second, sufficiently close together, to properly describe the EEG waveforms within the given time period. is expressed in the sampling rate of the analog to digital converter.

horizontal resolution

gray matter of the spinal column is sepearted into...

horns

Sites for new infection: susceptible person or organism.

host

is an independent bone that does not contact any other bone and thus is not part of the skull. It is a small U-shaped bone located in the upper neck near the level of the inferior mandible, with the tips of the "U" pointing posteriorly.

hyoid bone

associated with head two additional bones..

hyoid bone and the ear ossicles (three small bones found in each middle ear).

increase in voltage and rhythmicity of a pattern, appearing very regular, sinusoidal and high amplitude.

hypersynchronous

During adequate performance of the routine activation procedure hyperventilation, HV, in which hypocapnia is achieved, the normal adult will have a build up of EEG rhythms. This rather high voltage (50-150 microvolts) build up begins with a bilateral, frontally predominant theta frequency, which gives way to a slower delta frequency as HV continues (see illustration). Upon cessation of HV, the EEG should return to baseline within 30 to 60 seconds.

hyperventilation build up

activation procedure used to bring out abnormalities in EEG

hyperventilation, sleep, photic

A pattern of dramatic high voltage, diffuse theta-delta that occurs in bursts over a few seconds during sleep onset, in children and adolescents, is known as:

hypnagogic hypersynchrony

In the EEG of children and adolescents, transitioning from wake to sleep may produce dramatic high amplitude slow waves known as, _____. This normal drowsy pattern consists of high voltage, diffuse theta-delta that occurs in bursts over a few seconds. Note the synchrony of the rhythmic pattern

hypnagogic hypersynchrony

A pattern of dramatic high voltage, diffuse theta-delta that occurs in bursts over a few seconds during a tranistion from sleep to wakefulness, in children and adolescents, is known as:

hypnapomic hypersynchrony

. Located at the anterior-lateral margin of the foramen magnum is the ______. These emerge on the inferior aspect of the skull at the base of the occipital condyle and provide passage for an important nerve to the tongue.

hypoglossal canal

• type: mixed nerve (source Essentials chap 7 p221) • origin: medulla • function: • (motor) controls tongue movement

hypoglossal nerve

The rounded depression in the floor of the sella turcica is the ______ which houses the pea-sized pituitary (hypophyseal) gland.

hypophyseal pituitary fossa

Inferior and slightly anterior to the thalamus is the ______, the other major region of the diencephalon. is a collection of nuclei that are largely involved in regulating homeostasis. is the executive region in charge of the autonomic nervous system and the endocrine system through its regulation of the anterior pituitary gland. are involved in memory and emotion as part of the limbic system.

hypothalamus

within diencephalon, part of pituitary gland produces and regulates neuro chemicals

hypothalamus

Random high voltage slow waves and spikes interspersed with brief stretches of flattening associated with infantile spasms

hypsarrhythmia

Refers to period of time during a physiologic event such as a seizure.

ictal

refers to a physiologic event such as a seizure.

ictal

When you move a wire through a static magnetic field..

if you have a closed loop a current is generated in wire

Measurement of the opposition to the flow of alternating current (AC) which is used to test the connection between the electrode, the conductive media (jell or cream) and the scalp. Alternating current is preferred because it does not polarize the electrode

impedance

Opposition to alternating current flow which is used to test the connection between the electrode and the scalp.

impedance

Procedure used to test the contact between the electrode, the conductive media and the scalp

impedance

2 Channels of EEG recording one event of the same polarity, causing like deflections with the same timing

in phase

The other gate is the ______, which closes after a specific period of time—on the order of a fraction of a millisecond.

inactivation gate

the axial skeleton is made up of 80 bones which houses the..

including the skull, the vertebral column, and the thoracic cage

use greater distances to ____ the amplitude of recordings (for cerebral inactibity)

increase

What EEG finding should give rise to the question of drug toxicity?

increased beta activity

Lamictal (lamotrigine)

increases interictal spiking in photoparoxymal response

is the projection of axons from the striatum to the globus pallidus external segment (GPe), then to the subthalamic nucleus (STN), and finally to GPi/SNr.

indirect pathway

Formerly known as "jack-knife" seizures a type of seizure in infants, consisting of sudden tonic and myoclonic spasms with massive flexion of the head, trunk and extremities.

infantile spasms

This type of seizure is often associated with the EEG pattern of Hypsarrhythmia

infantile spasms

interrupting the spread of infection at the point of transmission between the source and host is called _______.

infection control

It consists of a sequence of vertebrae (singular = vertebra), each of which is separated and united by an _____

intervertebral disc

used during surgery to provide information to surgeoun about nervous system integrity

intraoperative neuromonitoring (IONM)

protrusion of the skull which can be felt by running finger up neck

ionion

This type of channel is also known as an _______ because when the ligand, known as a neurotransmitter in the nervous system, binds to the protein, ions cross the membrane changing its charge

ionotropic receptor

When a pattern is seen wide spread over one hemisphere, how is it best described?

lateralized

occurring only over one hemisphere

lateralized

- coming from one side

lateralized (unilateral)

is randomly gated, meaning that it opens and closes at random, hence the reference to leaking. There is no actual event that opens the channel; instead, it has an intrinsic rate of switching between the open and closed states. Leakage channels contribute to the resting transmembrane voltage of the excitable membrane (

leakage channel

the cerebrum is involved in what functions?

learning, reasoning, speech, sight, hearing

A seventh muscle in the orbit is the _______, which is responsible for elevating and retracting the upper eyelid, a movement that usually occurs in concert with elevation of the eye by the superior rectus

levator palpebrae superioris

The characteristic that distinguishes Lambda and POSTS is:

level of consciousness

A ______ opens because a signaling molecule, a ligand, binds to the extracellular region of the channel.

ligand-gated channel

is the region of the cerebral cortex that is part of the limbic system, a collection of structures involved in emotion, memory, and behavior.

limbic cortex

where to measure for parietal

measure from T5 to T6, intersecting P3, PZ and P4 and divide into 4 parts 25 and 50%

A ______ opens because of a physical distortion of the cell membrane. Many channels associated with the sense of touch (somatosensation) are mechanically gated

mechanically gated channel

This occurs at four places along the length of the vertebral column, each identified as a _____, whereas the other spinal nerves directly correspond to nerves at their respective levels.

nerve plexus

Bundles of axons in the PNS are referred to as...

nerves

Intricate communication system of neurons (nerve cells), fibers, and other structures • Activates and controls all functions of the body • Receives all input from the environment

nervous system

sudden appearance of a new pattern distinctly different from the background, most often of higher voltage, with abrupt return to the previous pattern.

paroxysmal

Generalized Rhythmic Delta Activity with frontal predominance GRDA frontally predominant

paroxysmal slowing

good tips for measuring accurately:

part hair, directly on scalp, don't create the domino effect, make marks on one side of measuring tape and hold securely

what happens with burr holes and amplitudes?

part of skull is removed, so amplitudes will be higher without the skulls insulation

connects all PCs to each other. Here, any computer in the network can act as a server, making its files and resources available to all the other computers. In the peer-to-peer arrangement, each computer can see into the other computers and can send information directly to them.

peer to peer mode;

Within the nerve, axons are further bundled into fascicles, which are each surrounded by their own layer of fibrous connective tissue called _______.

perineurium

(motor functions) The nervous system produces a response on the basis of the stimuli perceived by sensory structures (movement of muscles)

response

With the ions distributed across the membrane at these concentrations, the difference in charge is measured at -70 mV, the value described as...

resting membrane potential

It is theorized that the _____ and the thalamus may also have a significant effect upon the rhythmicity of the EEG.

reticular activating system

A diffuse region of gray matter throughout the brain stem, known as the _____ is related to sleep and wakefulness, such as general brain activity and attention.

reticular formation

It is theorized that the _____________and the __________, as well as other brain structures have a significant effect upon the rhythmicity of the EEG.

reticular formation and the thalamus

(sensory functions) receiving information about the environment to gain input about what is happening outside the body (or, sometimes, within the body)

sensation

esthesi/o

sensation

Recording ____ is an adjustment made to accommodate fluctuations in the amplitude of activity as it is being recorded.

sensitivity

The ratio of input voltage to output deflection. This is an instrument setting on all types of neurophysiological instruments. It is the parameter that the technologist or physician sets that controls the size of the waveform that will be created by a set voltage input. This setting has the ability to control the size of the displayed data by regulated the input voltage to output deflection.

sensitivity

Evaluates sensory function, including the patient's ability to feel touch, temperature, pain, and vibration.

sensory exam

Consists of nerve fibers that convey impulses from sensory receptors to the central nervous system. direction?

sensory/afferent division - ascending & location- dorsal/posterior

two principal subdivisions of functional PNS structures

sensory/afferent division • motor/efferent division

The anterior nasal septum is formed by the ______, a flexible plate that fills in the gap between the perpendicular plate of the ethmoid and vomer bones. This cartilage also extends outward into the nose where it separates the right and left nostrils.

septal cartilage

is so named because it serializes the data by taking a byte of data and transmitting the 8 bits in the byte, one at a time. The serial port uses only one wire to transmit the data which means that it is slower than the parallel port which uses 8 wires. Serial ports are usually bi-directional which allows each device to receive data as well as to transmit it.

serial

positive and negative connect-voltage rise amps stay the same

series connection

A computer that shares its resources, such as printers and files, with other computers on the network. An example of this is a Network Files System Server which shares its disk space with a workstation that does not have a disk drive of its own.

server

is a networked computer that allows other connected computers to have access to its resources. This means that if you are on a network, you can get files on the server, send files to the server, use the printer connected to the server, etc.

server

A record of the patient's recreational interests, hobbies and us of tobacco and drugs including alcohol is:

sh

A transient, clearly distinguished from background activity with pointed peak at conventional paper speeds, and a duration of 70- to 200-msec., i.e., over 1/14 to 1/5 sec. Main component is generally negative relative to other areas, amplitude variable. (5 Hz - 14 Hz) ( ≤ 6mm

sharp wave

A transient, usually negative in polarity but can be positive, with a duration of greater than 70 msec but less than 200 msec. Voltage is variable but usually is high. Morphology is sharply pointed.

sharp wave

Epileptiform activity includes the following descriptors: (select all that apply)

sharp wave b. spike and wave c. polyspike d. spike

The recommendations for electrode impedance are that they should be under 10,000 ohms but over 100 ohms. This guideline was written for use with analog equipment. Digital equipment users ____.

should follow the same ACNS guidelines.

second report of EEG

showing minor oscillations of cerebral activity at rest and demonstrating evoked potentials from the visual cortex. This very important work was done with equipment having a frequency response range of from 0 to 6 Hz

The transverse sinuses connect to the ______, which then connect to the jugular veins. From there, the blood continues toward the heart to be pumped to the lungs for reoxygenation.

sigmoid sinuses

Another term for Processed EEG, or Quantitative EEG, FFT, CSA, CDSA this refers to taking the EEG data in the form of the amount of voltage in the different frequency bands and displaying it graphically and comparing changes over time.

signal processing analysis

Further, the site on the membrane where current flows into the cell is referred to as the ____, and the area of outward current flow is referred to as the ___.

sink source

having a curved shape as in an "S" or a sine wave

sinusoidal

pt may be _______, orient self to both pt positions

sitting and lying down

Because of the surrounding water molecules, larger pores are not ideal for smaller ions because the water molecules will interact, by hydrogen bonds, more readily than the amino acid side chains.

size exclusion

Monitors are described in terms of their... Sizes can range from 12 to 46 inches (measured diagonally across the screen) with the 17 and 21 inch sizes being most common for digital EEG.

size, type, and resolution

cutane/o, derm/o, dermat/o

skin

crani/o

skull

Sampling skew causes a _______, such as a spike and can lead to incorrect localization and misinterpretation of the digital EEG

slanting distortion of a single event

He further showed, in 1948, that often this interictal activity was limited to _____

sleep

12 to 14 hertz bursts of rhythmic waves which often increase and decrease in voltage and are maximal in the central midline head region. Sleep spindles are seen in Stage N2 sleep and vary greatly in amplitude and can range normally from as low as 50 to 150 microvolts.

sleep spindles

12-15 Hz activity in the central areas with some spread to frontal and parietal areas during light sleep. Hallmark of NREM 2 sleep. Occurs in both N2 and N3

sleep spindles

are bursts of sinusoidal 12-14 Hz activity, tapered at both ends. They are seen over the fronto-central head regions, most often with a maximum over the central midline. last from .5 to 2 seconds.

sleep spindles

-paresis

slight paralysis

brady-

slow

Sound is transduced into neural signals within the cochlear region of the inner ear, which contains the sensory neurons of the ________.

spiral ganglia

schiz/o

split

Later,Vasili Yakovlevich Daniele demonstrated that there was......., and gave credit to Caton for first discovering this.

spontaneous electrical activity present in the brain

Propagation of EEG waves from one region of the brain to another

spread

The _______ is located on the lateral skull. It unites the squamous portion of the temporal bone with the parietal bone

squamous suture

Positive Occipital Sharp Transients of sleep can occur in some individuals. In the illustration below, note the runs of POSTS in ____

stage N1 sleep

Sleep spindles, indicate the onset of ____

stage N2 sleep

is characterized by an increase in higher voltage slow waves in the theta and delta range (see illustration). Sleep spindles and K complexes may be present. the frequencies seen are slower and the number of sleep spindles decreases. By definition, the tracing must display more than 20% delta activity

stage N3 sleep

Hand washing, wearing gloves, masks, eye protection, and gowns are all part of _____.

standard precaustions

State when a seizure lasts too long or when seizures occur close together without time to recover between seizures requiring medical intervention.

status epilepticus

is said to occur when a seizure lasts too long or when seizures occur close together without time and recover between seizures requiring medical intervention

status epilepticus

Spike morphology usually has a ______ while EMG waveforms tend to have a gradual incline and steep decline.

steep incline

Necessary when items penetrate or enter sterile tissue for destruction of all forms of microbes. Requires use of sporicides, steam, ethylene oxide, and/or dry heat methods

sterilization

The sensory functions of the nervous system register the presence of a change from homeostasis or a particular event in the environment, known as a (taste, touch, etc)

stimulus

gastr/o

stomach

lith/o

stone

The other processes of the neuron are dendrites, which receive information from other neurons at specialized areas of contact called _____

synapses

the small gap between the cells where the neurotransmitter diffuses the short distance to the postsynaptic membrane and can interact with neurotransmitter receptors

synaptic cleft

what make the connection with the target cell at the synapse, where the axon terminal ends

synaptic end bulb

a pattern that appears over both hemispheres simultaneously with similar timing

synchronous

Term used to describe the timing of how electrical events occur in different brain areas relative to one another

synchrony

Guidelines for recording digital EEG in the United States were written by:

the American Clinical Neurophysiology Society (ACNS)

On the EEG report, the clinical correlation should be an attempt to explain how

the EEG findings fit (or not) with the total clinical picture.

the electrocephalograph

the EEG instrument

the word electroencephalogram means

the EEG recording itself

A great advantage of digital instruments in performing Polysomnography is ____.

the ability to run sleep scoring programs and produce customized reports.

There are two phases of the refractory period:

the absolute refractory period and the relative refractory period.

Aliasing is what happens to a waveform when it is sampled at too low a sampling rate.

true

Amplifier gain is the ratio of input voltage to output voltage of an amplifier.

true

Can Digital EEG systems monitor patients in the ICU using multiple formats including compressed spectral arrays, and integrating data on body temperature, heart rate and intracranial pressure.

true

Digital EEG Instruments differentially amplify all inputs in relation to a common reference and then the software programs form montages by effectively subtracting input 2 from input 1 for each derivation.

true

is the special sense of sight that is based on the transduction of light stimuli received through the eyes.

vision

The posterior cavity is the space behind the lens that extends to the posterior side of the interior eyeball, where the retina is located. The posterior cavity is filled with a more viscous fluid called the ______

vitreous humor

An electrical potential or potential difference expressed in volts. In EEG, a measurement of the output deflection in mm multiplied by the sensitivity will obtain the output voltage.

voltage

spin/o

spine (thorn)

-ix, -ices

appendix, appendices

CVA

cerebrovascular accident

In the PNS, a cluster of neuron cell bodies is referred to as a

ganglion

is a group of neuron cell bodies in the periphery

ganglion

gangli/o

ganglion (knot or knotlike mass)

semi critical method of decontamination

high- intermediate level disinfection

phren/o, psych/o

mind

thym/o

mind

axons & dendrites; few cell bodies

molecular layer

is connected by a cable to the graphics / video card using an interface or to the motherboard directly.

monitor

what are the outputs?

monitor, printer, speakers

having one basic shape or frequency

monomorphic

having one dominant pattern or rhythm

monomorphic

do not have a stress mark. others separted by a hyphen

monosyllables

An organization of electrode derivations recording at the same time on the EEG is called

montage

The form or shape of EEG waves and patterns

morphology

What is the shape of the waveform?

morphology

_______ is important in differentiating spikes from EMG artifact.

morphology

Most of these cortical cells can be classified as either pyramidal or non-pyramidal based on their...

morphology, transmitter content and distribution in cortical layers.

This assesses muscle strength, tone, and coordination. The healthcare provider may ask the patient to perform various movements and evaluate muscle groups.

motor function

carries impulses from the CNS to effector organs • These impulses activate muscles and glands, they effect a muscle response

motor/efferent division direction

or/o

mouth

kinesi/o

movement

evaluates electrical potentials from peripheral nerves. stimulate nerve with an electrical current

nerve conduction studies (NDS)

NCV

nerve conduction velocity

The upper margin of the anterior orbit is the

supraorbital margin

The attenuation of activity expected activity or such as in the suppression of alpha or sleep activity. May be unilateral or bilateral suppression.

supression

What are noncritical items?

surface electrodes, electrode cap, tape measures and calipers, jackboxes, cables, marking pencils, hair clips and combs

Nitrous oxide= DS + fast activity; no effect on spikes - Halogenated anesthetics= DS> burst-supp> ECI • Halothaneno ECI, isoflurane, sevoflurane, enfluraneIEDs, desflurane - Etomidate= enhances IEDs in epilepsy - Methohexital= IEDs; Benzodiazepines= DS + frontal beta (low) - Opiods= lower seizure thresholds; IEDs reported - Ketamine= frontal theta + fast activity

surgery

-rrhaphy

suture

e is an immobile joint between adjacent bones of the skull. The narrow gap between the bones is filled with dense, fibrous connective tissue that unites the bones.

suture

comparing waveforms from left to right

symmetry

is used to describe EEG amplitude and frequency in homologous, or similar, regions of the head. In general, normal EEG activity that occurs over both hemispheres in expected to be symmetric. It may be difficult to assess the symmetry of a sinusoidal pattern because of amplitude changes that are characteristic of the pattern. The range of amplitude changes, however, should be similar.

symmetry

the same on both sides, patterns that appear the same over both hemispheres, there can be symmetry of frequency and symmetry of amplitude

symmetry or symmetrical

The ______ constitute a row of ganglia along the vertebral column that receive central input from the lateral horn of the thoracic and upper lumbar spinal cord. Superior to the chain ganglia are three paravertebral ganglia in the cervical region

sympathetic chain ganglia

The majority of ganglia of the sympathetic system belong to a network of _____ that runs alongside the vertebral column

sympathetic chain ganglia

2 Parts of the Autonimic Nervous System

sympathetic division and parasympathetic division

Increased... • blood pressure • heart rate • lung dilatation, liver function, pupillary dilation, perpersaton

sympathetic nervous system

Cortical neurons communicate via _____.

synapses

CNS depressant drugs, anoxia, intoxication, hypothermia and anesthesia can all induce:

burst suppression

working in Krakow, Poland, studied brain responses in rabbits and dogs. He stimulated the retina with bright light, the auditory system with sound, and the skin with an electric current. He was primarily interested in changes of the slow, steady potentials of the brain, but noted in his experiments that spontaneous oscillatory activity was blocked with these stimuli. He further showed a surrounding area of potential variation around a cortical injury.

Adolf Beck

When performing EEG It is acceptable practice to remove gloves

After prep is complete and before touching the keyboard, mouse or anything else

an eminent physiologist at Harvard Medical School, began to use his wartime experience with vacuum tube amplifiers to improve his string galvanometer.

Alexander Forbes (1882-1965

The recording stops by itself. Causes: Causes may include a hard drive that is too full, the hard drive is trying to write to a bad spot, the cable or pre-amp/head-box has become disconnected, too many functions are being performed at the same time, a blackout (loss of power) or gray-out (fluctuation in power) has occurred.

Always note what function you were performing immediately before the recording terminated as well as any error messages you encounter. These can be valuable clues for the manufacturer in assisting you. If the power was lost to a Win95- based instrument, the computer will ask you to allow it to run a Scandisk program on it (due to the fact that it was not shut down properly.)

Together, EEG technologists and electroencephalographers organized the _______ in 1964 which established standards of competency in this new profession. These standards of competency were further developed by the creation in 1972 of an accreditation process for training programs of EEG technology

American Board of Registration of EEG Technologists (ABRET) in 1964

ACNS stands for

American Clinical Neurophysiology Society

The new society began immediately to offer educational meetings and the first issue of the _____ was published in 1961

American Journal of EEG Technology (now The Neurodiagnostic Journal)

calibration (generally occurs upon entry into the EEG collection program)

Amplifier calibration

The wrinkled portion is the _______, and the rest of the structure is beneath that outer covering.

cerebral cortex

Occurring in children with central sharp waves or spikes, and sometimes but not always associated with seizures. When associated with seizures, they are either focal motor or generalized tonic-clonic seizures and the seizures have a high incidence of resolving with age, hence the name "benign".

Benign Rolandic Epilepsy (BRE)

are small, low amplitude, spike-like waveforms of rapid frequency (see illustration). As the name implies, they occur during light Stage N2 sleep, usually shifting from one temporal lobe to the other and are not present in deeper Stage N2 and Stage N3 sleep. Also known as...

Benign epileptiform transients of sleep, or BETS BETS also known as Small Sharp Spikes or SSSs

Diazepam, Clonazepam, Lorazepam, Chlorazepate, Midazolam

Benzodiaphenpines

What type of medication produces rhythmic fast activity of 18-25 Hz in frontal head regions, this is more pronounced immediately after administration, and at high doses can produce burst suppression and even electrocerebral inactivity?

Benzodiazapines and Barbituates

______ in 1932 had described some age-dependent changes in the EEGs of children. Lindsley made significant contributions in the 1930s with his longitudinal studies of the maturation of the EEG

Berger

Later that same year, Adrian reported on his confirmation of what he called the ______ to the American Neurological Association. Whereas Berger's recordings were of poor technical quality, Adrian and Matthews, using better equipment, were able to convince scientists of the validity of the discovery

Berger rhythm

The duration of a sharp wave is:

Between 70-200 msec

BIPDs are inherently asynchronous because they are independent processes occurring in each hemisphere

Bilateral Independent Period Discharges (BIPDs).

BIPD

Bilateral Independent Periodic Discharges

During a Wada test, which of these drugs might be used?

Brevital or Amytal

BIRDS

Brief Potentially Ictal Rhythmic Discharges

Focal or generalized rhythmic activity >4 Hz (at least 6 waves at a regular rate) lasting ≥0.5 to <10 s, not consistent with a known normal pattern or benign variant, not part of burst-suppression or burst-attenuation, without definite clinical correlate, and that has at least one of the following features: Similar morphology and location as interictal epileptiform discharges or seizures in the same patient (definite BIRDs) c. Sharply contoured but without (a) or (b) (possible BIRDs)

Brief Potentially Ictal Rhythmic Discharges

is responsible for the production of language, or controlling movements responsible for speech; in the vast majority of people, it is located only on the left side.

Broca's area

acute subdermal hematoma shows what on an EEG?

Burst Suppression due to SDH A focal cause

• Inconsistent: DS & theta with toxicity • Withdrawal of CBZ = faster PDR & less slowing • Contradictory reports of increased IEDs in IGE probably due to seizures occurrence.

CBZ (Carbamazepine)

Color Density Spectral Array a form of processed EEG using colors to indicate changes in power recorded in various frequencies

CDSA

Processes and interprets incoming sensory informa

CNS, brain and spinal cord

common or ground electrode can be used at fpz

COM

The following two EEG terms are synonymous

CPS, Hz

is the primary component of a computer that processes instructions. It runs the operating system and applications, constantly receiving input from the user or active software programs. It processes the data and produces output, which may be stored by an application or displayed on the screen.

CPU or "Central Processing Unit"

The system reference would be best placed where anatomically?

CPZ behind vertex

The former type of monitor was the _____ which was the standard, glass picture-tube type of monitor.

CRT (cathode ray tube)

Compressed Spectral Array a form of processed EEG using stacked epochs plotting power recorded at various frequencies

CSA

cushions the brain and spinal cord • regulate space inside the cranium • serves as a diagnostic aid • Circulation, fills the lateral ventricles o overflows into the 3rd ventricle o 4th ventricle enters the subarachnoid space of the brain and spinal cord then is reabsorbed by the arachnoid villi.

CSF

Felbamate

Carbamates

neurons are made up of what three things

Cell body (nucleus, dendrites) • Axon • Myelin (fat and protein sheath around axon)

brain and spinal cord

Central Nervous System (CNS)

Since the central component or "brain" of a digital EEG system is the _____ of the computer, the capabilities of this component are an essential factor in the performance of the system. • There are a variety of micro-processors available that influence the speed of processing functions and affect the systems ability to perform multiple tasks simultaneously. Selecting a dynamic computer system with the most RAM, the fastest processor, and the largest memory available improves the chance of surviving instrument transitions. • In this illustration, the CPU sits below the keyboard

Central processing unit (CPU)

The file copies, but it cannot be read from storage media. Causes: Causes include bad storage media, an unformatted storage disk, a corrupt file, and possibly a bad storage drive.

Check to see if other disks/studies can be read. Check to see if the storage disk is readable in Windows or in DOS. If the storage drive is external, switch it with another if available

The system will not power up (no power lights on any component

Check to see if the unit is plugged in and the central power block is turned on. The power block, as well as individual components in the system, will have their own power indicator lights. If these units are set to ON and nothing happens (no power lights come on), you can verify that the outlet is actually working by plugging in another device such as a light or radio. If the outlet is working, try plugging the system components directly to the wall outlet to rule out a bad power block or bad power block cable.

uses color-coding to display the amount of power or voltage in the component frequencies of each epoch of time.

Color Density Spectral Array (CDSA) is shown below. CDSA

a word root and a combining vowel that make it easier to form, spell, and pronounce medical terms

Combining form

for formal education, Many neurodiagnostic programs are accredited by the...

Commission on Accreditation of Allied Health Education Programs (CAAHP)

Consequently Gibbs and his followers favored referential recordings, which were best for demonstrating morphology. Jasper and his followers were showing the value of bipolar recordings with closely spaced electrodes for identifying epileptic foci. Jasper was chairman of the....

Committee on Methods of Clinical Examination in Electroencephalography for the International Federation of Societies for EEG and Clinical Neurophysiology that in 1958 published the 10-20 System for electrode placement.

Formed by a combination of basic word parts, Added to roots to provide a specific meaning

Compound suffixes

What do neurons do?

Conduct impulses • Do not reproduce • Are highly dependent on oxygen • Neurons can be permanently damaged as a result of: • prolonged anoxia • severe trauma • disease • hemorrhage

phosphololipid channel have 3 properties:

Conduct ions at extremely rapid rates Be selective to specific ions Open and close in response to chemical, mechanical, or electrical stimuli

embolus obstructs artery when it lodges

cerebral embolism

There are five main routes of transmission:

Contact: direct or indirect 2. Droplet: coughing, sneezing, talking 3. Airborne: air or dust 4. Common vehicle: items such as food, water medications, and equipment. 5. Vector borne: animals and insects such as rats and mosquitos.

how is vision transmitted to the brain?

Contralateral visual field information from the lateral retina projects to the ipsilateral brain, whereas ipsilateral visual field information has to decussate at the optic chiasm to reach the opposite side of the brain

what does the cerebellum do?

Controls balance, equilibrium, and muscle coordination.

Name an artifact seen on analog EEG instruments but never on digital EEG instruments.

Defective pen mount

The EEG frequency band <4 Hz

Delta

is a normal pattern found in deep stages of sleep (see illustration below). However, in the awake state in adult EEG is an abnormal finding. Artifacts with very slow potentials, such as rolling eye movement (see page 3), pulse, sweat, and respiration may produce similar frequencies <4 Hz, in EEG recordings.

Delta

considerations for equiomement use...

Demo Features Ease of Use Product Specs ACNS Guidelines Regulations Extras, options Price Lease/purchase Discounts Trade in values Delivery Warranty Terms & length Support 24/7 Contracts

This large, oval-shaped opening in the floor of the middle cranial fossa provides passage for a major sensory nerve to the lateral head, cheek, chin, and lower teeth.

Foramen ovale of the middle cranial fossa

CP

cerebral palsy

A ______ is an area of skin that is mainly supplied by afferent nerve fibers from the dorsal root of any given spinal nerve.

Dermatome There are 8 cervical nerves (C1 being an exception with no dermatome), 12 thoracic nerves, 5 lumbar nerves and 5 sacral nerves. Each of these nerves relays sensation (including pain) from a particular region of skin to the brain.

what is a med that can cause diffuse slowing?

Diffuse Slowing due to Midazolam

Negative Effects of Drugs on EEG

Diffuse slowing - ECI - Epileptiform discharges, Severe: burst suppression, IEDs • Clozapine • Lithium • Polysubstance - Seizures Sequence of Effects - Beta/Theta - Delta - Attenuations - Low voltage - Burst suppression - ECI

most common encountered drug effect

Diffuse slowing of the PDR is the most commonly encountered drug effect.

What is the most common drug effect on EEG?

Diffuse slowing of the posterior dominant rhythm

Aspirin (Overdose)

Diffuse slowing over anterior regions, occasionally in trains

The components that differentiate a digital EEG system from the office or home PC are the

Digitization hardware • EEG amplifiers • Sophisticated software package • Networking access

___________can be used to map the sensory and motor strips on the brain's surface using a strip of sterile electrodes placed directly on the surface of the brain to guide surgical resection.

ECog

Fred Gibbs was retained by the Army not only to help with training of EEG technicians but also to provide standard electrode positions, standard montages, and uniform calibrations. Gibbs published his first ______ in 1941. The updated 3-volume edition was published in 1950

EEG Atlas

Sleep Stage N1 EEG: >_____ EOG: ____ EMG: RESPIRATIONS:

EEG-50% of the epoch consists of relatively low voltage mixed (4-7 Hz) activity, vertex sharp waves. EOG-Slow rolling eye movements (SEMs) lasting several seconds often seen early in this stage. EMG-amplitude less than in waking record Respirations:regular

W-Wakefulness sleep scoring, EEG: >_____. Frontal beta. EOG: ____. EMG: high-amplitude muscle contractions and movement artifacts

EEG-50% of the page (epoch) consists of alpha (8-13 Hz) activity. Frontal beta. EOG- eye movement/blinking. EMG-high-amplitude muscle contractions and movement artifacts

Sleep Stage N2 EEG: ____ EOG: ___ EMG: ____RESPIRATIONS: ___

EEG-Appearance of sleep spindles (maximal over the central leads, have a frequency of 11-16 Hz, and last 0.5 seconds or longer) and K complexes EOG: Eye movements are unusual in this stage and are typically not seen. EMG: tone is variable. Respirations: regular

Sleep Stage N3 EEG: > _____ EOG: ____ EMG ____. RESPIRATIONS: ___

EEG: >20% of the epoch consists of high voltage (>75 µV), low frequency (.5-2 Hz) activity EOG: Eye movements are unusual in this stage and are typically not seen EMG: tone is variable Respirations: regular

Sleep Stage REM Stage REM scored in epochs that contain all of the following characteristics: EEG: _____ EOG: ______ EMG:_____ RESPIRATIONS: ____

EEG: Relatively low voltage mixed (2-7 Hz) frequency EOG: episodic rapid eye movements EMG: absent or reduced chin EMG activity. EMG: muscle tone at the lowest of any stage in the polysomnogram as detected by chin EMG electrodes. RESPIRATIONS: Irregular

Examples of biological or physiological artifacts are ____

EMG, EKG, EOG

what are elective add on through CAAHP?

EP, IONM, LTM, NCS and PSG, as well as stand-alone full programs in IONM

an interval of time, same as time base or equivalent paper speed

EPOCH

h is an interval of time as in the amount of time displayed on a page or screen at one time. (Also known as time base, display time or equivalent paper speed since in analog EEG, the data displayed on a given page was controlled by the paper speed)

EPOCH

The location of ____ on pyramidal cells also has an effect on the polarity of surface recorded activity. As illustrated below, EPSPs generated on apical dendrites of pyramidal cells in superficial layers will produce negative or up going deflections (electrode "B") while those in deeper cortical layers produce positive or down going deflections (electrode "A")

EPSP and IPSP synapses

______ generated in superficial layers will produce positive (downward) deflections while those in deeper layers will produce negative or (upward) deflections

Inhibitory post synaptic potentials (IPSPs)

The English physiologist, worked with physicist-engineer _____using a Matthews mirror galvanometer with a frequency response of more than 2 kHz. This galvanometer was combined with a vacuum tube amplifier and a direct ink-writer.

Edgar Douglas Adrian (Lord Adrian, 1889-1977) worked with physicist-engineer Brian Matthews,

________ string galvanometer was developed in 1901 to allow more sensitive recordings without distortion.

Einthovens

No EEG activity > 2 µV Artifacts such as ECG, EMG, amplifier noise can be seen Double distance recording, Clinically in deep coma • When iatrogenic and due to drug effect seizures rarely occur. • Burst suppression is used as the treatment goal due to less reduction in CMR/energy. • When not due to medication or temperature the findings of ECI are typically terminal • Prognosis - death or PVS • ACNS guidelines must be followed

Electrocerebral Inactivity

a recording of the ongoing electrical activity of the brain to assist in the diagnosis of epilepsy and a variety of neurological symptoms. These symptoms include common headaches, dizziness, seizure disorders, convulsions, changes in awareness, unexplained loss of consciousness, prolonged or unexplained coma, strokes, and degenerative brain disease.

Electroencephalogram [EEG]

what drugs can cause Diffuse Slowing and Attenuations

Encephalopathy due to Xanax and Lyrica

mysoline (primidone)

Enhanced anterior beta and in toxic levels increased delta activity with superimposed beta activity

is the extensive network of axons and neurons in the wall of the small and large intestines

Enteric plexus

______ often prepared the patients for the studies she did with her husband Fred, but the first EEG technicians were probably clerical staff who were shown where to put electrodes and what buttons to push. Fred Gibb's training of electroencephalographers to interpret for the armed forces during World War II has already been mentioned. Gibbs' and Gibbs' Atlas of Electroencephalography was often used as the first EEG textbook

Erna Gibbs

EPSP is...

Excitatory Neurons

:loosely packed stellate cells; intermediate-sized pyramidal cells.

External Pyramidal Layer

horizontal eye movement affects

F7 and F8 amplitude

measuing tape at what for frontal-

F7 to F8, intersecting F3, Fz, and F4 marks

for 10-10 system: T1= T3= T5= T2= T4= T6=

F9 T7 P7 F10 T8 P8

An algorhithm that transforms EEG data into a graphic representation of various voltages and frequencies present in the signal is called ____.

FFT

extracts the component frequencies (alpha, beta, theta, and delta) from a given EEG segment or epoch and provides a quantitative analysis of the power of each frequency, typically displayed in vertical, spectral graphs

FFT Technique

EMU also adds..

FT9 and FT10

an additional reference can be placed between ____

FZ and CZ

ASET is a resource for continuing education, offering a variety of educational products, a quarterly journal, webinars, and distance education as well as national and regional workshops. Documentation of this type of continuing education when completed, is not a requirement to maintain technologist registry and certification.

False

If your digital instrument performs square wave calibration, it should be done at the start and end of the recording using a montage that includes every electrode on the patient's head, but if your instrument does not perform square wave calibration, calibration of the instrument should be performed according to the manufacturer's specifications.

False

The correct level of disinfection for gold disk electrodes can be achieved by using a germicidal wipe

False

The ground electrode or common electrode placed on the patient is the same thing as the ground electrode in the electrical plug on the instrument.

False

is an algorithm used to process digital signals and display comparisons of power (voltage) in various frequency bands.

Fast Fourier Transform: FFT

alpha cativity described with 12Hz activity:

For example if one describes a 12 Hz activity (background frequency) in an awake adult (state) in the bilateral (symmetry -compare homologous channels) occipital area (location), that is rhythmic (type) and approximately 50 uv (medium amplitude) appearing on 80% of an epoch (moderate amount), you would safely determine it to be Alpha activity

This irregular opening is located in the base of the skull, immediately inferior to the exit of the carotid canal. This opening is an artifact of the dry skull, because in life it is completely filled with cartilage. All the openings of the skull that provide for passage of nerves or blood vessels have smooth margins; the word lacerum ("ragged" or "torn") tells us that this opening has ragged edges and thus nothing passes through it.

Foramen lacerum

Stage N3 =

NREM 3 Slow wave sleep (Formerly Stage III and IV Sleep now combined)

This small opening, located posterior-lateral to the foramen ovale, is the entry point for an important artery that supplies the covering layers surrounding the brain. The branching pattern of this artery forms readily visible grooves on the internal surface of the skull and these grooves can be traced back to their origin at

Foramen spinosum

verticle eye movement affects (supraorbital-open/close eye)

Fp1 and Fp2 amplitude

The engineer ______ joined Gerard's group in 1934. In 1936 he developed a highspeed, piezoelectric crystal ink-writer while working with Gerard. He later left to start Offner Electronics, Inc., manufacturing EEG instruments.

Franklin Offner

What is FIRDA?

Frontal Intermittent Rhythmic Delta Activity

Gabapentine, Vigabatrin

GABA analog

have general application

General suffixes

GPD

Generalized Periodic Discharges

GRDA

Generalized Rhythmic Delta Activity

Positive effects of drugs on EEG

Generalized spike and wave - Photoparoxysmal respons

collaboration over the next two decades saw a tremendous burst in epilepsy research, EEG pattern description, and improved instrumentation.

Gibbs-Grass

GCS

Glasgow Coma Scale

Added PPE used in conjunction with Standard Precautions and for specific patients or conditions

Gowns, gloves, eye ware, masks, caps/hoods, foot covers, room isolation

what are ground electrodes?

Grounding ties the canoes together so they can see the waves (noise) the same Without, electrical noise at amplifier is different at pt Grounding ties the amp and the patient together so they see the exact same noise and decreases artifacy

what are the high, medium, and low resistance impedences

HIGH-tendon, fat bone (100,000) MEDIUM-skin (40000, 100000) LOW-nerves, blood, mucous membrane, muscle (very conductive) )low resistance

what is a normal response to HV on an EEG

HV build up. Amplitude increases and theta/ delta appears. Likely due to alkalosis from reduction of CO2. This is a normal response to HV

The first published American work on human EEG was at Harvard University., a student of Alexander Forbes, had been doing audiologic research using a cathode ray tube instead of a galvanometer.

Hallowell Davis

His long series of articles, published between 1929 and 1938, have established him as the originator of electroencephalography.

Hans Berger (1873-1941),

had heard of the work of Caton and others as early as 1902. He hoped that this work could show an organic basis of psychological phenomena. Because his first equipment had a sensitivity of 1 mV/cm (millivolt per centimeter) he had to record with needle electrodes over skull defects and pad electrodes over intact skull

Hans Berger (1873-1941),

In EEG, during photic stimulation, photic driving can be at the exact rate of the stimulation frequency, a multiple of that frequency which is called a harmonic or a derivative of that frequency which is called a sub-harmonic. Example: When the photic stim rate is 12 Hz, the driving could be 12 Hz, 6 Hz, 24 Hz or 36 Hz. Photic driving greater than frequency of photic stimulation

Harmonics & Sub-harmonics with Photic Stimulation

Berger used the term.. he noted what on an EEG

He rejected Neminsky's term of Electrocerebrogram and named the procedure Eletrenkephalogramm He reported EEG correlates of changes in consciousness, recordings of sleep spindles, the effect of hypoxia on the human brain, and a variety of diffuse and localized brain disorders. Interestingly, he even recorded spike and wave activity from a patient with epilepsy, but failed to recognize the importance of this finding

. This is the first report of what is EEG today.

He showed an oscillating potential at rest and an electrical response to light stimulation. This is the first report of what is EEG today.

Travis's greatest contribution to EEG has been his students: ________ John Knott spent his life in research and especially in teaching at the University of Iowa. Charles Henry, likewise, is best known for teaching the intricacies of EEG recording and interpretation to generations of electroencephalographers and technologists

Herbert H. Jasper, Donald B. Lindsley, John R. Knott, and Charles E. Henry.

first gained prominence in the EEG laboratory at Brown University's Butler Hospital in Providence, Rhode Island in 1933. In 1935, he and Leonard Carmichael published studies of normal human brain rhythms. In 1937, Jasper left Brown for the Montreal Neurological Institute. There he collaborated for decades with the great neurosurgeon Wilder Penfield on recording from the exposed brain during surgery for epilepsy

Herbert Jaspar

Frequency is expressed in ____.

Hertz (Hz)

HD

Huntington's disease

Ethotoin, Phenytoin

Hydantoins

was well established as an activating procedure for clinical seizures

Hyperventilation

Name the cranial nerves in order

I. Olfactory-smell II. Optic-vision III. Oculomotor-eye movements, blink IV. Trochlear-eye movements, back and forth V. Trigeminal-jaw and facial movements VI.Abducens-eye movements VII. Facial-facial movements and taste VIII. Vestibulocochlear (Acoustic)-hearing IX. Glossopharyngeal-taste and throat movements X. Vagus-motor and sensory, visceral organs XI. (Spinal) Accessory XII. Hypoglossal

helps doctors monitor the brain activity of patients who are in a coma or deep unconsciousness in a specialized intensive care unit. It is particularly useful for patients who have experienced brain injuries or are at risk of bleeding or oxygen deprivation in the brain

ICU/Continuous EEG Monitoring [cEEG

Drug Effects and Focal Skull Defects may...

IEDS (interictal epileptiform discharges)

what is the effect of AEDs on IEDs?

IEDs are often not directly correlated to seizure frequency (besides absence) - Decrease IEDs: Benzos, PB, PRM, VPA (GSW & PPR), ETH (GSW), LTG (GSW & PPR) - Increase IEDs: CBZ, TGB (NCSE) - Withdrawal with variable effect on IED frequencysome with new foci or generalization of IED (ie PB). • Drug levels without effect on seizure onset, contralateral spread, coherence between discharges. • Drug dose reduction is without an effect on ictal morphology.

ASET - The Neurodiagnostic Society provides national competencies for these neurodiagnostic procedures

IONM, EP, LTM

Etiology (subclass of diffuse IS activity). - Non-specific encephalopathy - Structural brain disease less frequently • Supratentorial hemispheric (mesial frontal) • Midline lesion (frontal in adults/posterior in child) • Some alteration in consciousness • Usually seen soon after loss of alpha activity • Prognosis depends on underlying condition; favorable with drugs

IRDA

seizure

Ictus

Data has electrical artifact present. Causes: Causes include high electrode impedances; a bad patient ground lead; a bad chassis or outlet ground; a bad system reference lead; a head-box that is too close to the monitor; external interference from an electric bed, lights, or other devices; bad grounding at the outlet, and a bad or loose preamplifier or amplifier.

If all usual causes of electrical noise have been ruled out (including verification of a bad ground on the wall outlet), troubleshooting of the headbox /preamp, cable, and amplifier board is in order. Use a diagnostic program if available on your instrument or switch identical parts from another instrument one at a time to determine the bad part. Remember: you can alter the paper speed on a digital instrument to verify 60 Hz artifact just like on a paper machine.

Brevital (Methohexital)

Increased anterior beta DNA focal spikes in the susceptible

what is suspcious of drug toxicity?

Increased frequencies such as beta activity should raise the suspicion of drug toxicity.

IPSP is...

Inhibitory Neurons (IPSP)

Benzodiazepines= DS - Barbiturates= burst-suppression-ECI - Propofol= frontal delta + fast activity

Intensive Care Units

IRDA

Intermittent rhythmic delta activity

: bands of densely packed stellate cells; no pyramidal cells.

Internal granular layer

how to define medical terms

Interpret the suffix first, then the prefix (if present), and then the root or roots.

the use of neurophysiological monitoring techniques during surgery to provide information to the surgeon about nervous system integrity. guards against neurological complications during surgery and helps reduce the risk of negative surgical outcomes such as paralysis or stroke

Intraoperative Neuromonitoring [IONM] monitor neurosurgical procedures and orthopedic procedures, including spinal surgery for scoliosis, tumors, and aneurysms; vascular surgeries; acoustic neuroma surgery; and carotid endarterectomy.

The aforementioned advances with digital EEG technology have also improved the ability to assess neurological risks in the operating room. Neurophysiologic monitoring in the surgical suite is supported by neurosurgeons and neurologists who value the real-time data and its' role in improving patient outcome

Intraoperative Neurophysiological Monitoring (IONM

the zygomatic arch is made up of...

It is formed by the junction of two bony processes: a short anterior component, the temporal process of the zygomatic bone (the cheekbone) and a longer posterior portion, the zygomatic process of the temporal bone, extending forward from the temporal bone

Cranium is subdivided into

It is subdivided into the facial bones and the brain case, or cranial vault

In 1882, ________ developed the galvanometer that bears his name.

Jaques-Arsene dArsonva

Whereas Gibbs was interested in the various patterns shown on the EEG with different pathologies, ______ was more interested in the use of EEG for localization of spike activity and other abnormalities.

Jasper

was a prime mover in the formation of ABRET and in developing an accrediting process for EEG technology programs.

John Knott

Sleep transient appearing in N2-Stage II sleep, maximal over the central areas and phase reversing at the vertex. Sometimes generated in response to stimuli such as noise, they are a compound waveform with a slow and superimposed fast component

K Complex

During the resting state there is a higher concentration of _____ on the inside of the cell with respect to the outside while there is a higher concentration of ____ on outside of the membrane with respect to the inside.

K+ and A Na+ and Cl-

The primary type uses _____ technology - these are the flat panel monitors.

LCD (liquid crystal display)

Digital instrument filter settings allow ranges from ___LF to ___HF which is well in compliance of ACNS recommendations for ECI recording filters settings.

LF .1 Hz - HF 100 Hz

no significant effects on background • Reduced GSW and PPR (Photoparoxysmal response)

LTG (Lamotrigine)

refers to the simultaneous recording of brainwave activity (EEG) and clinical behavior (audio and video) over extended periods of time. used to evaluate patients with seizures and other disturbances of cerebral function and distinguish them from other physiological events

LTM long term monitoring

Adjunctive use in adults with LRE >17 - MOA: Primarily a (slow) sodium channel blocker - SE: Dizzy, HA, N, diplopia - Single case report of use in SE; none EEG

Lacosamide (Vimpat ®)

circled meds to know:

Lacosamide (Vimpat ®) Rufinamide (Banzel ®), Vigabatrin (Sabril ®)

Phenyltriazine

Lamotrigine

LPD

Lateralized Epileptiform Discharges

why we use ground electrode No earth ground on patients that connects to water pipe because of danger from ground loops

Leakage Current (leakage current from machine through the ground to the patient) With isolated grounds cant have ground loops

modified the diode into the triode or vacuum tube for amplification of voltage.

Lee de Forest (1907)

The duration of a spike is:

Less than 70 msec

became part of the Harvard team in the early 1930s. When Jasper went to Montreal, Lindsley filled his place at Brown. He later directed EEG research at the University of California in Los Angeles. His primary contribution was the study of maturational changes in the EEG.

Lindsley

Magnetic resonance image of the blood vessels, useful in detecting pathological conditions such as atherosclerosis and thrombosis.

MRA

Descends along the anterior (ventral) aspect of the spinal cor

anterior spinal artery

a functional measurement of the magnetic fields naturally produced by electrical currents in the brain. This diagnostic test maps brain activity using sensitive magnetometers. Applications include localizing pathology, such as traumatic brain injury and focal epilepsy using source imaging and other methods of analysis.

Magnetoencephalography [MEG]

The program will engage but will not allow the collection of data. Causes: You may be accessing a reader only version of the program. Also, the headbox/pre-amp may not be connected, the head-box/pre-amp or the head-box cable might be dysfunctional, the amplifier board could be bad or loose, the drive may be too full, or the wrong head-box may have been connected to the system.

Make sure that all appropriate hardware is connected properly and that power indicators are on (including the preamp box). If the machine has a head-box/ pre-amplifier diagnostic program, it should be run. Most digital machines will selfcalibrate when entering the diagnostic program so be sure to observe the text indicating that this has occurred. You can also try using a second head-box and cable from an identical machine.

A flat line and/or artifact in all channels. Cause: Causes can include high electrode impedances, a bad patient ground lead, a bad system reference lead, leads not plugged into the headbox, an impedance or calibration adapter is plugged into the head-box, the system is set for the square wave calibration mode and/or the display sensitivity set too low.

Make sure that the system completes a successful amplifier calibration upon entering the neurodiagnostic program and display the calibration table and/or square wave calibration. The impedance test should reveal low and balanced inter-electrode impedances. No adapters used for calibrating or diagnostic programs should be plugged in. Check all instrument settings as well as the display montage for correctness. A diagnostic test on the preamp and head-box should be run or, swap a headbox and cable from an identical system

What are some factors impacting the evaluation of EEG and medication effects? (select all that apply)

Many patients take multiple medications c.Individual patients differ in their reaction to drugs and their EEG effects d.Drug effect on patients are non-specific and hard to predict

The power lights come on but the system does not seem to boot.

Many problems that are thought to be booting-up problems turn out to be display problems instead. Careful examination of the power lights and computer noises heard may be necessary to determine if there is a monitor or a computer problem. When a computer is initially powered up, a fan starts up and the hard drive makes certain noises when it is accessed. The monitor will then show text indicating certain information about your computer (processor speed, version of BIOS, devices connected, etc.). If these noises do not occur and you see no text, check the power light on the computer, making sure it is plugged in and that its own power switch is turned on. If the computers power light does not come on, it could have a bad power cable or internal power supply

Dalmane

Marked increased beta

consists of a rhythmic 5-7 Hz sinusoidal, "spiky" waveform lasting from 4 to at most 20 seconds in duration (see illustration). As the name suggests, this rhythm is found focally in the fronto-central midline head regions, with a slight spread to the parasagittal electrodes in some subjects. The pattern can be persistent or may wax and wane during wakefulness and drowsiness. It disappears during sleep.

Midline theta rhythm

A surface negative, wicket-type rhythm of 9 Hz (plus or minus 2 Hz), found in the central head regions is known as:

Mu rhythm

The term "bits" is shorthand for binary digits. The formula for converting bits to voltage levels is_____. In this formula, "2 to the Nth power" the N is the number of times 2 is multiplied by itself. The following are examples of how the number of voltage levels are determined and expressed in bits

N bits = 2 to the Nth power voltage levels.

Rudimentary Vertex waves are seen in the following sleep stage

N1

Vertex waves, Spindles and K-Complexes are seen in this sleep stage:

N2

High voltage (>75 μV), low frequency (.5-2 Hz) activity are seen in >20 % of the epoch in this sleep stage:

N3

Electrical shock of peripheral nerves to record time of conduction used to diagnose various peripheral nervous system diseases:

NCV

Stage N1 =

NREM 1 Sleep (Drowsiness, rudimentary Vertex waves)

Stage N2 =

NREM 2 Sleep (Vertex waves, Spindles and K-Complexes)

evaluate electrical potentials from peripheral nerves. Technologists stimulate the nerve with an electrical current and then record how long it takes the nerve impulse to reach the muscle. nerve conditions which produce numbness, tingling, muscle pain, muscle weakness, muscle cramping, abnormal movements, pain or loss of sensation, or neurological diseases affecting primarily the feet, legs, hands, arms, back, and neck.

Nerve Conduction Studies [NCS]

Neurodiagnostic Technologists perform these types of studies:

Nerve Conduction Studies, Electroencephalograms, Polysomnograms, Evoked Potentials

describe neurodiagnostic scope of practice

Neurodiagnostics is the allied health care profession that records, monitors, and analyzes nervous system function to promote the effective treatment of pathologic conditions. Technologists record electrical activity arising from the brain, spinal cord, and peripheral nerves, and from somatosensory or motor nerve systems using a variety of techniques and instruments, and are responsible for generating technical reports. These duties are performed in a manner consistent with technologists' training, education, experience, and credentialing under the direction of administrative and clinical leadership as defined by facility policies and procedures.

what generates the EEG signal?

Neurons on the cortical surface of the brain generate the EEG signal. Cortical neurons communicate electrochemically via synapses. Neurons that are near each other are affected by synaptic and post-synaptic potentials. . As these neurons become collectively excited or inhibited, an electrochemically induced change in polarity occurs, causing a change in relative positivity or negativity in the area. Scalp electrodes located near each other, therefore, may record similar patterns.

The sample rate of an A-D converter must be at least twice that of the fastest frequency to be recorded. This frequency is known as the ____________ frequency.

Nyquist

most common vowel is a second is a

O I

check measurement between _____ for circumference

O1 and O2

Place for surgery

OR

Positive Drug Effects on EEG in EMU

Occasionally used for treatment response • Maybe useful for defining a focal onset in patients with generalized discharges - Lateralization of epileptogenic foci in secondary bilateral synchrony. • Used for resective surgery - Localizing dysfunctional cortex by region of reduced fast activity.

Paramethadione, Trimethadione

Oxazolidinediones

occurring in a variety of acute neurologic conditions, most often with cerebral infarctions. Sharp waves or sharp spike complexes mixed with slower frequencies occurring over one or both hemispheres

PDS Periodic discharges

No effect on EEG at therapeutic doses • >20 ug/dl= DS, theta, delta, high voltage delta • Most reports with no effect on IEDs

PHT (Phenytoin)

Link all parts of the body by carrying impulses from the sensory receptors to the CNS and from the CNS to the appropriate glands or muscles. Consists of the nerves that originate in the brain and spinal cord (communica

PNS

Route of oral medication

PO

Normal sleep transient occurring in the posterior head region of positive polarity and sharp morphology seen in light sleep.

POSTS

These normal sleep patterns have a positive polarity and sharp morphology and are seen in light sleep

POSTS

is the reverse of alpha reactivity in a fully alert individual. Upon eye opening in the normal alert adult, alpha rhythms are attenuated. Patients, however, alerted from a drowsy state can produce an accentuated alpha rhythm with eyes open. Since this is contradictory behavior for alpha rhythm, the term paradoxical is used.

Paradoxical alpha response

nerves that branch from the CNS

Peripheral Nervous System (PNS)

Anything extra or added on for your computer, such as a modem, a mouse, or a fax adapter, can be added on externally or installed inside the machine.

Peripherals

nasopharyngeal (optional for rewarding from medials aspect of temporal lobe, placed through nostril, tip of resting at roof of nasopharyngeal

Pg

Sometimes called "______", six hertz spike and wave are low voltage spikes followed by a theta wave (usually at 6 Hz)

Phantom spike and wave

Phenacemide

Phenylureas

Phonetic system uses (symbols) to indicate different pronunciations

Phonetic system uses diacritical marks (symbols) to indicate different pronunciations.

During photic stimulation, the activity elicited over the posterior portion of the head in response to the stimulus. It is either time locked and of the identical frequency as the photic stimulation or is a harmonic or subharmonic of the photic stimulation frequency

Photic driving

Brief repetitive muscle spikes over the anterior regions of the head during Photic stimulation. Not of epileptogenic origin

Photomyogenic response

Spike and wave and multiple spike and wave complexes which are bilaterally synchronous, symmetrical and generalized and may outlast the stimulus by a few seconds. May be associated with clinical seizure activity, brief impairment of consciousness and muscle jerks.

Photoparoxysmal response

Photoparoxsymal response will do what with meds?

Photoparoxysmal response Decrease •PB/PRM decrease IEDs with controlled seizures •ETH reduces GSW •LTG decrease spontaneous and light-induced GSW •VPA reduces or abolishes GSW not focal IEDs •In absence epilepy, GSW reduction helps gauge therapy •VPA suppresses PPR •VPA spike reduction that may persist 3 mos after D/C

In EEG it refers to an artifact caused by the the photic stimulator in the frontal leads. This artifact is eliminated by covering the electrode with something to shield the light.

Photovoltaic

if you have a history of left temporal lobectomy you would see..

Polymorphic with variable frequency isolated to the left temporal chain

a recording during sleep that uses EEG and other physiologic monitors to evaluate sleep and sleep disorders, such as loud snoring, difficulty staying awake during the day, falling asleep at inappropriate times, insomnia, and uncontrollable urge to move one's legs. identify dysfunction in sleep/wake cycles, to diagnose breathing disorders during sleep, and to evaluate treatment of these disorders.

Polysomnograms [PSG]

That portion of a computer through which a peripheral device may communicate. Often identified with the various plug-in jacks on the back of your computer. On a network hub, it is the connector that receives the wire link from a node.

Port

POSTS means...

Positive Occipital Sharp Transients of Sleep

PDR=

Posterior dominant rhythm.

how to boot up a computer

Press the power button, the power supply supplies power to the CPU, disks, etc through an AC power cord. CPU loads BIOS. Next, BIOS tests and intitailzes system hardwarre including CPU. It produces a POST (power on self test) to test for any errors. BIOS or UEFI examines storage device either in MBR or EFI and runs it, no boot device it will fail. The bootloader is a small program that has the large task of booting the rest of the operating system such as Windows Boot Manager. The kernel then loads the system Registry into memory and also loads any additional hardware drivers that are marked with "BOOT_START," . The Windows kernel then launches the session manager process (Smss.exe), which starts the system session and loads additional drivers. This process continues, and Windows loads background services as well as the welcome screen, which lets you sign in.

Benzodiazepines and barbiturates do what to an EEG?

Produce rhythmic fast activity during tx • Marked with younger age • More pronounced after acute administration • Maximal in the frontal head regions • Bandwidth 18-25 Hz • Toxicity may produce high amplitude beta May reduce alpha frequency and voltage • DS correlates with depressed LOC • Progression induces delta • Burst-suppression and ECI may occur (PB/ pentobarb)

describe flow of electricty with the pt

Pt-electroses-headbox-cable-eeg machine-power cord to outlet

-ex, -ices

apex, apices

Used to indicate a differential diagnosis when one or more diagnoses are suspected.

R/O

is temporary memory storage that is critical to rapid computer operations. The type of information contained in temporary memory is ever changing and entirely dependent on what task is being required of the computer at any given time. Any information stored in this type of temporary memory is lost when power to the computer is turned off.

RAM (random access memory)

Muscle tone at the lowest of any stage in the polysomnogram as detected by chin EMG electrodes in this sleep stage.

REM

Stage REM sleep, consisting of Rapid Eye Movements, reduced EMG activity and faster "saw-tooth" frequencies of EEG (non-delta) Determining REM sleep requires the use of polygraphic channels recording eye movements and EMG, EKG and respiration

REM

Stage R =

REM Sleep (Rapid Eye Movement)

is characterized by a loss of muscle tone, except for the muscles used in breathing and eye movements (see illustration). Respiration and heartbeat may become irregular. Small muscle movements, called phasic twitches, are seen in the face and extremities. Bursts of quick eye movements, called saccadic eye movements, can be seen under the person's closed eyelids. The EEG is of low voltage, with a mixture of rhythms. It may look very much the same as the EEG during wakefulness with eyes open, except for the lack of EMG contamination.

REM sleep

is main source of electrical burns from MRI

RF coil (radiofrequency)

Psychomotor Variant (figure 12) 1. A relatively rare pattern, recorded from anterior-temporal and frontal regions during drowsiness. Appear as flat topped, almost square waves, at a frequency of 6 Hz, but can be intermixed with a harmonic at 12 Hz. rhythmic mid-temporal theta of drowsiness 5 to 7 hertz activity with a notched appearance

RMTD Rhythmic MidTemporal Dischard

is used by the computer to store very basic functions on the hard drive, such as starting up the computer and carrying the programs it will run. This memory is permanent in that the information stored here is recorded on a chip and is preserved even if the computer is turned off. Start-up instructions for the computer are stored here which activate the operating system (Dos, Windows, etc.) and the hardware attached to the computer. Data files (results of the users work) can also be stored on the internal hard drive if they are not too big - these are considered to be semi- permanent in that the user can later remove some or all of the data and use the storage space to save new files

ROM (read only files)

Acute reaction from electrical injury include: (select all that apply)

Respiratory Arrest, Paralysis, or anoxia Asystole and dysrhythmias Spinal cord transection, and central nervous system shut down Renal failure (kidney failure)

appearing in light drowsiness, long runs of sharp theta waves of 5-6.5 Hz. The pattern is rare and in spite of its rhythmic sharp appearance is not clearly associated with seizure disorder

Rhythmic Mid Temporal Discharge also called Rhythmic Temporal Theta Bursts

The first recognized demonstration of the electrical activity of the brain was by _______ in Liverpool, England.

Richard Caton (1842-1926)

Adjunctive use in drop attacks and POS in the LGS - MOA: Primarily a sodium channel blocker - SE: Sleepy, N/V, HA, dizzy, fatigue/ interacts with valproate - No cases of EEG effect yet

Rufinamide (Banzel®)

_____ or slow, rolling, lateral eye movements can also be observed (see illustration below.) As Stage NI sleep progresses, the EEG background becomes a mixture of frequencies (4-7 Hz) and fairly low voltage Beta rhythm can be seen in the frontal and central regions. As an individual relaxes, the EMG contamination often present in the alert patient is reduced.

SEMs

Snapshot of blood perfusion within the brain (ideally at the onset of a seizure; so called ictal SPECT) • Typically compared with baseline perfusion of the brain (so called interictal SPECT) • SISCOM: subtrac3on ictal SPECT co-registered to MRI scan

SPECT: single-photon emission computed tomography

- repetitive 5 to 6 Hz discharges in the elderly population during which the patient is fully responsive

SREDA (Subclinical Rhythmic EEG Discharges)

semi critical items

Same as previous slide if exposure to non-intact skin I.e. surface electrodes, electrode caps etc. • Nasal/oral thermocouples CPAP/Bipap masks & tubing

What are the PNS glial cells?

Schwann cells and satellite cells

What are some indication for EEG?

Seizures, encephalopathy, syncope, episodic movements, sleep attacks

How does sensitivity differ from gain

Sensitivity is the ratio of input voltage to output deflection

functional classification:

Sensory • Motor • Interneurons / association

This design assigns a separate ADC to each channel. A command from the computer simultaneously initiates all ADCs to convert the EEG information to the digital format

Separate ADCs for each channel

what does SEMS stand for?

Slow Eye Movement of Sleep

epileptiform activity typically associated with seizure activity. spike and slow wave form, Typical spike wave discharges are 3 Hz or 3/sec but atypical spike wave discharges can range in frequency either slightly slower or slightly faster. Can be focal, lateralized or generalized.

Spike Wave Discharges

the two waves form one pattern but the two components are very different in frequency and morphology

Spike and Slow Wave Complexes

Vertex sharp transients, or V waves, appear in late ____ in the ___ regions.

Stage N1 and Stage N2 sleep in the central regions

Normal sleep in adults consists of 90 minute cycles of sleep stages in this order:

Stages NR1, NR2, NR3 and REM

Leviteracetam, Topiramate, Lacosamide, Rufinamide

Structurally distinct drugs

Phensuximide, Ethosuximide, Methsuximide

Succinimides

Zonisamide

Sulfonamide

describe a surgical treatment

Surgical (operative)

describe the evidence of illness

Symptomatic suffixes

used to record from the inferior, anterior portion of the temporal lobe from outer canthus. Distance?

T1 and T2 1/3 distance, 1cm up

Non-convulsive status epilepticus

TGB (Tiagabine)

1,099,551,627,776 bytes, often used to mean one trillion bytes (1,000,000,000,000).

Terabyte

exceptoions to medical terms

Terms may be formed by a root alone or by a combination of roots. • Example: oviduct • A term may be formed from the combination of a prefix and a suffix

what is the voltage range?

The ACNS Guidelines state that Most modern clinical EEG amplifiers record with a bit depth of 24. A resolution of 16 or more bits is preferable; this allows for an EEG resolution down to 0.05 mV while recording potentials up to plus-or-minus several millivolts without clipping. For example, with a 0.05-mV resolution and a 16-bit analog-to-digital conversion, the maximum allowed excursion would be plus or minus 1.638 mV

ASET - The Neurodiagnostic Society includes practice level descriptions within the job description guidelines in the following publication:

The ACNS guidelines

was born in 1959 with the first annual meeting being held in 1960. Training and recognition of technicians were early goals of ASET - goals which remain alive today

The American Society of EEG Technicians (ASET)

(joins) with the mandibular fossa and articular tubercle of the temporal bone, allows for opening and closing of mouth

The condyle of the mandible

______ extend laterally to either side away from the sella turcica, where they form the anterior floor of the middle cranial fossa. T

The greater wings of the sphenoid bone

While acquiring data on the right side of the screen, the monitor scrolls through previously recorded data on the left side of the screen.

The illustration shows a split screen review process.

there are 14 facial bones, what are the paired and non paired bones

The paired bones are the maxilla, palatine, zygomatic, nasal, lacrimal, and inferior nasal conchae bones. The unpaired bones are the vomer and mandible bones

A flat line and/or artifact in one or 2 channels. Causes: Causes can include a bad electrode, high electrode impedances, a bad jack on the head-box/pre-amplifier, or a bad preamplifier/amplifier channel.

The troubleshooting for this problem will be similar to that of the standard analog EEG instrument. Try moving the bad electrode lead into another input. If the problem moves to the new input, the lead is bad. If the problem does not move, the jack or channel could be bad. To determine if the jack or the channel is bad, rearrange the montage so that another input is used in that channel. If the problem resolves, the jack receptacle is bad; if the problem remains, the channel is bad.

the vertebral column consists of ____ bones, including sacrum and coccyx

The vertebral column consists of 24 bones, plus the sacrum and coccyx.

3 parts of the wall plug

The wall plug-ground, neutral, hot line

The brain case consists of what eight bones

These include the paired parietal and temporal bones, plus the unpaired frontal, occipital, sphenoid, and ethmoid bones.hese include the paired parietal and temporal bones, plus the unpaired frontal, occipital, sphenoid, and ethmoid bones.

is a normal finding during drowsiness in the adult EEG. may be seen at the onset of sleep as the alpha rhythm slows with drowsiness (see illustration). If theta frequencies are present in an alert, adult's EEG they are usually considered to be an abnormal finding

Theta rhythm

he advantages to Digital Filters includes the following: (select all that apply)

They have a relatively sharp frequency cutoff if desired c. they need not introduce any time delay (phase shift) d. they can be constructed and modified easily

The program will not engage or the computer reboots itself.

This may be due to a conflict over the use of the computers resources - not enough computer memory, the program has become corrupt, or a program has been deleted. Electrical Safety Troubleshooting: You will most likely need to talk to the manufacturer about such problems. Each Neurodiagnostic software program makes very specific demands of the computer.

The file will not copy. Causes: This might occur because the network is busy (heavy traffic), the network is down or disconnected, network mapping is not set up, the archive drive is not hooked up, the data path is not set up correctly, a malfunctioning or dirty archive drive, bad or unformatted storage media, corrupt data file/storage media, or there is not enough room for the data to fit on the destination.

This represents one of the most complex areas to troubleshoot in digital instrumentation. There are an enormous number of variables that may need to be investigated one by one. As the user, the following troubleshooting is most valuable :

A Scope of Practice describes the procedures, actions, and processes that a healthcare practitioner is permitted to undertake in keeping with the terms of their professional license.

True

A stress loop in an electrode lead wire is a bad idea because it acts as an antenna and picks up electrical current in the air. It is best to tape down a zig-zag rather than a loop.

True

Authentication is the process of establishing who you are.

True

Birds on electrical lines do not get shocked because they are not grounded.

True

Many neurodiagnostic programs are accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) with both seated and distance educational programs available. Primary neurodiagnostic education is offered through 1- and 2- year certificate or associate degree programs.

True

Neurodiagnostic procedures are performed in all areas of the hospital, including acute and critical care areas such as the operating room, intensive care units and the emergency department as well as out-patient settings

True

Neurodiagnostic testing analyzes and monitors nervous system function to promote the effective treatment of neurological diseases and conditions.

True

They are designed to offer a high-speed connection into the computer with options to connect many devices.

USB universal serial bus

What is the best way to measure sensitivity on a digital EEG instrument?

Use the computerized voltage indicator, usually an on screen ruler or legend, or use the cursor function found in the software itself.

No effect at therapeutic doses • DS with toxicity • Reduces GSW (generalized spike and wave) and PPR

VPA (Valproate)

corroborated Caton's findings in his work at the University of Kharkov. He first studied changes in the brain's activity evoked by stimulation.

Vasili Yakovlevich Danielevsky (1852-1939)

- 3rd line AED for adjunctive use in partialonset seizures and infantile spasms - MOA: Gaba-ergic - SE: HA, sleepy, fatigue, dizzy, VFDs, weight gain, edema - No significant findings on EEG... yet but ? effect on myoclonic & absence seizures

Vigabatrin (Sabril ®)

was one of the Russian leaders in studies of electrophysiology. He measured the electrical activity of dog brains using an Einthoven string galvanometer and a camera. He was perhaps the first investigator to make photographic records of EEG, records he called electrocerebrograms.

Vladimir Vladimirovich Pravdich-Neminsky (1879-1952)

_____s of the membrane operate in an all-or- nothing mode. That is, once threshold is reached either the channels always open or they do not open at all and they always do so under the same set of conditions.

Voltage sensitive (or gated) channels

Testing with "Focal Drug Effect" Brevital infrequently activates IEDs • Amytal does but less often. • Route of delivery explains "focal" effect from drugs.

WADA Testing and Barbiturates with "Focal" Drug Effect

When the American EEG Society was formed in 1946, technicians were encouraged to join. In 1958 Dr. Peter Kellaway and his technician Nina Kagawa, acting under the direction of the AEEGS Technicians Committee, talked to leading technicians about the goals of a new society for technicians and drafted a prototype constitution, based on ideas from the constitutions of the _______.

Western Society of EEG Technicians and the Canadian Society of EEG Technicians

How does DC cause injury?

When dc current is applied to skin, acidic buildup under anode, basic alkaline buildup under the cathode Each creates and electrochemical burn in a short time In electrodes, electrons are the charged particle that moves to make currect flow In tissues, ions (electrolytes) are the charged particles that moves to make current flow (positive ions migrate to negative cathode) anode migrates negative ions from tissue -causes at anode, hydrochloric acid is built up -sodium hydroxide, chemical built up Longer duration more acide and alkali buildup More current more acide and alkali buildup (stining, leakage current through machine to electrode

The data is clipping and/or squared off. Causes: The amplifier setting is too low or too high or the baseline clip feature is engaged.

Your digital instrument may have an adjustable gain setting much like an evoked potential instrument. This setting is adjustable only for newly collecting data, not previously recorded data (not to be confused with sensitivity). If your incoming raw data is too small or too large for the selected gain, the data may not be processed correctly by the instrument. Your manufacturer can advise you on the proper gain settings.

used to indicate the location of the electron and is on the midline or "zero" meaning its neither L or R hemisphere

Z

A flat line in all channels could be ____.

a bad ground electrode or system reference.

If the symptom is that the data has electrical artifact present the cause could be: (select all that apply)

a bad system reference lead b. a bad chassis or outlet ground c. a bad patient ground lead d. Causes include high electrode impedances

An abnormality seen in a clearly delineated area of the brain such as a temporal spike or frontal slowing is called _____.

a focus or focus discharge

Measurements of wave heights can be taken with: (select all that apply)

a millimeter ruler on a paper EEG page. a digital calibration marker on a digital instrument.

Waves of mixed frequencies are thought to be (select all that apply)

a mixture of the products of different wave generators from various locations in the brain recorded because of wave-generating circuits in the brain that produce complex, nonsinusoidal waveforms

Electrodes placed extracellularly may record activity generated by sinks and sources. When an extracellular electrode is placed adjacently to a sink it records _____ and when placed adjacent to a source a ______ is recorded. This is due to the ionic changes produced in the extracellular space as a result of membrane changes.

a negative potential a positive potential

Forbes and Catherine Thatcher combined the vacuum tube with the string galvanometer to form the string galvanometer amplifier (1920), a device with a sensitivity of 50 microvolts per centimeter and a frequency response from DC to 200 Hz. This was a...

a significant turning point in instrumentation for electrophysiology research.

for infection transmission to occur there must be a chain of

a source of infection 2. a susceptible host 3. a transmission pathway

Select the appropriate prefix to complete the term: __________duction= to turn away from

ab

abdomin/o

abdomen

lapar/o

abdomen

type: motor nerve • origin: pons • function: o lateral gaze controls the o lateral rectus muscle of the eye

abducens nerve

super-, supra-

above or excessive

hyper-

above, excessive

is rapidly reversed and the inside of the cell is returned to its resting state by the rapid pumping of intracellular Na+ outside the cell. In so doing, the membrane potential may go beyond its resting potential to a potential that is more negative and at this point the cell is said to be hyperpolarized

acrion potential

dia-, trans-

across or through

demonstrates how changes in the membrane can constitute a signal. Looking at the way these signals work in more variable circumstances involves a look at graded potentials

action potential

Sleep is considered an _____ for recording EEG abnormalities. Most _____ discharges appear during sleep.

activating procedure epileptiform

). The voltage-gated Na+ channel actually has two gates, which opens when the membrane potential crosses -55 mV

activation gate

Changes in sensitivity on a digital EEG instrument

adjust only the visual representaion

post-

after, behind

anti-, contra

against or opposed to

aer/o

air, gas

pneum/o, pneumon/o

air, lung

condition without speech, impairement due to localized brain injury that affects understanding, retrieving, and formulating

aphasia

includes all bones of the upper and lower limbs, plus the bones that attach each limb to the axial skeleton. There are _____ bones in the appendicular skeleton of an adult.

appendicular skeleton 126 bones

According to the text book, a clinical description on the report serves to: (select all that apply)

alert the technologist to the necessity of using specific recording techniques. b. alert the technologist and the reader to areas of the scalp that are inaccessible due to bandages or other instruments on the head. c. if the EEG is one in a sequence of others. d. alert the technologist and the reader to skull defects from previous surgeries

false representation of waveforms (need to sample it three)

aliasing

pan-

all

para

alongside of or abnormal

The frequency band in EEG that contains frequencies from 8-13 Hz

alpha

The normal adult EEG frequency band of 8-13 Hz.

alpha

______ is often sinusoidal in its morphology"

alpha

the normal adult EEG frequency band seen in posterior area in the awake state with eyes closed.

alpha

Berger recorded only one channel, using a frontal and an occipital electrode. He defined the waveforms previously described by Neminsky as...

alpha and beta waves

________ is the only "all-inclusive" range and includes both boundary frequencies (8 and 13 Hz)

alpha range

Eyes close=

alpha resumes

a transient increase in alpha frequency immediately following eye closure.

alpha squeak

was first recognized and described by Storm van Leeuwan and Bekkering in 1958. The normal phenomenon can occur momentarily after eye closing and is a brief acceleration of the patient's normal alpha rhythm. It can be facilitated by visual attention before eye closure but does not occur every time the eyes are closed.

alpha squeak

positive and ng switching really fast, electrical force vibrate instead of flow (wave like an ocean)

alternating current

This is the upper border of the mandibular body and serves to anchor the lower teeth.

alveolar process of the mandible

The curved, inferior margin of the maxillary bone that forms the upper jaw and contains the upper teeth is the ______

alveolar process of the maxilla

how much electricity through wire, how big wire needs to be (how thick the water hose) larger wire to power and appliance.

amp

The ratio of input voltage to output voltage of a differential amplifier

amplifier gain

Voltage the force (power) of an EEG wave expressed in microvolts A guide to express amplitude could be low 5-20 uv, medium 40-80 uv, high 80-150uv or more.

amplitude

is the measurement of the deflection in mm

amplitude

the peakto-peak measurement (millimeters) is multiplied by the sensitivity, in microvolts per millimeter to calculate the voltage of the EEG wave or in some digital instruments the sensitivity may be "full scale" such as 50uV or 100 uV, in other words, the maximum voltage that can be displayed full scale.

amplitude

equally spaced electrodes allows what on an EEG

amplitude and symmetry

ALS

amyotrophic lateral sclerosis

A chain of events leading to depolarization and repolarization of a neuron is referred to as _____.

an action potential

what is the 10-10 system?

an additional electrode placement system that changes T3 to T7, T4 to T8, T5 to P7, and T6 to P8

must be converted to numbers in order for the computer to be able to store and process the EEG data.

analog eeg signal

is the scientific study of the body's structures.

anatomy

a localized, abnormal dilation or ballooning of a blood vessel, typically an artery, due to a weakened vessel wall. This weakening can be congenital or caused by conditions like atherosclerosis. The presence of an aneurysm can disrupt circulation because the weakened vessel wall may eventually rupture, leading to massive internal bleeding and potentially life-threatening consequences

aneuyrism

blindness of one eye o optic nerve damage affecting both fields of vision of that eye.

anopsia

Supplies most medial portions of frontal lobes and superior medial parietal lobes

anterior cerebral artery

Between the two anterior horns, and bounded by the axons of motor neurons emerging from that gray matter area, are the _____

anterior columns

Connects the anterior cerebral arteries at their closest juncture

anterior communicating artery

Inside the skull, the base is subdivided into three large spaces, called the...

anterior cranial fossa, middle cranial fossa, and posterior cranial fossa

what horn sends out motor signals to the skeletal muscles. T

anterior horn

Supplies the inferior cerebellum and portions of pons and medulla

anterior inferior cerebellar artery

The anterior midline of the brain stem is marked by the ______, and the posterior midline is marked by the ______

anterior median fissure posterior median sulcus

. Branches off the left and right vertebral arteries, supplying the anterior aspect of the spinal cord, found along the anterior median fissure.

anterior spinal artery

Examples of software applications include word processing programs for writing documents (Microsoft Word), financial programs to manage your checkbook (Quicken), graphic arts programs for making brochures and more (PageMaker), games, and digital EEG recording and analysis programs.

applications software

Rather than being hardwired, like analog filters, digital filters are...

applied through the software program allowing for quick changes and modifications. Another advantage is that the digital filter does not delay or distort waveforms as analog filters do (phase shift) when narrow filter settings are applied.

The anterior cavity is the space between the cornea and lens, including the iris and ciliary body. It is filled with a watery fluid called the ______

aqueous humor

. The arachnoid emerges into the dural sinuses as the _______, where the CSF is filtered back into the blood for drainage from the nervous system.

arachnoid granulations

is a membrane of thin fibrous tissue that forms a loose sac around the CNS.

arachnoid mater

Beneath the arachnoid is a thin, filamentous membrane which looks like a spider web, giving this layer its name

arachnoid trabeculae

The progression of sleep through these stages, is called sleep _____

architecture

To copy programs and data onto an auxiliary storage medium (disk, tape,etc.) for long-term retention, such as when disk space has become full.

archive

circum-

around

peri-

around

The smooth ridge located immediately anterior to the mandibular fossa. Both the articular tubercle and mandibular fossa contribute to the temporomandibular joint, the joint that provides for movements between the temporal bone of the skull and the mandible.

articular tubercle

Any potential difference recorded due to an extracerebral source recorded in an EEG record. Examples: EKG, Pulse, EMG, Eye movements, 60 Hz noise

artifact

________ of nervous system fibers in these columns carry sensory information up to the brain,

ascending tracts

how does the 10-20 system specify locations of the brain?

assigns a number

describes EEG activity that is different (present/absent or increased/decreased) in one hemisphere when compared to the same region of the opposite hemisphere. can be caused by damage to an area of the brain or even by skull defects, which are changes in the skull bone caused by injuries or medical procedures. An increase in the amplitude is seen over the skull defect. A minimal degree of asymmetry is acceptable in normal EEG recordings

assymetry

SUPPORT. One cell providing support to neurons of the CNS is the ______ so named because it appears to be star-shaped under the microscope (astro- = "star"). Generally, they are supporting cells for the neurons in the central nervous system. Some ways in which they support neurons in the central nervous system are by maintaining the concentration of chemicals in the extracellular space, removing excess signaling molecules, reacting to tissue damage, and contributing to the blood-brain barrier (BBB).

astrocyte

What are the CNS glial cells?

astrocytes, oligodendrocytes, microglia, ependymal cells

waveforms with timing that is not the same.

asychronous

a change or difference in the appearance of a rhythm on one side.

asymmetrical An EEG can be asymmetrical because of an occurrence of or lack of a feature on one side I.e., suppression of activity over one side

Appearing with different timing over the cerebral hemispheres. The non-simultaneous occurrence of EEG activity over regions of the same or opposite sides of the head

asynchronous

V waves occur synchronously over both hemispheres, usually with a phase reversal _____. It is normal for V waves to be higher in amplitude on one side, and then shift to the other hemisphere, as long as they are not consistently decreased on one side. V waves often exceed 100 microvolts

at the midline

ADHD

attentiondeficit/hyperactivity disorder

Reduction in the amplitude of EEG activity

attentuation

Alpha rhythm ____ with eye opening and/or during mental activity/such as concentrating to answer questions.

attenuates

Alpha _____ by Eye Opening

attenuation

Reduction in the amplitude of EEG activity:

attenuation

Eyes open=

attenuation of alpha

Hearing, or ______ is the transduction of sound waves into a neural signal that is made possible by the structures of the ear

audition

The large, fleshy structure on the lateral aspect of the head is known as the _____.

auricle

a=

auricular (ear lobes)

Permission to access nonpublic information or use equipment that is either fully or partially restricted. Process of establishing what you can do.

authorization

Developmental disability commonly appearing during the first 3 years of life, affects brain function evidenced by verbal and nonverbal communication difficulties, inability to relate to anything beyond oneself

autism

A pattern characterized by bursts of theta and /or delta, at times intermixed with faster frequencies, with intervening periods of relative quiescence or flattening is called

burst suppression

designed to measure how well the autonomic nervous system regulates internal organs and functions, such as blood pressure, body temperature, heart rate, digestion, and sweating. Tests include quantitative sudomotor axon reflex test (QSART), cardiovascular tilt-table test, deep breathing/Valsalva maneuver, thermoregulatory sweat test (TST), and bladder ultrasound. Autonomic dysfunction (also known as autonomic neuropathy) may be caused by autoimmune disease, diabetes, infections or even some type

autonomic

Involuntary, unconscious regulation • Parasympathetic and sympathetic divisions associated with smooth muscle, cardiac muscle, various glands, adipose tissue

autonomic nervous system

is responsible for involuntary control of the body, usually for the sake of homeostasis (regulation of the internal environment), regulate the organ systems of the body, which usually means to control homeostasis.

autonomic nervous system

ab

away from

forms the vertical, central axis of the body and includes all bones of the head, neck, chest, and back (Figure 7.2). It serves to protect the brain, spinal cord, heart, and lungs. It also serves as the attachment site for muscles that move the head, neck, and back, and for muscles that act across the shoulder and hip joints to move their corresponding limbs.

axial skeleton consists of 80 bones

fiber that connects a neuron with its target, long nerve fiber - conducts impulses away from a nerve cell body

axon

_______ transfer electrical signals and _____ receieve them in a neuron

axon dendrites

Where the axon emerges from the cell body, there is a special region referred to as the _____. This is a tapering of the cell body toward the axon fiber

axon hillock

The length of the axon between each gap, which is wrapped in myelin, is referred to as an ______

axon segment

At the end of the axon is the axon terminal, where there are usually several branches extending toward the target cell

axon terminal

Within the axon hillock, the cytoplasm changes to a solution of limited components called ______

axoplasm

where an axon of one neuron synapses onto the soma or cell body of another neuron

axosomatic

Pathological response to stimulation of the plantar surface of the foot: a positive sign is indicated when the toes dorsiflex

babinski reflex

re-

back, again

description of the background frequencies during awake, drowsy, asleep states as well as changes seen during HV or photic stimulation. Also, consider other levels of consciousness like coma.

background and state

retro-

backward, behind

um, -a

bacterium, bacteria

Methabarbital, Primidone, Phenobarbital

barbituate

The ______ contains nuclei that are important in learning and memory.

basal forebrain

The ______ are responsible for cognitive processing, the most important function being that associated with planning movements

basal nuclei

This comes from the initial development of the spinal cord, which is divided into the _____ and the ______. The basal plate is closest to the ventral midline of the neural tube, which will become the anterior face of the spinal cord and gives rise to motor neurons. The alar plate is on the dorsal side of the neural tube and gives rise to neurons that will receive sensory input from the periphery

basal plate alar plate

An abnormal recording may have an abnormal background during resting wakefulness which may be slow or irregular but is their....

baseline rythm

Formed by the junction of the two vertebral arteries, it terminates as a bifurcation into the posterior cerebral arteries

basilar artery

The two vertebral arteries then merge which gives rise to branches to the brain stem and cerebellum.

basilar artery

The organs of Corti lie on top of the _______, which is the side of the cochlear duct located between the organs of Corti and the scala tympani. As the fluid waves move through the scala vestibuli and scala tympani, the basilar membrane moves at a specific spot, depending on the frequency of the waves.

basilar membrane

After recording, filter settings on digital EEG machines can ____.

be adjusted in the display data during review to aid in the interpratation

All transmitter substances meet certain criteria. They must be able to :

be synthesized in the pre-synaptic neuron be stored in vesicles in the pre-synaptic neuron be released by neuronal activity bind with receptors on the post synaptic cell be removed from the synaptic cleft

ante-, pre-, pro-

before

square wave should be run at the...

beginning and end

infra-

below or under

hypo-

below, deficient

14 hz and higher...

beta

A 15 Hz wave would fall into which frequency band

beta

The frequency band in EEG containing faster frequencies 13 Hz to 30 Hz

beta

inter-

between

where can you place your ground?

between fp1 and fp2

meta-

beyond, change, after

ultra-

beyond, excessive

the loss of lateral peripheral vision, known as _____

bilateral hemianopia

An appropriate _____ in a digital EEG instrument, is to record every recording electrode, in a channel where it is recording to the system reference. This allows the technologist to evaluate the input and look for asymmetries of amplitude, electrode pops, artifacts, and 60 Hz noise.

biological calibration

collabration responding equally (each channel), (i.e., Fp1-O2 all channels) should be run at the beginning of the recording after the square wave calibration

biological calibration

a waveform having 2 phases or 2 deflections on each side of the baseline

biphasic

A ____ would have 2 components or 2 phases

biphasic wave

Another name for montages designed in chains across the head

bipolar

cells have two processes, which extend from each end of the cell body, opposite to each other. One is the axon and one the dendrite. They are found mainly in the olfactory epithelium (where smell stimuli are sensed), and as part of the retina.

bipolar

The change in membrane potential alters the amount of neurotransmitter that the photoreceptor cells release onto ______ in the outer synaptic layer.

bipolar cells

BD

bipolar disorder

are less artifact-prone and provide localization and polarity information with easily recognized phase-reversals.

bipolar montages

visual loss of the temporal visual fields of both eyes o damage at the optic chiasm

bitemporal hemianopsia

melan/o

black

melano

black

examples of eye artifact

blinking & EMG in frontal leads

hem/o, hemat/o

blood

a physiological barrier that keeps many Chapter 12 | The Nervous System and Nervous Tissue 517 substances that circulate in the rest of the body from getting into the central nervous system, restricting what can cross from circulating blood into the CNS.

blood brain barrier

semi-permeable wall allows specific chemicals into brain

blood brain barrier

cyan/o

blue

somat/o

body

oste/o

bone

The other plexus from the cervical level is the ______. Spinal nerves C4 through T1 reorganize through this plexus to give rise to the nerves of the arms, as the name brachial suggests.

brachial plexus

Critical Systems in the body that are potentially harmed by electrical injury are: (Select all that apply)

brain and spinal cord, cardiovascular, respiratyory, renal system

The structures that come from the mesencephalon and rhombencephalon, except for the cerebellum, are collectively considered the brain stem, which specifically includes the midbrain, pons, and medulla.

brain stem

connects the spinal cord to the brain

brain stem

is an enlarged extension of the spinal cord. It contains all the fiber tracts connecting the higher brain structures with the spinal cord, is divided into: • Midbrain • Pons • Medulla Oblongata

brainstem

Asymmetry example shown here is the result of a skull defect note activity seen at C3 due to a called a ____. Poor electrode placement can cause assymetry. a sharply focal 6-11 Hz pattern associated with a defect in the skull, resulting from surgery or an accident (see illustrations). This rhythm is of higher amplitude than alpha rhythm, (generally exceeding 80 microvolts) and often has a spike-like appearance, particularly when beta frequencies are riding atop of it. T

breach rhythm

increase in amplitude or voltage of EEG waveforms recorded over a Burr hole

breach rhythm

a breach in the skull, causing higher amplitudes on EEG

breach rhythms

u-shaped symbol placed over vowels with a short sound

breve

describe the anatomical distinctions within the cortex, anatomy align very well with the functional differences within the cortex

brodmann's areas

Term used to describe the progressive increase in voltage of the EEG or the appearance of waves of increasing amplitude and sometimes a decrease in frequency. Sometimes used to describe the hyperventilation response.

build up

A group of waves which appear and disappear abruptly and are distinguished from the background activity by difference in frequency, form and /or amplitude.

burst

Bursts (≥0.5 s AND >3 phases) of generalized activity, in between bursts there is lower amplitude background activity (<50% of the background/bursts, but ≥10 µV i.e. not suppression)

burst attenuation

Etiology - CNS depressant drugs - Intoxication - Iatrogenic for status epilepticus or trauma - Hypothermia - Anesthesia • As coma deepens, suppression duration increases and burst duration decreases • Prognosis dependent on etiology - Poor if due to anoxia - Better when due to drugs or trauma

burst suppression

A pattern characterized by bursts of theta and/or delta at times intermixed with faster frequencies with intervening periods of relative quiescence or flattening.

burst supression

Chart speed changes the distance traveled but not the...

but not the frequency. 1 sec=1000m

Eight bits of information are called a _____. The eight bits can be in a great variety of sequences, but are always a series of the numbers 0 or 1.s are used in computer language to describe the amount of RAM that a system has, the size of a computer disk, or the size of a file

byte

_____ any EEG instrument is a means to verify that all recording channels are amplifying and filtering the same signal (a known voltage, such as 50 uV) in the same way.

calibrating

the rounded top of the skull, (skullcap)

calvaria (skullcap)

carcin/o

cancer

Acetazolamide

carbonic anhydrase inhibitor

medulla oblongata is responsible for what activities?

cardiac activity, respiration, digestion, sleep

This is the zig-zag passageway through which a major artery to the brain enters the skull. The entrance to the carotid canal is located on the inferior aspect of the skull, anteromedial to the styloid process (see Figure 7.8a). From here, the canal runs anteromedially within the bony base of the skull. Just above the foramen lacerum, the carotid canal opens into the middle cranial cavity, near the posterior-lateral base of the sella turcica

carotid canal

a zig-zag shaped tunnel that provides passage through the base of the skull for one of the major arteries that supplies the brain. Its entrance is located on the outside base of the skull, anteromedial to the styloid process. The canal then runs anteromedially within the bony base of the skull, and then turns upward to its exit in the floor of the middle cranial cavity, above the foramen lacerum.

carotid canal

Valproic Acid

caroxylic acid

ascending (afferent) tracts

carry information to the brain, direction

phor/o

carry or bear

The vacuum tube contains a ______ and a metal plate separated by a grid of wire mesh

cathode

. As the vertebral column grows, these nerves grow with it and result in a long bundle of nerves that resembles a horse's tail and is named the _____.

cauda equina

The major structures of the basal nuclei that control movement which are located deep in the cerebrum

caudate, putamen, globus pallidus

cyt/o

cell

l is the smallest independently functioning unit of a living organism.

cell

a varity of molecules combine to form the fluid and organelles of a body cell

cellular level

how to apply?

center of cross mark, use side of cue tip, seep through and gauz, R and L ekg right under clavicle

c=

central

There are four ventricles within the brain, all of which developed from the original hollow space within the neural tube, the _____

central canal

A ______ in the lateral horn of any of these spinal regions projects to ganglia adjacent to the vertebral column through the ventral spinal roots.

central neuron

there is a major curve between the brain stem and forebrain, which is called the ______. starts in an inferior position—the end of the spinal cord—and ends in an anterior position, the front of the cerebrum

cephalic flexure

What is the 2nd largest part of the brain?

cerebellum

is the "little brain." It is covered in gyri and sulci like the cerebrum, and looks like a miniature version of that part of the brain. is largely responsible for comparing information from the cerebrum with sensory feedback from the periphery through the spinal cord

cerebellum

cerebell/o

cerebellum (little brain)

X-ray of the blood vessels in the brain made after intracarotid injection of contrast medium.

cerebral angiogram

The third ventricle is the space between the left and right sides of the diencephalon, which opens into the _______ that passes through the midbrain

cerebral aqueduct

At another synapse, neurotransmitter is released and binds to its receptor. The thalamus then sends the sensory information to the _______, the outermost layer of gray matter in the brain, where conscious perception of that water temperature begins.

cerebral cortex

thromus gradually builds, blocking artery

cerebral thrombosis

Relating to the opposite side of the head or body

contralateral ex: "A contralateral ear reference montage is one that refers the electrodes on one side of the head to the ear on the opposite side." FP1-A2 FP2-A1 F3-A2 F4-A1 C3-A2 C4-A1 P3-A2 P4-A

Tests like the finger-to-nose test and heel-to-shin test assess coordination and balance.

coordination and balance

runs from side to side across the skull, within the coronal plane. It joins the frontal bone to the right and left parietal bones

coronal suture

Deep within the cerebrum, the white matter of the ________ provides the major pathway for communication between the two hemispheres of the cerebral cortex

corpus callosum

The simplest and correct way to access the frequency of a wave is to:

count how many times it cycles within 1 second

power cord near lead wires will pick up signal

coupling

The combining form meaning skull

crani/o

The interior space that is almost completely occupied by the brain is called the

cranial cavity

: Tests each of the 12 cranial nerves to evaluate functions like vision, smell, eye movement, and facial sensation.

cranial nerve exam

Another type of sensory ganglion is a _______. This is analogous to the dorsal root ganglion, except that it is associated with a cranial nerve instead of a spinal nerve.

cranial nerve ganglion

carry impulses to and from the brain.

cranial nerves

excision of part of the skull to approach the brain:

craniectomy

Incision into the skull to approach the brain

craniotomy

is the skeletal structure of the head that supports the face and protects the brain

cranium, skull

National organizations offer examination for registry and/or certification to demonstrate competence in all specialties of the profession

creditentialing

To either side of the crista galli on the ethmoid bone is the ______ (cribrum = "sieve"), a small, flattened area with numerous small openings termed olfactory foramina. Small nerve branches from the olfactory areas of the nasal cavity pass through these openings to enter the brain.

cribiform plate

______ ("rooster's comb or crest") is a small upward bony projection located at the midline of ethmoid bone. It functions as an anterior attachment point for one of the covering layers of the brain.

crista galli

Items that enter tissue or vascular spaces or that blood flows through

critical items

-tripsy means

crushing

______ are provided for making measurements of voltage and duration on the monitor screen. The voltage of waveforms is calculated by measuring the deflection/height of the waveform and multiplying by the sensitivity setting in microvolts (V= SxD). It is more helpful and accurate to consider how may seconds of EEG are on the computer screen and to use the computer generated rulers

cursors

A complete series of changes undergone by a wave or complex before the series of changes are repeated

cycle

Unit of frequency. Also called Hertz abbreviated "Hz"

cycle per second or hertz

Channels for anions (negative ions) will have positively charged side chains in the pore. This is, meaning that the channel pore is charge-specific

d electrochemical exclusion,

Data files are the ones that you create. If the hard drive should fail, all data files will be lost, unless a backup copy has been safely stored. • All computer files are saved in the computer index, which lists a name, date and time of creation, size, and other information. Computer files can be copied, renamed, archived, deleted, etc.

data software files

A device or medium that can retain data for subsequent retrieval.

data storage

necr/o

death

The process of removing infectious organisms and rendering objects safe for handling

decomanitation

Zarontin (ethosuximide)

decreased spike wave activity with altered vigilence or no effects

DTR

deep tendon reflex

During the digital recording, it is necessary for the technologist to change display montages on the computer screen in order to

define artifacts, localize activity, stage sleep, see alpha reactivity, etc.

During the digital recording, it is necessary for the technologist to change display montages on the computer screen in order to ______.

define artifacts, localize activity, stage sleep, see alpha reactivity, etc.

The frequency band in EEG containing frequencies less than 4 Hz

delta

W. Grey Walter, in England (1936), had demonstrated the presence of a _____ focus over brain tumors, opening the way for other non-epileptic uses for the EEG

delta

less tha 4 hz is..

delta

The requirement for verifying that the electrodes and electrode board (head-box) are connected to the instrument

demonstrates to the interpreting physician that the electrodes are placed on the patient's head and the cabling is connected to the equipment.

structural classification of the nervous system

divides the nervous system in terms of its structures

meaning the membrane potential moves toward zero. The resting potential is the state of the membrane at a voltage of -70 mV, so the sodium cation entering the cell will cause it to become less negative.

depolarization

the potential across the membrane is reversed from its resting value to the extent that the inside of the cell is now more positive than the outside (also referred to as...

depolarization

One set of two electrodes placed into one channel of the electroencephalograph is called _____.

derivation

_______ carry motor commands from the brain along the spinal cord

descending tracts

controls the video card in order to send the correct signals to the monitor. • The three elements must be fitted and matched to achieve quality images. Even the highest level, expensive monitor will display only mediocre images if it is connected through a low-quality video card. The video system is its own sub- system of the PC and experiences its own technological development.

device driver

is, es

diagnosis, diagnoses

provide the name of a medical condition

diagnostic suffixes

is the one region of the adult brain that retains its name from embryologic development. translates to "through brain." It is the connection between the cerebrum and the rest of the nervous system

diencephalon

size of an apricot, regulates sensations, weight regulation, energy, and instinctual behaviors

diencephalon

______ exist for different people with variable effects possible on EEG due to AEDs and other drugs.

different thresholds

The technical improvements introduced by Adrian and Matthews include the mirror galvanometer, a writer unit using a pen motor powered by electromagnetic driving coils, and an early type of ______. (Present-day differential amplifiers were probably developed at Bell Labs in the early 1930s.)

differential amplifier

Widespread, occurring over large areas of one or both hemispheres

diffuse

The types of negative effects of drugs on EEG include: (select all that apply)

diffuse slowing, electrocerebral inactivity

assigning numerical value to waveform theough analog to digital coverter

digital EEG

are a high-capacity optical disk that is the same physical size as the CD. Like the CD, data is stored in small indentations in a spiral track, only the DVD tracks are narrower allowing for more storage capacity.

digital verstile disks or DVDs

Thomas Edison (1883) accidentally discovered the _____. He found that electrons will flow from a hot wire in a vacuum to a positively charged plate in the same tube but will not flow if the plate is negative.

diode

Means having 2 equal and opposite electrically charged poles separated by a short distance.

dipole

positive and negative lead, two wires, electricl force flow through wires to appliance and back to battery (like a river through whole thing)

direct current

The ______ is the projection of axons from the striatum to the globus pallidus internal segment (GPi) and ______

direct pathway substantia nigra pars reticulata

Motor/Efferent Division direction

direction-descending & location-ventral/anterior

-rrhea

discharge

seen occasionally, interrupted

discontinuous

path/o

disease

The direct pathway causes the ______of the thalamus (inhibition of one cell on a target cell that then inhibits the first cell), whereas the indirect pathway causes, or reinforces, the normal inhibition of the thalamus. The thalamus then can either excite the cortex (as a result of the direct pathway) or fail to excite the cortex (as a result of the indirect pathway)

dishinhibition

Widespread changes in frequency, form, topography, or quantity of EEG patterns with a lack of rhythmic occurrence of background activity

disorganization

In Evoked Potentials, display gain is an "after the average" increase or decrease in the size of the waveform displayed on the screen or page. It has a similar effect as a change in sensitivity but is done after the averaging process is completed.

display gain

The difference between display montage and recording montage is that the_____.

display montage is what you see on the computer monitor, recording montage is what is stored to disk.(raw data)

The information collected using the system reference montage will form the raw data that is used to create the variety of _____ during recording, review and interpretation. Knowledge of the appropriate use of montages to display EEG activity is an important skill that aids the interpreting physician to better recognize abnormalities.

display montages

n (sometimes referred to as topography) refers to a surface location of the brain where a pattern or waveform appears. (where is the pattern located, occipital, etc.)

distribution

scalp distribution expressed in electrode location or area of the head (temporal, occipital) generalized, focal, multifocal symmetry, synchrony

distribution and location

how to measure parasagittal-

divide into 4 parts, 25 and 50% F3, C3, P3

how to measure frontal

divide into 4 parts, 25 and 50% (anterior coronals)

functional classification of the nervous system, is used with PNS structures

divides the nervous system in terms of its ac)vi)es

a solid, liquid, or gas particle that travels through the bloodstream and lodges in a smaller blood vessel, causing an obstruction. Emboli can be composed of various materials, such as blood clots, fat, air bubbles, or foreign objects. When an embolus becomes lodged in a blood vessel, it can block blood flow, leading to tissue damage or infarction in the area downstream from the obstruction. This can disrupt circulation and result in various medical conditions, such as pulmonary embolism or stroke

embolism

The combining form meaning entire brain

encephal/o

By the 7th week of development, these three areas divide again. This process is called ______.

encephalization

Finally, individual axons are surrounded by loose connective tissue called the ________

endoneurium

responsible for controlling the smooth muscle and glandular tissue in your digestive system. It is a large part of the PNS, and is not dependent on the CNS.

enteric nervous system

y. Many of the neural structures that are incorporated into other organs are features of the digestive system; these structures are known as the ______ and are a special subset of the PNS

enteric nervous system

encephal/o

entire brain

line brain venticles

epednymal cells

CREATING CSF. ______ is a glial cell that filters blood to make _______, the fluid that circulates through the CNS.

ependymal cell cerebrospinal fluid (CSF)

Waveforms often associated with epilepsy such as spikes, sharp waves or spike and slow waves

epileptiform

Morphology of waves in the shape of an epileptic discharge. Distinctions exist between ictal (during a seizure) and interictal (between seizures). Descriptors include spikes (duration <70ms), sharp waves (duration 70-200msec), polyspikes and spike and slow wave complexes. Location/ Topography can vary. Note examples of generalized and multifocal epileptiform discharges.

epileptiform activity

The exact location of the brain from which an underlying epileptiform discharge originates.

epileptogenic focus

The outer surface of a nerve is a surrounding layer of fibrous connective tissue called the ______

epineurium

There are other structures, such as the _____, which contains the pineal gland, or the _____, which includes the subthalamic nucleus that is part of the basal nuclei.

epithalamus subthalamus

esophag/o

esophagus

The lateral aspects of the ethmoid bone contain multiple small spaces separated by very thin bony walls. Each of these spaces is called an ______. These are located on both sides of the ethmoid bone, between the upper nasal cavity and medial orbit, just behind the superior nasal conchae.

ethmoid air cell

is a single, midline bone that forms the roof and lateral walls of the upper nasal cavity, the upper portion of the nasal septum, and contributes to the medial wall of the orbit, also forms a portion of the floor of the anterior cranial cavity

ethmoid bone

The study of the cause of a disease:

etiology

right is....

even

Ralph W. Gerard led a group of investigators studying electrical changes in nerve cells. Using a concentric needle electrode on a stereotaxic electrode carrier they explored the cranial contents of exposed animal brains. They were able to distinguish spontaneous activity from _____, terms that they introduced.

evoked potentials

recordings of electrical activity from the brain, spinal nerves, or sensory receptors in response to specific external stimulation, are helpful in evaluating a number of different neurological problems, including spinal cord injuries, hearing loss, blurred vision and blind spots, acoustic neuroma, and optic neuritis, using either earphones to stimulate the hearing pathway, a checkerboard pattern on a television screen to stimulate the visual pathway, or a small electrical current to stimulate a

evoked potentials

recording of elcetrical activity from the brain, spinal nerves, or senesory receptors, in response to external stimuli

evoked potentials (EP)

Some AEDs may...

exacerbate seizures! Non-convulsive status epilepticus may occur with TGB with electroclinical features of absence

phob/o

exaggerated fear or sensitivity

-rrhage, -rrhagia

excessive discharge

To understand how neurons are able to communicate, it is necessary to describe the role of an ________ in generating these signals.

excitable membrane

Physiologically, the EEG is the result of..

excitatory and inhibitory post synaptic potential activity which is volume conducted through the extracellular space. EEG activity recorded on the surface of the scalp is the result of summed ionic currents from many thousands of neurons located under each recording electrode.

These changing areas of positivity and negativity are _______. Pyramidal neurons are arranged within the cortical layers in a way that facilitates the creation of field potentials, or areas of positivity or negativity, near the cortical surface.believed to be the origin of the EEG waveforms seen on scalp recordings

excitatory post synaptic potentials (EPSP) and inhibitory post synaptic potentials (IPSP).

Looking at transient changes in blood oxygen levels triggered by certain tes3ng procedures (so called paradigm) • Non-invasive way to iden3fy language and memory dominance as well as mapping of motor/sensory func3on

fMRI

The _______ underlie the facial structures, form the nasal cavity, enclose the eyeballs, and support the teeth of the upper and lower jaws. ______ surrounds and protects the brain and houses the middle and inner ear structures

facial bones rounded brain case

type: mixed sensory and motor nerve • origin: pons • function: • (sensory) provide some taste -anterior tongue. • (motor) Activates muscles for facial expressions, lacrimal and salivary glands (supplies all facial muscles, except those provided by the fifth nerve.

facial nerve

A sharp wave is a transient with a duration of less than 70 msec but more than 20 msec and commonly (though not exclusively) negative in polarity.

false

A waveform may appear continuously or discontinuously. Continuous means in a constant on and off pattern

false

After the statement regarding normality or degree of abnormality of the record, the reasons upon which the conclusion is based should be briefly listed. When dealing with several types of abnormal features, the list should be limited to the two or three main ones; the least characteristic of the record.

false

Areas of the cortex contain changing positivity and negativity known as excitatory positive somatic potentials and inhibitory post synaptic potentials.

false

Careful use and understanding of EEG terminology brings specific disadvantages to the writers and readers of EEG reports.

false

Cleaning is the same thing as disinfecting and disinfecting is the same thing as sterilizing

false

Data collection during surgery has not yet expanded to multiple modality monitoring.

false

Digital EEG Instruments differentially amplify all inputs in relation to ipsilateral references and then the software programs form montages by effectively subtracting input 1 from input 2 for each derivation.

false

Digital EEG is recorded in a bipolar montage and is then remontaged referentially.

false

Dr. Libenson, describes arousal hypersynchrony as an abnormal transition between wakefulness to drowsiness.

false

Hypnapomic hypersynchrony is abnormal EEG finding, Hypnagogic hypersynchrony is an abnormal EEG finding

false

Microsurgery utilizes a microscope to dissect minute structures during an EEG

false

Neurodiagnostics is the allied health care profession that records, monitors, andanalyzes integumentary system function to promote the effective treatment of pathologic conditions.Technologists record electrical activity arising from the brain, spinal cord, peripheral nerves,somatosensory or motor nerve systems using a variety of techniques and instruments.Technologists prepare data and documentation for interpretation by a physician

false

PERRLA is an abbreviation for pupils evaluated, round and reactive to light and accommodation

false

Research does not support EEG as an important tool for diagnosing clinical and subclinical status epilepticus to help insure earlier intervention and better patient outcomes.

false

Response to opening and closing eyes as well as to purposeful movement of the extremities when appropriate, should not be described.

false

SREMS are rapid eye movements typically seen 60-90 minutes after sleep onset during a state of dreaming.

false

Sleep is considered an activating procedure for recording normal EEG

false

There is no difference between the calibration function in an analog and a digital EEG instrument.

false

Using Fp1-O2 for a BioCal on a digital equipment would only show the frequency response in those two electrodes in all individual amplifiers.

false

tachy-

fast

As technology advances, converters become even faster, thereby eliminating the skew problem based simply on their rapid operation.

faster ADCs

lip/o

fat

The _____ is one of the major nerves from this plexus, which gives rise to the saphenous nerve as a branch that extends through the anterior lower leg

femoral nerve

oligo-

few or deficient

fibr/o

fiber

deflective/flabby or absent muscle control caused a nerve lesion

flaccid paralysis

Significantly dulled emotional tone or outward reaction

flat affect

Vowels that are not accented have a ____

flat sound

The more anterior projection on the mandlible which provides attachment for one of the biting muscles

flattened coronoid process of the mandible

confined to one area

focal

in a clearly delineated area of the brain as in a focal temporal spike or focal slowing.

focal

Plural of focus.

foci/focuses

A limited region of the scalp, cerebral cortex or depth electrode recording site displaying a given EEG activity, either normal or abnormal.

focus

The bones of the newborn skull are not fully ossified and are separated by large areas called ____, which are filled with fibrous connective tissue. allow for continued growth of the skull after birth. At the time of birth, the facial bones are small and underdeveloped, and the mastoid process has not yet formed.

fontanelles

The vertebral arteries enter the cranium through the foramen magnum of the occipital bone.

foramen magnum

allows for passage of the spinal cord as it exits the skull.

foramen magnum

This rounded opening (rotundum = "round") is located in the floor of the middle cranial fossa, just inferior to the superior orbital fissure. It is the exit point for a major sensory nerve that supplies the cheek, nose, and upper teeth.

foramen rotundum

morph/o

form

quadri-

four

quadro

four

This galvanometer has a time constant of about _______, a great improvement over the Thomson galvanometer used by Caton.

four seconds

The aqueduct opens into the ________, which is the space between the cerebellum and the pons and upper medulla

fourth ventricle

at the exact center of the retina is a small area known as the ______. At the fovea, the retina lacks the supporting cells and blood vessels, and only contains photoreceptors. Therefore, visual acuity, or the sharpness of vision, is greatest at the fovea.

fovea

Left frontal pole= frontal= inferior frontal= anterior temporal= mid-temporal= posterior temporal= central= parietal= occipital=

fp1 f3 f7 t1 or f9 t3/t7 t5/p7 c3 p3 o1

10% of circumference across fpz to find horizontal mark...

fp1 and fp2 (5%)

for parasagittal you measure from _____

fp1 to o1 interescting c3 fp2 to o2 intersecting c4

Right frontal pole= frontal= inferior frontal= anterior temporal= mid-temporal= posteror temporal central= parietal= occipital=

fp2 f4 f8 t2 or f10 t4/t8 t6/p8 c4 02 p4

Midline frontal pole= frontal central parietal= occipital=

fp2 fz cz pz oz

what two electrodes are not standard but are used in achieving others

fpz and oz

what intersection marks are in the circumference, typical is 50-60

fpz, oz, t3, and t4 (measure above or below)

cycles per second. The standard unit of frequency is "Hertz"

frequency

is the number of repetitions of an EEG wave in one second. The unit of measurement is cycles per second or hertz (abbreviated Hz, we use a capital in Hz because it is named after a person, Heinrich Hertz, who made contributions to the science of electromagnetism). is calculated by counting the number of waves that occur during one second of time. is expressed in cycles per second, or Hertz (Hz).

frequency

The adult human EEG is comprised of patterns and waveforms that vary in...

frequency, amplitude, location and polarity

de-

from, down, or not

Anterior section of each cerebral hemisphere responsible for voluntary muscle movement and personality

frontal

f=

frontal

e is the single bone that forms the forehead

frontal bone

are important in eliciting eye movements and in attending to visual stimuli.

frontal eye fields

Anterior to the central sulcus is the ______, which is primarily associated with motor functions.

frontal lobe

higher intellectual functions • dominant hemisphere expressive or motor speech center (Broca's area). • primary motor cortex (motor strip) o homunculus type body projection o Location: frontal pole to the central sulcus

frontal lobe

is the plane that divides the body or an organ into an anterior (front) portion and a posterior (rear) portion. The frontal plane is often referred to as a coronal plane

frontal plane

Fp=?

frontal polar

is located just above the eyebrows, within the frontal bone, This irregular space may be divided at the midline into bilateral spaces, or these may be fused into a single sinus space.

frontal sinus

cerebral death uses a ____ set, must be under _____ ohms but over _____ ohms and interelcetrode sitance should be at least ____cn

full 10,000 100 10

Taking quantitative EEG one step further is the combination of EEG data with functional mapping and MRI/CT images to provide a 3D image of the brain. Such systems are currently commercially available, and offer insights into the

functional MRI (fMRI)

-us, -i

fungus, fungi

a prefix is used only as needed to...

further modify the root or roots.

Evaluates the patient's walking pattern and coordination while walking.

gait exam

, first called a multiplier because it used coils of current-carrying wire to measure small electrical currents

galvanometer

consists of a current-carrying coil mounted on a shaft. The shaft and coil are set between the poles of a permanent magnet. As soon as current passes through the coil, it becomes a magnet with a north and south end. The attraction between the magnetic north end of the coil and the south end of the fixed magnet causes the shaft to rotate. The stronger the electrical current in the coil, the stronger the magnetic attraction.

galvanometer

The frequency band in EEG containing faster frequencies above 30 Hz

gamma

The enteric plexus is actually part of the enteric nervous system, along with the ______. Though the enteric nervous system receives input originating from central neurons of the autonomic nervous system, it does not require CNS input to function

gastric plexuses and esophageal plexuses

Ion channels do not always freely allow ions to diffuse across the membrane. Some are opened by certain events, meaning the channels are...

gated

open and close in response to various types of stimuli and are useful for rapid neuronal signaling.

gated membrane channel

Diffusely spread across all channels.

generalized

occurring simultaneously throughout the recording electrodes. A discharge can be primarily generalized (generalized from the onset) or secondarily generalized (beginning focally and spreading to become generalized)

generalized

seen over the entire head; not limited to a specific area

generalized

For the unipolar cells of sensory neurons—both those with free nerve endings and those within encapsulations—graded potentials develop in the dendrites that influence the generation of an action potential in the axon of the same cell. This is called a ________

generator potential

The _______ name is the official, non-proprietary name given to a drug.

generic

Approximately 1 billion bytes, 1 GB is 1 gigabyte or 1 gig

gigabyte

At its anterior midline, between the eyebrows, there is a slight depression called the ______

glabella

aden/o

gland

is one of a variety of cells that provide a framework of tissue that supports the neurons and their activities.

glial cell

slow wave patient moves tongue while talking, highest in infra orbital electrodes

glossokinetic artifact

• type: mixed sensory and motor nerve • origin: medulla • function: • (sensory) impulses o for taste sensation (posterior portion of the tongue) o pressure receptors of the carotid artery • (motor) impulses for pharynx o swallowing o saliva production

glossopharygeal nerve

gli/o

glue

A neurotransmitter associated with EPSP:

glutamate

eu-

good, normal

if the stimulus is strong, the voltage of the cell membrane will change enough to generate an electrical signal that will travel down the axon

graded potential

This is also called the video card or video adapter. It is an expansion card (back to the motherboard) that delivers electric signals to the monitor.

graphics card

(the regions with many cell bodies and dendrites

gray matter

beta range is..

greater than 13 hz

y is the study of the larger structures of the body, those visible without the aid of magnification

gross anatomy

wire in wall that goes to ground

ground

is the ridge of one of those wrinkles in cerebral cortex

gyrus

The organs of Corti contain hair cells, which are named for the ______ extending from the cell's apical surfaces

hair like stereocilia

hemi-, semi-

half

The three ossicles are the malleus, incus, and stapes, which are Latin names that roughly translate to _______.

hammer, anvil, stirrup

The _____ is the bony plate that forms the roof of the mouth and floor of the nasal cavity, separating the oral and nasal cavities.

hard palate

A computer component that you can see and touch:

hardware

A wave or frequency that is an integral multiple of a given fundamental frequency. Harmonics and subharmonics are seen in Photic driving responses and sometimes in electrical noise.

harmonic

cephal/o

head

INFECTIONS ACQUIRED IN A HOSPITAL/health care setting, Patients have increased susceptibility to infectious disease: compromised health, immune disorders, prematurity /infancy.

health care associated infections

An infection that is acquired in a healthcare facility is currently known as

healthcare associated infections

cardi/o

heart

60 mm/second, 5 seconds does what?

helps identify fast frequencies like 60 Hz

occurs when a blood vessel in the brain ruptures and causes bleeding within the brain tissue. This rupture is often due to the weakening of blood vessel walls, such as those affected by an aneurysm or hypertension (high blood pressure). Hemorrhagic strokes disrupt circulation by releasing blood into the brain, increasing intracranial pressure, and compressing brain tissue. This leads to neurological symptoms and potential brain damage

hemmorahgic stroke

Codeine

high amplitude diffuse beta

Valium (diazepam)

high amplitude diffuse beta

Alcohol (ETOH) Acute Use

high concentration of seizures

disinfection achieved by using germicides, sporicides and tuberculocides, sodium hypochlorite, chlorine dioxide, and hydrogen peroxide.

high level

is the inferior pair of these enlargements and is part of the auditory brain stem pathway. Neurons of the inferior colliculus project to the thalamus, which then sends auditory information to the cerebrum for the conscious perception of sound

inferior colliculus

bony plates are seen projecting from each lateral wall, an independent bone of the skull

inferior nasal concha

form a curved bony plate that projects into the nasal cavity space from the lower lateral wall

inferior nasal conchae

The _____ muscle originates from the floor of the orbit and inserts into the inferolateral surface of the eye.

inferior oblique

Sensory information from the periphery, which enters through spinal or cranial nerves, is copied to a nucleus in the medulla known as the ______

inferior olive

Consent of a patient after being informed of the risks and benefits of a procedure and alternatives, often required by law when a reasonable risk is involved.

informed consent

is the point of emergence for a sensory nerve that supplies the anterior face below the orbit.

infraorbital foramen

Below the level of the zygomatic arch and deep to the vertical portion of the mandible is another space called the _____

infratemporal fossa

Hyperpolarization in a postsynaptic potential is an _____ because it causes the membrane potential to move away from threshold.

inhibitory postsynaptic potential (IPSP)

Because the axon hillock represents the beginning of the axon, it is also referred to as the ______

initial segment

This confirmation of the presence of a spontaneous brain rhythm spurred Davis to improve the recording system. E. L. Garceau, the department's electronic engineer, produced an on-line recording system. This equipment used a recorder developed by Western Union for writing with an...

ink stylus

The stapes is then attached to the ______, where the sound waves will be transduced into a neural signal.

inner ear

Photoreceptor cells have two parts, the _______

inner segment and outer segment

devices that send information to a computer for processing

input

Devices that allow you to enter information and communicate with the computer:

input devices

are components that are connected to the computer and send information to it. • Keyboard, mouse, trackball or touch pad • Scanners • Audio and Video

input devices signals can be sent to the computer from microphones, cameras, or prerecorded tapes. Both audio and video signals are allowed to enter the computer through cards (sound or video) that are inserted into the motherboard expansion slots. These cards do not use serial or parallel ports. The card edge faces towards the back of the computer where a connector for the input is located. The software that operates the cards is needed and provides the capability of hearing, viewing, and manipulating the results. Multimedia is the buzz word for a computer that simultaneously outputs visual displays and sound.

Some instruments accomplish calibration by sending the exact same trigger signal (or voltage) from the computer into each amplifier and then the computer will store the response of the amplifiers. This is similar to..

inputting a 50 uV signal into all of the amplifiers and recording the pens response on paper.

"graph"

instrument

association areas, combines sensory perceptions and higher cognitive functions such as memories, learning, and emotion to produce a response. Stimuli that are received by sensory structures are communicated to the nervous system where that information is processed and information is compared.

integration

Spinal nerves of the thoracic region, T2 through T11, are not part of the plexuses but rather emerge and give rise to the ______ found between the ribs, which articulate with the vertebrae surrounding the spinal nerve.

intercostal nerves

A development of particular importance to technologists was Fred Gibbs dramatic discovery of _______ spike or sharp activity in the anterior temporal regions of patients with psychomotor epilepsy.

interictal

In EEG this term is used to describe those abnormal EEG discharges not associated with clinical symptoms of a seizure. discharges can look exactly the same as ictal discharges but interictal discharges not associated with a seizure.

interictal

disinfection achieved using germicides and tuberculocides with sodium hypochlorite, and ethanol or isopropyl alcohol

intermediate level

happening from time to time with no definite periodic pattern

intermittent

This opening is located inside the cranial cavity, on the medial side of the petrous ridge. It connects to the middle and inner ear cavities of the temporal bone

internal acoustic meatus

the common carotid arteries, which further branch into the _____

internal carotid arteries

Ascends through base of skull to give rise to the anterior and middle cerebral arteries, and connect with posterior half of circle of Willis via posterior communicating artery

internal carotid artery

enters the cranium through the carotid canal in the temporal bone.

internal carotid artery

very large pyramidal cells; a few loosely packed stellate cells

internal pyramidal layer

processes info by...

interprets the sensory input & makes decisions about what to do with info.

Infection Control Practices place emphasis on ________ of infection at the point of transmission ______ source and host.

interrupting the spread between

The first two are named the lateral ventricles and are deep within the cerebrum. These ventricles are connected to the third ventricle by two openings called the ______

interventricular foramina

On the same side

ipsilateral ex: An ipsilateral ear reference montage, is a montage that refers all the electrodes in Grid 1 (aka Input 1) to the ear or mastoid on the same side of the head in Grid I (aka Input 2). FP1-A1 FP2-A2 F3-A1 F4-A2 C3-A1 C4-A2 P3-A1 P4-A2

Overlaying the ciliary body, and visible in the anterior eye, is the ______—the colored part of the eye. The iris is a smooth muscle that opens or closes the pupil, which is the hole at the center of the eye that allows light to enter.

iris

One of the greatest advantages of the digital EEG recording over analog recordings

is the ability to change motages and filter settings after the recording has been made

Symptom: The system will not power up and there are no lights on any component. What is the first troubleshooting question?

is the machine plugged in?

describe a symmetric EEG:

is used to describe EEG amplitude and frequency in homologous, or similar, regions of the head. In general, normal EEG activity that occurs over both hemispheres in expected to be symmetric. It may be difficult to assess the symmetry of a sinusoidal pattern because of amplitude changes that are characteristic of the pattern. The range of amplitude changes, however, should be similar.

happens when there is a blockage (usually an embolus or thrombus) in a blood vessel that supplies blood to the brain. This blockage results in reduced or entirely blocked blood flow to a specific region of the brain. As a result, brain cells in the affected area do not receive enough oxygen and nutrients, leading to their injury or death. Ischemic strokes disrupt circulation by depriving the brain of blood flow, causing neurological deficits and potentially permanent damage

ischemic stroke

Up until the point that you actually activate the program in which you wish to collect or analyze neurodiagnostic data, you are mainly dealing with: (select all that apply)

its operating system (Windows, NT, or DOS), b. the basic computer and startup routine (BIOS or CMOS), c. the hardware peripherals associated with it (keyboard, mouse, monitor, network, external drives).

arthr/o

joint

Immediately inferior to the internal acoustic meatus is the large, irregularly shaped ______. Several cranial nerves from the brain exit the skull via this opening. It is also the exit point through the base of the skull for all the venous return blood leaving the brain

jugular foramen

usually appear in Stage N2 sleep, and may also seen in Stages N3 sleep. They are high voltage transients with similarities to V waves in amplitude and location. consists of a small sharp component followed by a high voltage slow wave, often with sleep spindles superimposed upon it (see illustration)

k complex

what are the inputs?

keyboard, mouse, video camera, amplifier

nephr/o, ren/o

kidney

Literally, a thousand bytes but it is actually 1,024 bytes. 640 KB is read as 640

kilobyte

gnos/o

knowing

(an excessive posterior curvature of the thoracic region)

kyphosis

is a small, rectangular bone that forms the anterior, medial wall of the orbit

lacrimal bone

The anterior portion of the lacrimal bone forms a shallow depression called the ______, and extending inferiorly from this is the ______

lacrimal fossa nasolacrimal canal

Tears are produced by the _____, located beneath the lateral edges of the nose. Tears produced by this gland flow through the _______ to the medial corner of the eye, where the tears flow over the conjunctiva, washing away foreign particles

lacrimal gland lacrimal duct

Sharp transients occurring over the occipital region of the head of awake patients during visual scanning of a pattern. This is a normal pattern seen in some patients and not readily seen in others.

lambda

Sharp transients occurring over the occipital region of the head of waking patients during visual scanning of a pattern

lambda

Which of the following occipital waveforms can be elicited by having the patient scan a complex image?

lambda

only seen with eyes open F. 4 - 6 Hz M. Sharply contoured with variable amplitude, usually less than 50 uv T. Occipital, positive polarity R. Occurs during wakefulness while the subject is scanning a pattern or busy picture

lambda waves

extends downward and laterally to either side away from its junction with the sagittal suture. joins the occipital bone to the right and left parietal and temporal bones. This suture is named for its upside-down "V" shape, which resembles the capital letter version of the Greek letter lambda (Λ). T

lambdoid suture

macro-

large, long

Most voltage buildup=_____impedances

largest

. The single median aperture and the pair of ______ connect to the subarachnoid space so that CSF can flow through the ventricles and around the outside of the CNS.

lateral apertures

The white matter on either side of the spinal cord, between the posterior horn and the axons of the anterior horn neurons, are the _____

lateral columns

what horn is only found in the thoracic, upper lumbar, and sacral regions, is the central component of the sympathetic division of the autonomic nervous system.

lateral horn

separates the temporal lobe from the other regions is one such landmark.

lateral sulcus

Activity isolated to one hemisphere or bilateral with consistently higher amplitude in one hemisphere over the other

lateralized

This small flap of bone is named for its shape, It is located immediately next to the mandibular foramen, on the medial side of the ramus. A ligament that anchors the mandible during opening and closing of the mouth extends down from the base of the skull and attaches

lingula

e. There should be _____ or no difference in the frequency of the alpha rhythm between the left and right hemispheres.

little (less than 1 Hz)

Chloral Hydrate

little to no effects or increased anterior beta activity

hepat/o

liver

Limited to a definite area or part

localized

(aka Topography)

location

recording of EEG (with ot without video) over extended periods oof time

long term monitoring (LTM)

(commonly known as the double banana) montages, group channels into left hemisphere and right hemisphere sets for easy comparison between hemispheres.

longitudinal bipolar

There is a large separation between the two sides of the cerebrum called the _______. separates the cerebrum into two distinct halves, a right and left _____

longitudinal fissure cererbral hemisphere

s (an excessive anterior curvature of the lumbar region),

lordosis

what is the goal of prepping the skin?

low and equal skin impedence without skin breakdown

disinfection achieved by wiping with hospital disinfectants, sodium hypochlorite, ethanol or isopropyl alcohol

low level

An EEG with the majority of waveforms less than 20 uv

low voltage EEG

the shorter the distance between electrodes, the ______ the amplitude

lower (placing a full one on an infant creates low amplitude)

At the level of the spinal cord at which this axon makes a synapse, a graded potential occurs in the cell membrane of a ______

lower motor neuron

Lowest voltage buildup=_____ impedence

lowest

Later, as the child begins to stand and then to walk, the ______ of the lower back develops

lumbar curve

The _____ arises from all the lumbar spinal nerves and gives rise to nerves enervating the pelvic region and the anterior leg.

lumbar plexus

LP

lumbar puncture

The spinal cord does not extend through the lower lumbar region of the vertebral column, a needle can be inserted through the dura and arachnoid layers to withdraw CSF. This procedure is called a ______ and avoids the risk of damaging the central tissue of the spinal cord

lumbar puncture

straight line (¯) placed over vowels with a long sound

macron

A term used in cardiology to denote a moderate to high level of electric current passing across two areas of intact skin: aprox 100 mA can cause ventricular fibrillation

macroshock

MRA

magnetic resonance angiography

what to do with scalp lesions or sutures?

maintain seemtry, midline move anterior or posteirior and document

how to measure skull deformities?

make separate measurementd over deformity

60 Hz artifact can be reduced or eliminated by ____

making sure that the electrode impedances are low 1-5K ohms and balanced.

Cancerous

malignant

forms the lower jaw and is the only moveable bone of the skull

mandible

This opening is located on the medial side of the ramus of the mandible. The opening leads into a tunnel that runs down the length of the mandibular body. The sensory nerve and blood vessels that supply the lower teeth enter and then follow this tunnel. Thus, to numb the lower teeth prior to dental work, the dentist must inject anesthesia into the lateral wall of the oral cavity at a point prior to where this sensory nerve enters the mandibular foramen

mandibular foramen

This is the deep, oval-shaped depression located on the external base of the skull, just in front of the external acoustic meatus. The mandible (lower jaw) joins with the skull at this site as part of the temporomandibular joint, which allows for movements of the mandible during opening and closing of the mouth.

mandibular fossa

The broad U-shaped curve located between the coronoid and condylar processes is the _______

mandiubular notch

is the only moveable bone of the skull

mandlible

multi-, poly-

many

m=

mastoid

which serves as a muscle attachment site, Projecting inferiorly from the temporal bone this region is a large prominence

mastoid process

is one of a pair that together form the upper jaw, much of the hard palate, the medial floor of the orbit, and the lateral base of the nose

maxillary bone

The largest sinus is the ______. These are paired and located within the right and left maxillary bones, where they occupy the area just below the orbits. most commonly involved during sinus infections

maxillary sinus

A reviewer can recognize end of chain situations by looking for focal deflections that are

maximal at the last electrode in the chain.

Asymmetry in the EEG _____.

may sometimes be caused by a poor electrode placement .may be caused by a skull defect .refers to a difference in EEG amplitude between homologous areas

On the inferior aspect of the skull, each half of the sphenoid bone forms two thin, vertically oriented bony plates. form the posterior, lateral walls of the nasal cavity and serve as attachment sites for chewing muscles that fill the infratemporal space and act on the mandible.

medial pterygoid plate and lateral pterygoid plate "wing shaped"

Medium voltage buildup=____impedence

medium

is the region known as the myelencephalon in the embryonic brain. The initial portion of the name, "myel," refers to the significant white matter found in this region—especially on its exterior, which is continuous with the white matter of the spinal cord

medulla

Respiratory and vasomotor functions o origin of Cranial nerves IX through XII

medulla oblangata

The myelencephalon corresponds to the adult structure known as the...

medulla oblongata

motor and sensory pathways between midbrain and brain stem

medulla oblongata

Approximately 1 million bytes, 8 MB is 8 megabytes or 8 megs.

megabyte

A potential is a distribution of charge across the cell membrane, measured in millivolts (mV), The electrical state of the cell membrane can have several variations

membrane potential

In order for the computer to hold and manipulate information, the information must be expressed as a series of 0s and 1s. This two-choice numbering system is called binary. The smallest unit of information is either the number 0 or the number 1 - each unit is called a bit (binary digit.) The electrical representation of either the 0 or the 1 correlates to the voltage on the chip being either on or off.

memory bytes

The outer surface of the CNS is covered by a series of membranes composed of connective tissue called the meninges, which protect the brain

meninges

mening/o, meningi/o

meninges

The opening located on each side of the anterior-lateral mandible, which is the exit site for a sensory nerve that supplies the chin.

mental foramen

The forward projection from the inferior margin of the anterior mandible that forms the chin

mental protuberance

In a neuro exam, This assesses a patient's mental function, including memory, attention, language, and orientation

mental status change

The _______ (mes- = "middle") is the next vesicle, which can be called the midbrain

mesencephalon

The rhombencephalon develops into the ______

metencephalon and myelencephalon.

IMMUNE SURVEILANCE AND PHAGOCYTOSIS. smaller than most of the other glial cells. Ongoing research into these cells, although not entirely conclusive, suggests that they may originate as white blood cells, called macrophages, that become part of the CNS during early development, ingest and digest those cells or the pathogens that cause disease.

microglia

(or central processor) is a small electronic circuit chip (technically called an integrated circuit) that is responsible for all of the operations performed by the computer; it is what actually does the computing.

micropressor and motherboard

is mounted on a printed circuit board or motherboard. Additional boards or cards are plugged into slots on the motherboard. These slots are sometimes called expansion slots because they allow us to expand the system by adding devices such as a printer, mouse, modem, sound and/or video cards, or an additional monitor.

micropressor chip

is the study of structures that can be observed only with the use of a microscope or other magnification devices

microscopic anatomy

A term used in cardiology to denote a low level of electric current applied directly to myocardial tissue as little as 0.1 mA causes ventricular fibrilation

microshock

The voltage of an EEG waveform is measured in ____. The voltage can vary depending on the recording technique. The voltage seen on the EEG recording is the difference in electrical potential between the 2 inputs. It may appear higher or lower depending on the type of montage used to record it. Remember, the montage selection, bipolar or referential, will alter the display or deflection due to cancellation or summation of the EEG signal.

microvolts

above the pons, responsible for movement, auditory, and visual in the brainstem

midbrain

motor control • righting reflexes, o head upright, maintain balance & equilibrium • relay nucleus of the visual reflex & auditory reflex (Corpora quadrigemina): - automatically twisting away & coordination of eye movement when something comes in your direction, turning your head to sound • origin of cranial nerves III & IV

midbrain

tha brainstem has three regions:

midbrain, pons, and medulla

meso-

middle

Trifurcates into temporal, frontal, and parietal branches that supply most of the parenchyma of these lobes

middle cerebral artery

Located just above the inferior concha is the _____ which is part of the ethmoid bone

middle nasal concha

Sleep spindles seen best in...

midline and central electrodes

The duration of an EEG waveform is expressed in ____

milliseconds

The cell membrane is essentially a double layer of phospholipid structure in which there are many different kinds of protein molecules. The structure of these lipid layers allows for the...

movement of ions, molecules, and water from the extracellular or interstitial fluid to the interior of the cell and vice versa through channels or openings.

A normal central rhythm attenuated by real or imagined contralateral motor activity.

mu

"A _____ is attenuated by real or imagined contralateral motor activity.

mu rhythm

A normal variant central rhythm, having the morphology of rows of the letter "m" (mmmmmmmm) or the letter "u" (uuuuuuuuu). attenuated by real or imagined contralateral motor activity. If on the left, having the patient make a fist with the right hand will attenuate it. (even thinking about making a fist with the right hand will attenuate it

mu rhythm

Henri Gastaut in Marseilles, France, did further work with photosensitivity, combining photic stimulation with Metrazol to determine individual epileptic thresholds. Gastaut was the first to describe _______, which he called rhythm en arceau

mu rhythm

Seen with eyes open or closed; attenuated by movement of the contralateral extremity (real or imagined) or by tactile stimulation; must be verified by testing on EEG; seen in about 19% of healthy adults

mu rhythm

Having two or more spatially separated sites of origin.

multi-focal

independent left & right temporal spike & wave complexes.

multifocal

Pyramidal cells of various sizes; loosely packed stellate cells.

multiform layer

MS

multiple sclerosis

muscul/o, my/o

muscle

In a digital system, there is an amplifier for every active electrode that can be plugged into the headbox. This is to say that if the headbox has jacks for 32 electrodes, then there...

must be 32 amplifiers in the system.

-most common type. Found in all motor and association neurons; neurons are all of the neurons that are not unipolar or bipolar. They have one axon and two or more dendrites (usually many more). With the exception of the unipolar sensory ganglion cells, and the two specific bipolar cells mentioned above

mutipolar

_______ is a lipid-rich sheath that surrounds the axon and by doing so creates a myelin sheath that facilitates the transmission of electrical signals along the axon

myelin

acts as insulation much like the plastic or rubber that is used to insulate electrical wires, made up of glial cells

myelin

white matter is white because axons are insulated by a lipid-rich substance called

myelin

facilitates the transmission of electrical signals along the axon

myelin sheath

X-ray of the spinal cord made after intraspinal injection of contrast medium.

myelogram

This bony ridge extends along the inner aspect of the mandibular body (see Figure 7.11). The muscle that forms the floor of the oral cavity attaches on both sides of the mandible

mylohyoid line

-y, -ies

myopathy, myopathies

The combining form meaning stupor, sleep

narco

is one of two small bones that articulate (join) with each other to form the bony base (bridge) of the nose. They also support the cartilages that form the lateral walls of the nose

nasal bone

Attached to the lateral wall on each side of the nasal cavity are the superior, middle, and inferior _____ which are named for their positions. These are bony plates that curve downward as they project into the space of the nasal cavity. They serve to swirl the incoming air, which helps to warm and moisturize it before the air moves into the delicate air sacs of the lungs.

nasal chonchae

visual loss of the nasal visual fields of one eye o The temporal axons from the retina are affected causing a defect in the nasal visual field of one eye

nasal hemianopsia

consists of both bone and cartilage components, The upper portion is formed by the perpendicular plate of the ethmoid bone. The lower and posterior parts are formed by the triangular-shaped vomer bone.

nasal septum

he nasal cavity is divided into halves by the ______

nasal septum

indentation between forehead and bridge of nose

nasion

what are the 4 landmarks of the 10-20 system?

nasion, inion, preauricular point

were introduced in 1938 by Grinker and Serota in the U.S. and by Hill in England. These electrodes record from the anterior medial and inferior surface of the temporal lobes; sphenoidal electrodes, introduced by Giuseppe Pampiglioni in 1956, record from the lateral and inferior surfaces of the temporal lobe

nasopharyngeal electrodes

what are critical items and required method of decontamination:

needle electrodes, indwelling electrodes, electrocorticographic electrodes, sphenoidal electrodes, tympanic electrodes, nasopharyngeal sterilization

Phase Reversals can be either....

negative or positive

Ellingson and Lindsley had recorded from neonates as early as 1949 but modern _____ recording techniques follow the work of DreyfusBrisac starting in the 1960s

neonatal

A bundle of axons, or fibers, found in the PNS is called a t

nerve

neur/o

nerve

A collection of two or more computers interconnected by telephone lines, coaxial cables, satellite links, radio, and/or some other communication technique. A computer "network" is a group of computers which are connected together and which communicate with one another for a common purpose. Computer networks support "people and organization" networks, users who also share a common purpose for communicating.

network

is a means to interconnect personal computers with each other and to actually share resources like a centrally located printer, storage system, and programs. If the network is connected by dedicated cables in a small area (such as a room or building), it is referred to as a Local Area Network or LAN. If the network is expanded to include distant sites, it is called Wide Area Network or WAN.

networking

Cells from the neural folds then separate from the ectoderm to form a cluster of cells which runs lateral to the neural tube. migrates away from the nascent, or embryonic, central nervous system (CNS) that will form along the neural groove and develops into several parts of the peripheral nervous system (PNS), including the enteric nervous tissue.

neural crest

The ridge-like edge on either side of the neural groove is referred as the _____

neural fold

Over the next few days, a "trench" is formed in the neural plate - this creates a ______. visible as a line along the dorsal surface of the embryo

neural groove

The first sign of the developing nervous system is the ______ that can be seen at about the 16th day of development. Molecular signals induce cells in this region to differentiate into the neuroepithelium

neural plate

The innermost layer of the eye is the _____, or retina, which contains the nervous tissue responsible for photoreception

neural tonic

By the 21st day of development, a ______ is formed when the edges of the neural groove meet. The rostral (front) part of the neural tubes goes on to develop into the brain and the rest of the neural tube develops into the spinal cord. Neural crest cells become the peripheral nervous system. As the neural folds come together and converge, the underlying structure forms into a tube just beneath the ectoderm

neural tubes

pain along the course of a nerve

neuralgia

First, the neural tube establishes the anterior-posterior dimension of the nervous system, which is called the ______

neuroaxis

Quality patient care through recording and study of the electrical activity of the brain and nervous system.

neurodiagnostic testing

the allied health care profession that records, monitors, and analyzes nervous system function to promote effective treatment of pathologic conditions. Technologists record electrical activity arising from the brain, spinal cord, peripheral nerves, and somatosensory or motor nerve systems using a variety of techniques and instruments. Technologists prepare data and documentation for interpretation by a physician. Considerable individual initiative, reasoning skill, and sound judgement are all ex

neurodiagnostics

Drugs used to treat psychosis, especially schizophrenia

neuroleptic agents

is the more functionally important of the two, in terms of the communicative function of the nervous system

neuron

Surgical repair of a nerve

neuroplasty

When this signal reaches the end bulbs, it causes the release of a signaling molecule called a neurotransmitter

neurotransmitter

the allied health care profession that records, monitors, and analyzes nervous system function to promote the effective treatment of pathologic conditions. Technologists record electrical activity arising from the brain, spinal cord, peripheral nerves, somatosensory or motor nerve systems using a variety of techniques and instruments. Technologists prepare data and documentation for interpretation by a physician.

neurpdiagnopstics

neo means

new

neo-

new

on the mid-temporal and posterior temporal locations what locations?

new nomenclature T7, T8, P7, P8

Depakote

no consistent effect other than decreased epileptiform activity and seizure reduction

Artifacts originating from the patient are ___

no different with digital machines than they are with analog machines

Neurontin (Gabapentin)

no effects seen except with computer assisted sprectral analysis

Each gap in the myelin is called a ______ and is important to the way that electrical signals travel down the axon

node of Ranvier

system for naming things, especially in particular area of science

nomenclature

_____ in the cortex, such as stellate (star shaped) are found at other levels of the neocortex. Their axons, however are more oriented vertically and horizontally and do not leave the cortex and appear to act more as interneurons as they terminate on nearby neurons (______ ) and pyramidal cells. contain an inhibitory transmitter substance (GABA) and it is thought that these cells may play an inhibitory action in the cortex.

non-pyramidal cells intercortical connections

Items that have contact with intact skin

noncritical items

ACTH (Adrenocorticotropic hormone) Aldomet (methyldopa) Decadron, Baldex, Dalmane, Dexacort, Desasome, Maxidex, Solurex, (Ergotamine) Cafatine, Cafergot, Cardtrate, Ercaf, Ergomar, Wagraine, Inderal, Paradione, Phenurone (phenacemide)

none

always open and play an important role in the resting membrane potential

nongated channel

Some ion channels are selective for charge but not necessarily for size, s allow cations—particularly Na+ , K + , and Ca2+—to cross the membrane, but exclude anions

nonspecific channel

_______ had been described in 1935 by Loomis, Harvey, and Hobart. By 1937, Blake and Gerard had defined a null stage in allnight sleep recordings, a term describing the EEG findings of rapid eye movement (REM) sleep

normal sleep patterns

nas/o, rhin/o

nose

BETS can be distinguished from spikes that are found with Complex Partial Seizures (CPS) because BETS are _____.

not associated with focal slowing in the temporal areas

A localized collection of neuron cell bodies in the CNS is referred to as a

nucleus

The minimum sampling rate that should be used is defined by the _____which states that you must sample information at a rate that is a minimum of at least twice the frequency of the fastest waveforms you want to resolve. For example, if you want to accurately store a 10 Hz wave you MUST sample at least 20 times per second, to store 30 Hz activity the sample rate must be at least 60 Hz

nyquist sampling theorem

multiple movements in eye (verticle, horizontal) what else can you use to record verticle and horizontal eye movements?

nystagmus Right inferior canthus Left Superior Canthus

o=

occipital

is the single bone that forms the posterior skull and posterior base of the cranial cavity

occipital bone

form joints with the first cervical vertebra and thus support the skull on top of the vertebral column on either side of foramen magnum

occipital condyle

The posterior region of the cortex is the ______, which has no obvious anatomical border between it and the parietal or temporal lobes on the lateral surface of the brain

occipital lobe

• visual cortex calcarine fissure Location: parieto-occipital fissure

occipital lobe

type: motor nerve • origin: midbrain • function: o lifts the eye lids o constricts pupils o accommodates the lens for focusing • controls the superior,inferior & medial rectus muscles and inferior oblique to direct the eyeballs

occulomotor nerve

In what age group, patient state does the pattern occur? How often does the pattern occur? Frequency: Continuous, abundant, frequent, occasional, rare. Description: Paroxysmal, intermittent, periodic, burst...

occurence

left is...

odd

A record of the patient's work habits,that may involve work-related risks:

oh

electrons flowing in electrical circuit

ohms law

The senses are...

olfaction (smell), gustation (taste), somatosensation (sensations associated with the skin and body), audition (hearing), equilibrium (balance), and vision.

type: sensory nerve • origin: cerebrum/temporal lobe • function: carries impulses for the sensation of smell

olfactory nerve

INSULATION, MYELNATION. sometimes called just "oligo," which is the glial cell type that insulates axons in the CNS. The name means "cell of a few branches", There are a few processes that extend from the cell body. Each one reaches out and surrounds an axon to insulate it in myelin. will provide the myelin for multiple axon segments, either for the same axon or for separate axons. The function of myelin will be discussed below

oligodendrocyte

mono-

one

uni

one

uni-

one

allow the applications software and the physical computer hardware to work together. An example of an operating system is Windows 7

operating system files

The operating system is the basic software that allows the computer to set up and initialize the devices that are connected to it and allows you to run software applications. Initializing devices involves the operating system telling the CPU what kind of optical drive you have, what type of printer you are using, which memory region is reserved for doing a specific task, etc. The operating system functions also include basic capabilities such as formatting and erasing disks, copying and moving files, and displaying information about the system. Examples of operating systems include, MS-DOS (Microsoft Disk Operating System), Unix, Apple DOS, and Windows 7. • Operating systems may differ in their capabilities for multi-tasking and in the software and hardware that can be used with the system. Historically, it had been possible to use only one type of operating system on a particular computer. Now computers can have m

operating system software

The cone-shaped outer segments of the cone photoreceptor contain their photosensitive pigments in infoldings of the cell membrane. There are three cone photopigments, called _____, which are each sensitive to a particular wavelength of light.

opsins

At the posterior apex of the orbit is the opening of the _____, which allows for passage of the optic nerve from the retina to the brain. Lateral to this is the elongated and irregularly shaped superior orbital fissure, which provides passage for the artery that supplies the eyeball, sensory nerves, and the nerves that supply the muscles involved in eye movements.

optic canal

This opening is located at the anterior lateral corner of the sella turcica. It provides for passage of the optic nerve into the orbit.

optic canal

is a suddenly appearing (_____) electrical explosion that looks on the paper record like a spike or large nail. The sharp wave is the same as a spike except when it comes to duration

paroxysmal

Within each eye, the axons projecting from the medial side of the retina decussate at the _____. the axons from the medial retina of the left eye cross over to the right side of the brain at the optic chiasm.

optic chiasm

The axons of RGCs, which lie at the innermost layer of the retina, collect at the ______ and leave the eye as the optic nerve

optic disc

type: sensory nerve • origin: thalamus • function: carries impulses for vision

optic nerve

Extending from the optic chiasm, the axons of the visual system are referred to as the _____ instead of the optic nerve.

optic tract

t is the bony socket that houses the eyeball and muscles that move the eyeball or open the upper eyelid

orbit

tax/o

order, coordination

n is an anatomically distinct structure of the body composed of two or more tissue types. Each organ performs one or more specific physiological functions

organ

two or more different tissues combine to form an organ

organ level

is a group of organs that work together to perform major functions or meet physiological needs of the body.

organ system

two or more organs work together to perform the function of a body system

organ system

A human cell typically consists of flexible membranes that enclose cytoplasm, a water-based cellular fluid together with a variety of tiny functioning units called

organelles

is a living being that has a cellular structure and that can independently perform all physiologic functions necessary for life

organism

many organ systems work together to create

organism

The cochlear duct contains several ______i, which tranduce the wave motion of the two scala into neural signals.

organs of corti

gen/o

origin or production

is a reaction to this change in body position, so that blood pressure is maintained against the increasing effect of gravity

orthostatic reflex

force across the wire, electrical force through vibration

oscillation

The middle ear consists of a space spanned by three small bones called the _______.

ossicles

Two channels of EEG having waves with opposite deflections indicating "Eye leads placed below the eye, and frontal polar leads record eye movements as out of phase waveforms while frontal slowing is recorded as in phase waveforms." a focal event located between the 2 channels

out of phase

e-, ec-

out or away

devices that display the results of that processing

output

accept information that is sent from the computer

output devices

ecto-, exo-, extra-

outside

The cochlea is attached to the stapes through the ______.

oval window

dys-

painful, difficult, or faulty

The _____ is one of a pair of irregularly shaped bones that contribute small areas to the lateral walls of the nasal cavity and the medial wall of each orbit.

palatine bone

On the inferior skull, the ______ from each maxillary bone can be seen joining together at the midline to form the anterior three-quarters of the hard palate

palatine process

The inner surface of each lid is a thin membrane known as the _____

palpebral conjunctiva

Time scale, Time Base, Display Time or epoch, are terms used in digital EEG that are similar to the term ______ , used with analog EEG.

paper speed

often called LPT1, LPT2, etc. because they were originally designed for printers and LPT is short for Line PrinTer.

parallel

all positive and all negatoves (voltage does not change, but amps do)

parallel connection

takes path of least resistance (voltage is the brain to the amplifier)

parallel pathways

-plegia

paralysis

are hollow, air-filled spaces located within certain bones of the skull

paranasal sinuses

In EEG the 2 planes running front to back on either side of the midline

parasagittal

Decrease or slow down... • blood pressure • heart rate • lung dilate

parasympatheic

The main sensation associated with the ______ is somatosensation, meaning the general sensations associated with the body.

pareital lobe

p=

parietal

forms most of the upper lateral side of the skull, These are paired bones, with the right and left joining together at the top of the skull.

parietal bone

Functions: • contains the sensory cortex (somatesthetic area) • receipt of tactile stimuli o recognize size, shape, weight, texture, consistence & Intensity Location: central sulcus to the parieto-occipital fissure

parietal lobe

Superior to the lateral sulcus are the...

parietal lobe and frontal lobe,

an obvious landmark separating the parietal and occipital lobes is called the...

parietal occipital sulcus

the time interval between the occurrence of a wave or pattern. A waveform is said to be periodic if it occurs at regular intervals of time. Waveforms are considered periodic if and only if it continues for at least six consecutive cycles (e.g., 1 Hz for 6 seconds, or 3 Hz for 2 seconds)

periodicity GPDs with triphasic morphology

. The upper portion of the nasal septum is formed by the ____ and the lower portion if formed by the _____

perpendicular plate of the ethmoid bone vomer bone

On the interior of the skull, the petrous portion of each temporal bone forms the prominent, diagonally oriented ______ in the floor of the cranial cavity

petrous portion

The condition existing when two or more waves recorded on two or more channels of the EEG are 180° out of phase. In other words they reach peak values of opposite polarity at the same instant.

phase reversal "Phase reversals are the localization method of bipolar montages, indicating the location of a focal abnormality."

on, a

phenomenon, phenomena

can be seen as a frequency that is a frequency equal to or an integral submultiple of the photic frequency

photic driving

In 1946 Walter and Dovey used _____ to evoke clinical and EEG seizures. This activation technique quickly joined hyperventilation and sleep in routine EEG examination of patients with suspected epilepsy

photic stimulation

y is the scientific study of the chemistry and physics of the structures of the body and the ways in which they work together to support the functions of life.

physiology

Directly adjacent to the surface of the CNS is the ______, a thin fibrous membrane that follows the convolutions of gyri and sulci in the cerebral cortex and fits into other grooves and indentations

pia mater

top/o

place

Recommendation or disposition

plan

is an imaginary two-dimensional surface that passes through the body. There are three planes commonly referred to in anatomy and medicine, as illustrated

plane

Terminal ganglia below the head and neck are often incorporated into the wall of the target organ as a plexus. In a general sense, is a network of fibers or vessels. This can apply to nervous tissue (as in this instance) or structures containing blood vessels

plexus

meaning that information flows in this one direction ex: Information flows through a neuron from the dendrites, across the cell body, and down the axon

polarity

Having a negative, positive or neutral value.

polarity In EEG this relates to the polarity convention which states that if Grid 1 is more negative or less positive than Grid 2 , the deflection is up, if Grid 2 is more negative or less positive than Grid 1, the deflection is down.

multiple frequencies together creating complex waveforms.

polymorphic

EEG activity containing multiple frequencies that combine to create complex shapes.

polymorphic r. K complexes, which was described earlier in this course is an example of a polymorphic waveform

Recording of various aspects of sleep such as eye and muscle movements, respiration and brain patterns to diagnose sleep disorders

polysomnograph

Modern ______ however, was not born until the 1953 paper by Aserinsky and Kleitman documented the accompanying ocular, muscular, and autonomic changes. William C. Dement, a student of Kleitman's in Chicago, continued his investigations into nocturnal sleep at Stanford.

polysomnography

PSG

polysomnography

It is visible on the anterior surface of the brain stem as the thick bundle of white matter attached to the cerebellum. the main connection between the cerebellum and the brain stem

pons

lies between the midbrain & medulla oblongata contains tracts, nuclei, fibers to interconnect the brainstem and cerebellum • Respiratory centers - some respiratory function, work closely with the medulla to produce a normal breathing rhythm • sleep regulation, level of consciousness - Raphe nuclei NREM - Nucleus coeruleus REM • origin of Cranial nerves V through VII

pons

part of the brain stem, nerve fibers that have sensory info

pons

All digital equipment must consider capabilities • Analog to digital converter • Vertical resolution • Horizontal resolution (sampling rate) • Space Needs • Record Storage • Processing Speeds, and...

portability

Offner built EEG instruments from 1935 to 1960. He developed the average reference, with Dr. Douglas Goldman. Offner was also the first to use transistors in EEG, attempting to make a...

portable instrument

Devices communicate to the computer via connectors that are called _____

ports

Snapshot of sugar metabolism (breakdown) within the brain • Brain that is dysfunc3onal, scarred or has less neurons (e.g. stroke, tumor or malforma3on) = decreased signal (aka hypometabolism) • Brain with increased func3on (e.g. highly ac3ve seizure focus) = increased signal (aka hypermetablosim)

positron emission tomography PET

Period of time after an ictal event such as a seizure. The post-ictal period after a seizure may show slowing on the EEG and the patient may experience confusion, disorientation or drowsiness

post ictal

Posterior to the central sulcus is the _____, the primary somatosensory cortex, which is identified as Brodmann's areas 1, 2, and 3. All of the tactile senses are processed in this area, including touch, pressure, tickle, pain, itch, and vibration,

postcentral gyrus

Supplies the occipital lobe and the inferior portion of temporal lobe. A branch supplies the choroid plexus.

posterior cerebral artery

Between the two posterior horns of gray matter are the _____

posterior columns

Connects the anterior circle of Willis with the posterior cerebral artery of vertebral-basilar circulation posteriorly

posterior communicating artery

what horn is responsible for sensory processing.

posterior horn

Supplies the inferior-posterior cerebellum, choroid plexus in 4th ventricle, and portions of medulla

posterior inferior cerebellar artery

is the graded potential in the dendrites of a neuron that is receiving synapses from other cells

postsynaptic potential (PSP)

Types of ions are found in unequal distributions on either side of the a neuron's cell membrane include: (select all that apply)

potassium (K+) b. sodium (Na+) c. organic anions (A) d. chloride (Cl-)

is located inside the computer box and is connected by an electrical cord to a wall outlet. The power supply accepts 115 volt alternating current (USA) and converts it into comparatively low (5 to 12 volt) direct current, which is then supplied to the internal computer circuits. Should the alternating current power level spike or surge, the internal computer components could be permanently damaged.

power supply

Select the appropriate prefix to complete the term: __________operative = before surgery.

pre

indentation above external opening to ears, just above cartilage and covers external ear opening

preauricular points

is the primary motor cortex. Cells from this region of the cerebral cortex are the upper motor neurons that instruct cells in the spinal cord to move skeletal muscles

precentral gyrus

—added to the beginning of a term to further modify the root

prefix

serves cognitive functions that can be the basis of personality, short-term memory, and consciousness. This lobotomy is an outdated mode of treatment for personality disorders (psychiatric conditions) that profoundly affected the personality of the patient.

prefrontal lobe

is responsible for thinking of a movement to be made.

premotor area

common characteristics of synapses

presynaptic element • neurotransmitter (packaged in vesicles) • synaptic cleft • receptor proteins • postsynaptic element • neurotransmitter elimination or re-uptake

Three other autonomic ganglia that are related to the sympathetic chain are the ______ which are located outside of the chain but have similar functions. They are referred to as prevertebral because they are anterior to the vertebral column. T

prevertebral ganglia

A discharge that occurs simultaneously throughout the recording electrodes is called _____.

primarily generalized

because they are retained from the original fetal curvature of the vertebral column.

primary curve

Three vesicles form at the first stage, which are called _____

primary vesicles

"graphy"

process

ation

process

each extension of the cell is generally referred to as a

process

Probable outcome of a disease:

prognosis

the action potential travels—a process known as propagation—along the axon from the axon hillock to the axon terminals and into the synaptic end bulbs

propagation

are the senses of body position and movement, respectively.

proprioception and kinesthesia,

The ________ (pros- = "in front") is the forward-most vesicle, and the term can be loosely translated to mean forebrain

prosencephalon forebrain

At the intersection of four bones is the _____, a small, capital-H-shaped suture line region that unites the frontal bone, parietal bone, squamous portion of the temporal bone, and greater wing of the sphenoid bone. It is the weakest part of the skull.

pterion

py/o

pus

have long dendrites extending from lower layers of the cortex to the outermost layers of the neocortex. These dendrites are known as apical dendrites. The length of these dendrites and the fact that they are oriented perpendicular to the surface of the brain allows for input and synapses from other cells in several layers of the cortex.

pyramidal cells

Using computer programs to analyze and display EEG data for easy visual comparisons of changes over time. Processed EEG allows the user to monitor even subtle EEG changes over long periods of time.

quantitative EEG

Digital systems depend on monitors that relate to ______. It is the responsibility of the digital manufacturer to ensure that every EEG system produced is supporting appropriate display and resolution criteria

resolution of the screen and pixels

The ability of the monitor to offer a quality and rapid display is determined by its...

resolution, dot pitch, refresh rate

goes a step further by examining the frequency or spectral content of the four EEG spectral bands of clinical interest - delta, theta, alpha, and beta. The QEEG begins with the digital EEG study. The data is then entered into a second computer program and the spectral content of the EEG is rigorously determined by the use of techniques of mathematical signal analysis (typically by the fast Fourier transform [FFT] algorithm). The resulting array of numbers and values can then be mapped by using colored or grey scaling on maps of the head

quantitative EEG

According to the ACNS regarding EEG report, the description should start with the background activity, beginning with the dominant activity including its: (select all that apply)

quantity b. symmetry/asymmetry c. location d. frequency e. rhythmic/irregular

Although no exact quantities can be given some labs quantify the activity by using these terms to describe how little or often a particular wave is seen: rare 5-10%, occasional 10-20%, moderate 20-40%, many 40-80%, continuous 80-100%

quantity/amount

A large nerve from te brachial plexus is the ____ from which the axillary nerve branches to go to the armpit region. The radial nerve continues through the arm and is paralleled by the ulnar nerve and the median nerve

radial nerve ulnar and median nerve

Each side of the mandible consists of a horizontal body and posteriorly, a vertically oriented ramus of the _______. The outside margin of the mandible, where the body and ramus come together is called ______

ramus of the mandible (ramus = "branch") the angle of the mandible

a pattern that changes with stimulation as in eye opening and attenuation of alpha in the occipital leads.

reactivity

The report should include this information about activation procedures: (select all that apply)

reasons if omitted effects of the activation procedure (normal or abnormal)

. For other sensory receptor cells, such as taste cells or photoreceptors of the retina, graded potentials in their membranes result in the release of neurotransmitters at synapses with sensory neurons. This is called a receptor potential.

receptor potential

Collecting data on the digital EEG instrument, however, requires a set _____ (the montage that is used to store the data, allowing for later remontaging for display purposes).

recording montage

erthyo

red

erythr/o

red

Thiopental testing causes what?

reduces beta activity

determines whether activity is in phase or out of phase or if there is frontal slowing

referential montage

allow for the voltage measurement and voltage comparison of EEG waveforms, as well as more accurate visualization of the waveform morphology or shape.

referential montages

which refers to the digital process of recording raw data compared to the system reference electrode. The common average reference montage is based, in part, on the physics principle that the net charge, or potential, averaged over the entire head at any time must be zero - negativity balancing out positivity.

referential recording

Reflexes are tested, such as the knee jerk (patellar reflex) or the biceps reflex, to assess the integrity of the spinal cord and peripheral nerves.

reflex testing

Test performed to observe the body's response to a stimulus

reflex testing

Reflexes such as the Babinski reflex may be tested to assess how the nervous system responds to specific stimuli

reflexes

gray matter of spinal cord

reflexes

is a computer technique for creating montages from stored, digitally recorded EEG signals where all electrodes have been recorded to a single, separate, recording reference, called the system reference

reformatting

While an action potential is in progress, another one cannot be initiated. That effect is referred to as the _____

refractory period

is the rate at which the display is repeatedly updated. The image is not fixed but is drawn from left to right, top to bottom, one line at a time. Typical refresh rates are 72 Hz - 87 Hz

refresh rate

y is the study of the interrelationships of all of the structures in a specific body region, such as the abdomen, helps us appreciate the interrelationships of body structures, such as how muscles, nerves, blood vessels, and other structures work together to serve a particular body region

regional anatomy

subtracting one from the other

remontaging

The ability to access a computer from outside a building in which it is housed. It requires communications hardware, software, and actual physical links, although this can be as simple as common carrier (telephone) lines or as complex as TELNET login to another computer across the Internet.

remote access

are used in an external hard drive.

removable hard disks

Much as water runs faster in a wide river than in a narrow creek, Na+ -based depolarization spreads faster down a wide axon than down a narrow one. This concept is known as ______ and is generally true for electrical wires or plumbing, just as it is true for axons, although the specific conditions are different at the scales of electrons or ions versus water in a river.

resistance

is measured in the number of horizontal dots (pixels or picture elements) displayed on the screen versus the number of vertical dots displayed. Basic, low resolution displays might use 800 dots across by 480 dots down (which equals 384,000 pixels). Increasing the size of a monitor with this resolution would not improve the image - the dots would just be bigger. Many digital EEG systems have a minimum of 1024 dots across by 768 dots down which offers 786,432 pixels. Monitors that are already becoming common are 1280 x 1024 pixels = 1,310,720 pixels and options with new systems are 19 to 21 monitors with 1600 x 1200 resolution.

resolution

. It is the bipolar cell in the retina that connects a photoreceptor to a _______ in the inner synaptic layer. There, amacrine cells additionally contribute to retinal processing before an action potential is produced by the RGC.

retinal ganglion cell

The rod-shaped outer segments of the rod photoreceptor contain a stack of membrane-bound discs that contain the photosensitive pigment ______

rhodopsin

The third vesicle at this stage is the _______, called hindbrain

rhombencephalon

having a marked regularly occurring pattern of activity or feature or set frequency range

rhythmic I.e in "Alpha rhythm"

Assesses a patient's ability to maintain balance with their eyes closed, which can help identify sensory ataxia.

romberg test

foundation or subject of the term

root

medical terms are built from the...

root

The scala tympani ends at the ______ which is covered by a membrane that contains the fluid within the scala. As vibrations of the ossicles travel through the oval window, the fluid of the scala vestibuli and scala tympani moves in a wave-like motion. The frequency of the fluid waves match the frequencies of the sound waves

round window

rrhexis

rupture

quick waves that match eye movement in REM

saccadic eye movement

The _______ comes from the lower lumbar nerves L4 and L5 and the sacral nerves S1 to S4

sacral plexus

formed by the sacrum and coccyx

sacrococcygeal curve

e is the plane that divides the body or an organ vertically into right and left sides. If this vertical plane runs directly down the middle of the body, it is called the midsagittal or median plane. If it divides the body into unequal right and left sides, it is called a parasagittal plane or less commonly a longitudinal section

sagittal plane

extends posteriorly from the coronal suture, running along the midline at the top of the skull and It unites the right and left parietal bones. On the posterior skull, it terminates by joining the lambdoid suture.

sagittal suture

along the length of a myelinated axon, it is _______

saltatory conduction

This system utilizes a sample-and-hold circuit in each amplifier of the digital EEG system. A single ADC in the computer sends the signals to sample-andhold the data and also to convert th

sample and hold

Nyquist sample at twice of rate of fastest rate to prevent aliasing

sample rate

is the number of points of information that are stored in each second, expressed in samplespersecond or Hertz (Hz).

sampling rate

time lag between each channel

sampling skew

SUPPORT. One of the two types of glial cells found in the PNS is the ______. found in sensory and autonomic ganglia, where they surround the cell bodies of neurons

satellite cell

faster frequencies in REM

sawtooth

. The fluid-filled tube, now called the _______ returns to the base of the cochlea, this time travelling under the cochlear duct

scala tympani

The oval window is located at the beginning of a fluid-filled tube within the cochlea called the ______.

scala vestibuli

INSULATION, MYELINATION. The second type of glial cell is the ________, which insulate axons with myelin in the periphery. different than oligodendrocytes, wraps around a portion of only one axon segment and no others.

schwann cell

The most significant systemic nerve to come from the sacral plexus is the _____ which is a combination of the tibial nerve and the fibular nerve. extends across the hip joint and is most commonly associated with the condition sciatica, which is the result of compression or irritation of the nerve or any of the spinal nerves giving rise to it.

sciatic nerve

an abnormal, lateral curvature, accompanied by twisting of the vertebral column)

scoliosis

describes the procedures, actions, and processes that a healthcare practitioner is permitted to undertake in keeping with the terms of their professional license.

scope of practice

sad

seasonal affective disorder

develops gradually after birth as the child learns to sit upright, stand, and walk.

secondary curve

The three primary vesicles become five ______

secondary vesicles

is a two-dimensional surface of a three-dimensional structure that has been cut

section

Agent that has a calming effect

sedative

Dyshormia (Spike + K-complex)

seen in N2/3 during sleep

-lepsy

seizure

sudden trainsent disturbances in brain function with abnormal firing of nerve impulses

seizures

is located at the midline of the middle cranial fossa. This bony region of the sphenoid bone is named for its resemblance to the horse saddles used by the Ottoman Turks, with a high back and a tall front

sella turcica

Items exposed to non-intact skin or blood & body fluids

semi critical items

is a mixture of the alpha rhythm and slower frequencies, usually half the frequency of the patients normal alpha rhythm. Slow alpha variant is reactive to eye opening just as is the alpha rhythm and is considered normal.

slow alpha variant

The EEG in Stage NI sleep is characterized by a ____. The predominant waking alpha rhythm becomes intermixed with theta, and the amplitude may decrease slightly

slowing and attenuation of the posterior background rhythm.

micro-

small

enter/o

small intestine

if it is closer to the midline, the number is ______

smaller

Utilizing energy from the intracellular molecule adenosine triphosphate (ATP), the pump binds intracellular Na+ and "carries" it through the membrane channel to the extracellular space. The "pump" protein then binds K+ from the extracellular space and "transports" it through the channel back into the inside of the cell. This is an on-going process in the neuron which results in the unequal distribution of ions across the membrane. This, in turn gives rise to the resting membrane potential and it is the resting membrane potential that prepares the neuron for action

sodium patassium pump

Data or information used to run a computer:

software

are sets of instructions that tell a computer what to do.

software programs

cell body of a neuron

soma

The combining form meaning body

somat/o

sensory fibers delivering impulses from skin, skeletal muscles, & joints are called

somatic (soma = body) sensory (afferent) fibers

Voluntary, conscious control (skeletal muscles)

somatic nervous system

is responsible for conscious perception and voluntary motor responses

somatic nervous system

The main sensation associated with the parietal lobe is ______, meaning the general sensations associated with the body.

somatosensation

The combining form meaning sleep:

somn/o

Reservoirs of infectious organisms -bacterial, viral, fungal or parasitic

source

is related to associating the activity of multiple inputs to a neuron with each other

spatial summation

John Knott and Charles Henry were among the many investigators of ______ of the EEG. Current spectral analysis relies on analog to digital conversion of the EEG and the fast Fourier transform developed by Cooley and Tukey in 1965

spectral analysis

In processed EEG, this is the point along the frequency line where 80% (or some other majority percentage)of the power falls. This allows for easy visualization of shifts in the majority of the power to different frequencies

spectral edge

Tool used in Processed EEG to make shifts in the majority of power more easily visualized

spectral edge

phas/o

speech

The CPU is the brain or control center for the computer; it directs many functions such as controlling the flow of information to, from, and between input, output and storage devices. • Pentium processors have dropped the clock-speed reference but an example of this would be the Pentium 3 which has a clock-speed of 700 MHz and the Pentium 4 runs at a speed of greater than 2 GHz (gigahertz.) • Though a faster running system is usually the goal, the computer operating system and software may also be limiting factors if they are not able to make use of the computers speed.

speed of the micropresser

The __________of data in a computer network is of critical importance, especially when sending data from the operating room that requires immediate interpretation.

speed of the transmission

is a single, complex bone of the central skull, It serves as a "keystone" bone, because it joins with almost every other bone of the skull, forms much of the base of the central skull and also extends laterally to contribute to the sides of the skull

sphenoid bone

______ is a single, midline sinus. It is located within the body of the sphenoid bone, just anterior and inferior to the sella turcica, thus making it the most posterior of the paranasal sinuses.

sphenoid sinus

A transient with a duration of less than 70 msec but more than 20 msec and commonly (though not exclusively) negative in polarity. Spikes of faster frequencies have been recorded from the cortical surface.

spike

A transient, clearly distinguished from background activity with pointed peak at conventional paper speeds, and a duration from 20- to under 70-msec., i.e., 1/50 to 1/14/sec. and main component is generally negative relative to other areas, amplitude variable. (14 Hz - 50 Hz)

spike

consists of a spike followed by a wave. These complexes usually repeat themselves especially at the frequency of 3/sec and at times under 3/sec or at 6/sec when bilateral.

spike and wave complex

type: motor nerve • origin : medulla • function: consists of cranial and spinal roots o (motor) impulses to sternocleidomastoid & trapezius muscles • controls neck muscles to turn the head and lift the shoulders.

spinal accessory nerve

myel/o

spinal cord, bone marrow

carry impulses to and from the spinal cord.

spinal nerves

Visible on the outside of the computer box are slots that access the different storage systems or drives that are available on the computer

storage systems Your computer may have one or more drives available, depending on the number and variety of storage options you need. • The drives are named for the type of storage medium that they utilize: floppy disks, hard disks, optical disks, compact disks (CDs), Zip disks, or DVDs etc. Information is not stored in the drive itself; the data is stored on the disk that has been inserted into the drive.

orth/o

straight, normal, correct

Muscle strength is assessed in different muscle groups using resistance and movement tests

strength assessment

Together, the caudate and putamen are called the ______. The globus pallidus is a layered nucleus that lies just medial to the putamen; they are called the lenticular nuclei because they look like curved pieces fitting together like lenses

striatum

narc/o

stupor, sleep

While Hallowell Davis at Harvard was doing audiology research, Lee E. Travis at the University of Iowa in Iowa City was working on the problem of ______.

stuttering

Posterior to the mandibular fossa on the external base of the skull is an elongated, downward bony projection called the styloid process, so named because of its resemblance to a stylus (a pen or writing tool). This structure serves as an attachment site for several small muscles and for a ligament that supports the hyoid bone of the neck

styloid process

This small opening is located between the styloid process and mastoid process. This is the point of exit for the cranial nerve that supplies the facial muscles

stylomastoid foramen

The trabeculae are found in the _______, which is filled with circulating CSF

subarachnoid space

As described by Dr. Libenson, K-complexes can be elicited in an environment of the sleeping patient by a stimulus such as a noise that can cause a mild______.

subarousal

structures of the body in terms of fundamental levels of organization t

subatomic particles, atoms, molecules, organelles, cells, tissues, organs, organ systems, organisms and biosphere

Beneath the cerebral cortex are sets of nuclei known as _______ that augment cortical processes

subcortical nuclei

Frequency that is below the fundamental frequency, a frequency that divides evenly into the fundamental frequency

subharmonic

Frequency that is below the fundamental frequency, a sub-multiple of the original frequency. This may occur during photic stimulation

subharmonic

The switch between the two pathways is the ______, which projects to the striatum and releases the neurotransmitter dopamine. Dopamine receptors are either excitatory (D1-type receptors) or inhibitory (D2-type receptors)

substantia nigra pars compacta

SISCOM

subtrac3on ictal SPECT co-registered to MRI scan

Early ADCs had trouble doing this because the ADC would sample and display each channel in ______, which would cause a time delay in the collection and display of data from the 1st to the 32nd channel.

succession rather than simultaneously (sampling skew)

ending that gives essential meaning to the term

suffix

is the groove between two gyri.

sulcus

These changes can lead to the neuron reaching threshold if the changes add together, or ______

summate

Supplies the dorsal cerebellum, pons, and midbrain

superior cerebrellar artery

is the superior pair and combines sensory information about visual space, auditory space, and somatosensory space. Activity in the superior colliculus is related to orienting the eyes to a sound or touch stimulus.

superior collicus

A third bony plate, also part of the ethmoid bone, is the ______. It is much smaller and out of sight, above the middle concha.

superior nasal concha

Lateral to either side of this bump, lines represent the most superior point at which muscles of the neck attach to the skull, with only the scalp covering the skull above these lines.

superior nuchal line (nuchal = "nape" or "posterior neck").

This large, irregular opening into the posterior orbit is located on the anterior wall of the middle cranial fossa, lateral to the optic canal and under the projecting margin of the lesser wing of the sphenoid bone. Nerves to the eyeball and associated muscles, and sensory nerves to the forehead pass through this opening.

superior orbital fissure

Four of the muscles are arranged at the cardinal points around the eye and are named for those locations. They are the ______.

superior rectus, medial rectus, inferior rectus, and lateral rectus

runs in the groove of the longitudinal fissure, where it absorbs CSF from the meninges

superior sagittal sinus

what is the function of glial cells

support / insulate cells form myelin regulate ions & control transmitters provide phagocytosis guide the migration of neurons Do not transmit nerve impulses never lose their ability to divide Tumoral Growth astrocytoma oligodendroglioma glioblastoma multiforme

Select the appropriate prefix to complete the term: __________nasal = above the nose

supra

Located near the midpoint of the supraorbital margin is a small opening called the____. This provides for passage of a sensory nerve to the skin of the forehead

supraorbital foramen

describes waveforms that occur simultaneously. Patterns that occur at the same time in both hemispheres may be called bilaterally synchronous. Eye blinks seen on an EEG are an example of activity that is bilaterally synchronous

synchrony

having to do with the timing of a pattern's appearance

synchrony

timing of waveforms

synchrony

fainting

syncope

Digital systems either require that an additional electrode be placed on the scalp a combination of regularly applied electrodes to serve the same purpose as a:

system reference

The "________" is critical to a good digital recording. Usually place 2 (one is redundant) in a low artifact area (such as vertex).

system reference

or use a combination of regularly applied electrodes to serve the same purpose (common average reference). Some authors suggest that the system reference electrode be placed in an area that will be relatively free of movement or muscle artifact, such as CPZ between FZ and CZ.

system reference

The recording montage typically records data to the computer, using a ____

system reference, referitial montage

is the study of the structures that make up a discrete body system—that is, a group of structures that work together to perform a unique body function

systemic anatomy

Axons from different spinal nerves will come together into a ____.

systemic nerve

The stereocilia extend up from the hair cells to the overlying the _______, which is attached medially to the organ of Corti. When the pressure waves from the scala move the basilar membrane, the tectorial membrane slides across the stereocilia

tectorial membrane

One of the original regions of the embryonic brain, the midbrain is a small region between the thalamus and pons. It is separated into the

tectum and tegmentum

The prosencephalon enlarges into two new vesicles called the ______

telencephalon and the diencephalon

t=

temporal

In young adults, alpha rhythm can spread into the mid and posterior temporal head regions. This so-called _____ and behaves just like alpha rhythm in the occipital head regions and is symmetrical as well as reactive to eye opening

temporal alpha

forms the lower lateral side of the skull, Common wisdom has it that is so named because this area of the head is where hair typically first turns gray, indicating the passage of time.

temporal bone

On the lateral side of the brain case, above the level of the zygomatic arch, is a shallow space called the _____.

temporal fossa

Functions: • sound, word & memory patterns • dominant hemisphere sensory or receptive speech (Wernicke's area) • uncus (smell) • Heshl's transverse gyri (auditory cortex) Location: below the frontal and parietal lobes (Sylvian fissure) to the parieto-occipital fissure

temporal lobe

is associated with primary auditory sensation, known as Brodmann's areas 41 and 42, Because part of the limbic system, memory is an important function associated with that lobe.

temporal lobe

is the relationship of multiple action potentials from a single cell resulting in a significant change in the membrane potential

temporal summation

Approximately 1 trillion bytes.

terabyte

When not due to medication or temperature, the findings of electrocerebral inactivity are typically_____.

terminal

Another group of autonomic ganglia are the_______ that receive input from cranial nerves or sacral spinal nerves and are responsible for regulating the parasympathetic aspect of homeostatic mechanisms.

terminal ganglia

During an ECS/ECI recording it is necessary to ____.

test the integrity of the entire recording system

In addition, some non-pyramidal cells receive input directly from thalamic centers and are believed to act as a link from the thalamus to the cortex in pacing thalamocortical electrical activity (______).

thalamocortical connections

The target of this neuron is another neuron in the _________ of the brain, the part of the CNS that acts as a relay for sensory information

thalamus

is a collection of nuclei that relay information between the cerebral cortex and the periphery, spinal cord, or brain stem. All sensory information, except for the sense of smell

thalamus

two gray matter nuclei deep within the brain responsible for relaying sensory information to the cortex.

thalamus

within the diencephalon, processes and transmits info from all sense except smell

thalamus

The majority of the connections of the optic tract are to the ______ specifically, the lateral geniculate nucleus. Axons from this nucleus then project to the visual cortex of the cerebrum, located in the occipital lobe. Another target of the optic tract is the superior colliculus. In addition, a very small number of RGC axons project from the optic chiasm to the suprachiasmatic nucleus of the _____

thalamus hypothalamus

thalam/o

thalamus (a room)

The two major regions of the diencephalon are the...

thalamus and hypothalamus

In the computer, the information of time and voltage can be used to reconstruct, or to "draw" the EEG on a monitor or to send it to a printer. Imagine taking a series of voltage measurements, plotting the points on a graph and "connecting the dots". This numerical information is also available in the computer for mathematical operations that can reshape _____, such as averaging and frequency analysis.

the appearance of the EEG

what are the two functions of the nervous system

the basic functions of the nervous system are sensation, integration, and response. Secondly, control of the body can be somatic or autonomic—divisions that are largely defined by the structures that are involved in the response.

The EEG was demonstrated live on patients with epilepsy at the 1936 annual meeting of the American Neurological Association. This was...

the birth of modern EEG instrumentation

the parietal lobe and frontal lobe are separated by the...

the central sulcus

Alpha attenuation refers to ____ .

the decrease in alpha rhythm seen with eye opening

Perhaps the greatest advance in IONM monitoring has been:

the digital network

If the input range is too low for high voltage waveforms (e.g. hypsarrhytmia, spike-and-wave, depth electrode recording) the peaks may be lost. If correctly recorded, however, the user can decrease and see the entire waveform.

the display sensitivity Selecting the input range of the AD converter is NOT the same as selecting display sensitivity.

a recording of the ongoing electrical activity of the brain, assist in diagnoses of epilepsy

the electroencephalogram (EEG)

there is eye artifact because.. the front of eye is: back of eye is:

the eye is polarized positive negative

Gibbs, Lennox, and Davis confirmed in man...

the findings other investigators had reported in animals such as hyperventilation and spike and wave

The ACNS guidelines for recording electrocerebral silence studies states ____.

the full compliment of 21 electrodes plus ground and system reference (International 10/20 System) are required for ECS/ECI recordings and montages should be used with an inter-electrode distance of at least 10 cm.

The three components directly responsible for the display on the monitor are ____.

the monitor, monitor cable and video card

a recording during sleep that uses EEG and other physiologic monitors to monitor sleep

the polysomnogram (PSG)

The metencephalon corresponds to the adult structure known as.....

the pons and also gives rise to the cerebellum

While the brain is developing from the anterior neural tube, the spinal cord is developing from ______. As the spinal cord develops, the cells making up the wall of the neural tube proliferate and differentiate into the neurons and glia of the spinal cord.

the posterior neural tube

the word electroencpholagraphy means

the process of performing the EEG and the study

At the front end of the neural tube, three major brain areas are formed: .

the prosencephalon (forebrain), mesencepalon (midbrain) and rhombencephalon (hindbrain).

"gram"

the recording

If the resolution of waveforms improves when data is printed compared to the resolution of data on the screen, the fault may be ______.

the resolution of the video display (pixels)

which resemble the wings of a flying bird, form the lip of a prominent ridge that marks the boundary between the anterior and middle cranial fossae.

the right and left lesser wings of the sphenoid bone

Morphology refers to _____.

the shape of an EEG waveform

When distinguishing SREDA from a questionable complex partial seizure, it is most important for the technologist to demonstrate:

the state of alertness and level of consciousness of the patient.

two lateral ventricles • third and fourth ventricle choroid plexus located in the ventricles is responsible for the production of cerebrospinal fluid.

the ventricular system

Computers that are medical-use computers (with a connection to the patient - through electrodes in this case) need to have surge protection built into...

their circuitry, most commonly through optical isolation

Dilantin (phenytoin)

therapuetic dose=mild slowing and toxic=diffuse delta

Found in the skin of your fingers or toes is a type of sensory receptor that is sensitive to temperature, called a thermoreceptor

thermoreceptor

(In 1944, Grey Walter also described ____ rhythm, so called because it was believed to arise from the thalamus.)

theta

4-7 hz inclusive

theta

The frequency band in EEG containing frequencies from 4 Hz to less than 8 Hz

theta

which involves the thoracic vertebrae

thoracic curve

Activation procedures are methods used to bring out or stimulate abnormalities in the EEG. Examples include HV, photic, sleep, eye opening and eye closing.

true

The sympathetic division of the autonomic nervous system influences the various organ systems of the body through connections emerging from the thoracic and upper lumbar spinal cord. It is referred to as the ______ to reflect this anatomical basis.

thoracolumbar system

-ax, -aces

thorax, thoraces

In practice, the EEG is sampled at least three to ten times the highest signal frequency. The ACNS Guidelines state that "Digital storage ... should occur at a minimum sampling rate of at least _____ times the high frequency filter setting

three

tri

three

Gibbs contracted with Albert Grass, an engineer at M.I.T., to build a...

three-channel recorder

stere/o

three-dimensional or solid

tri-

three; triple

The voltage at which such a signal is generated is called the ______, and the resulting electrical signal is called an _______.

threshold action potential

a blood clot that forms within a blood vessel, typically an artery or vein. Thrombosis occurs when there is an abnormal activation of the coagulation system. A thrombus can partially or completely block blood flow through the vessel, leading to reduced or halted circulation. This can result in conditions like deep vein thrombosis (DVT), which can cause pain, swelling, and sometimes lead to more serious complications if the clot dislodges and travels to other parts of the body

thrombus

how does the brain transmit info?

through neurons

paroxysmal, intermittent, continuous, periodic etc.

timing

hist/o

tissue

is a group of many similar cells (though sometimes composed of a few related types) that work together to perform a specific function

tissue

a community of similar cells form a body tissue

tissue level

crin/o

to secrete

hypn/o

to sleep

somn/i

to sleep

somn/o

to sleep

ad-

to, toward, or near

ton/o

tone, tension

A bundle of axons, or fibers, found in the CNS is called a t

tract

landmark just above the cartilage on the ear

tragus

was first introduced in 1982 to non-invasively measure blood flow within the brain. A pulsing, low frequency, ultrasonic beam is delivered via a probe or transducer. This beam passes through the skull and is reflected from the target vessel, resulting in a sound wave or echo. T

transcrabial doppler sonography

An isolated wave or pattern that is distinctly different from the background and lasting only a short time and quickly coming to an end

transient

TIA

transient ischemic attack

the spread of infection between source and host.

transmission

Lying or going crosswise or at right angles to something In EEG, a Transverse montage is one that goes crosswise, across the head from left to right. (Coronal chains across the head)

transverse

display anterior and posterior electrode pairs in a coronal fashion across the head (ear to ear.)

transverse montages

is the plane that divides the body or organ horizontally into upper and lower portions. Transverse planes produce images referred to as cross sections.

transverse plane

The superior sagittal sinus drains to the confluence of sinuses, along with the occipital sinuses and straight sinus, to then drain into the...

transverse sinuses

the ______ is superficial to the temporal bone whereas its associated nerve is attached to the mid-pons region of the brain stem. The neurons of cranial nerve ganglia are also unipolar in shape with associated satellite cells.

trigeminal ganglion

• type: mixed motor & sensory nerve • origin: pons three branches (tri) • ophthalmic • maxillary • mandibular • function: • (sensory): skin of the face (feels the vertex ear, face,jawbone, chin) • (motor): masticatory (chewing) muscles

trigeminal nerve

A ____ wave would have 3 changes in phase (see illustration).

triphasic

a waveform having 3 phases

triphasic

Etiology - Toxic effects from drugs-legal and illicit • VPA encephalopathy - Metabolic encephalopathies • Hepatic • Uremia - Neurodegenerative disorders - Strokes - Tumors - Increased ICP • Prognosis depends on underlying cause

triphasic waves

The superior oblique originates at the posterior orbit, near the origin of the four rectus muscles. However, the tendon of the oblique muscles threads through a pulley-like piece of cartilage known as the _____

trochlea

type: motor nerve • origin: midbrain • function: o rotation of the eyeball, o controls the superior oblique muscle

trochlear nerve

According to the ACNS, the report of an EEG should consist of three principal parts. (A) Introduction, (B) Description of the record, and (C) Interpretation, including (a) impression regarding its normality or degree of abnormality, and (b) correlation of the EEG findings with the clinical picture.

true

Digital systems incorporate a scaling of the waveforms that relates to the analog to digital conversion, the vertical resolution, the number of bits, etc. An amplitude legend/scaled tool bar is used by digital systems to display the specific amplitude of the waveform selected.

true

Dorsiflexion of the toes means to curl upward

true

HEENT is an abbreviation for head, eyes, ears, nose, throat

true

Hypsarrhythmia is characterized by high voltage slow waves and spikes interspersed with brief stretches of flattening associated with infantile spasms.

true

If an EEG is abnormal it is indicative of cerebral dysfunction, since EEG is a manifestation of cerebral function.

true

In intensive care units, benzodiazepines produce diffuse slowing, barbituates can cause burst suppression and ECI, and Propofol can produce frontal delta and fast activity.

true

Introducing a specialized needle into the spine in the lumbar region for diagnostic or therapeutic purpose such as obtaining CSF is known as an lumbar puncture

true

One of the first EEG changes seen in drowsiness is a subtle slowing of the posterior rhythm.

true

Positron Emission Tomography (PET) is a technique that combines nuclear medicine and computed tomography and is used to study stroke, Alzheimers, epilepsy, metabolic brain disorders, chemistry of nerve transmissions in the brain with greater accuracy than SPECT scans.

true

Posttraumatic stress disorder (PTSD) is a condition resulting from an extremely traumatic experience, injury or illness that leaves the sufferer with persistent thoughts and memories of the ordeal. Symptoms include feelings of fear, detachment, exaggerated startle response, nightmares etc.

true

Problems that occur only when accessing the neurodiagnostic programs involve the neurodiagnostic software, hardware itself, or some interaction between the neurodiagnostic program and the computers hardware.

true

Sampling skew is an error in the timing of the sampling of waveforms and was a problem in early digital EEG instruments but no longer a problem in modern digital EEG instruments.

true

Six Hz "phantom spike and wave" can be seen in wakefulness and drowsiness as well as during activation procedures.

true

Some drugs may produce EEG features that are inconsistent and variable.

true

Sweat decreases the body's defenses against against electrical injury.

true

The Laplacian at an electrode X can be approximated as the sum of the potentials at the four nearest neighbors to X minus four times the potential at X.

true

The abbreviation "EEG" can be used to refer to the instrument, the process and the record

true

The abbreviations ROS and SR have the same meaning.

true

The ability of the computer to store a large amount of data over an extended period of time has also allowed for the continuous recording of the EEG (cEEG) and continuous video EEG with Video (cVEEG).

true

The fluctuations of these field potentials in the pyramidal layer are believed to be the origin of the EEG waveforms seen on scalp recordings.

true

The formula to find duration is: 1 divided by frequency

true

The formula to find wavelength is: 1 divided by frequency

true

The location of an EEG event is usually best described in therm of the electrode(s) it involves.

true

The nervous system is an intricate communication network of structures that activates and controls all functions of the body.

true

The terms paper speed and chart speed are used interchangeably to describe scrolling EEG in mm/sec.

true

The trade name is the manufacturer's name given to a drug.

true

The type of photic stimulation used (i.e., stepwise or glissando) should be stated and the range of frequencies given.

true

Using Fp1-O2 for a BioCal on a digital equipment would only show the frequency response in those two amplifiers, the system reference and ground. It does nothing to test the frequency response of the other amplifiers.

true

onc/o

tumor, mass

bi-

two, both

At the end of the auditory canal is the ______, or ear drum, which vibrates after it is struck by sound waves

tympanic membrane

Morphology - characteristics related to the shape of the waveform rhythmic, irregular, triphasic, sharp, spike, spike & wave, polyspike etc

type of activity

An abbreviation used to note that the patient had commonly contracted illnesses in their youth such as chickenpox, measles etc.

uchd

sub-

under, below

restricted or remaining in one hemisphere as the suppression on the right side below is

unilateral

-sensory neurons in PNS ganglia; cells have only one process emerging from the cell, are only found in invertebrate animals. exclusively sensory neurons and have two unique characteristics. First, their dendrites are receiving sensory information, sometimes directly from the stimulus itself. Secondly, the cell bodies are always found in ganglia.

unipolar

epi-

upon

The _______ is in this region, called the __________, which has an axon that extends all the way down the spinal cord

upper motor neuron precentral gyrus of the frontal cortex

ur/o, urin/o

urine

In the description of activation procedures such as HV, a statement should be included pertaining to their:

use of pinwheel prop

Bipolar Montages...

usually contain less EKG and muscle artifact and are good for localizing focal abnormalities with phase reversals

• type: mixed sensory and motor nerve • origin: medulla • function: two major components o (sensory) impulses from and Pharynx, larynx and abdominal and thoracic viscera o (motor) impulses to parasympathetic portion serving o Digestion and heart rat

vagus nerve

The middle layer of the eye is the _____, which is mostly composed of the choroid, ciliary body, and iris.

vascular tunic

Infection spread through insects such as mosquitoes is called

vectorborne transmission

The axons emerging from the anterior side do so through the _____

ventral anterior nerve root

Ependymal cells line each ______, one of four central cavities that are remnants of the hollow center of the neural tube formed during the embryonic development of the brain

ventricle

ventricul/o

ventricle

Another aspect of the adult CNS structures that relates to embryonic development is the ______ —open spaces within the CNS where cerebrospinal fluid circulates. They are the remnant of the hollow center of the neural tube. the tubular spaces associated with them can be linked back to the hollow center of the embryonic brain

ventricles

are the open spaces within the brain where CSF circulates

ventricles

open spaces within the brain where CSF circulates

ventricles

spondyl/o

vertebra

vertebr/o

vertebra

a, ae

vertebra, vertebrae

A second set of vessels that supply the CNS are the _____, which are protected as they pass through the neck region by the transverse foramina of the cervical vertebrae.

vertebral arteries

The vertebrals emerge from the posterior base of skull and merge to form the basilar artery

vertebral artery

the electrode placed at CZ is said to be the _______ neaning it is mid central or at the top of the head

vertex

"V" shaped waves seen in central regions phase reversing at the vertex in late N1-Stage I and N2 Stage II sleep.

vertex waves

how precisely the voltage measurements are made

vertical amplitide resolution

left preauricular to right preauricalr intersects with ____

vertical at CZ (vertex of head)

The second important issue in analog to digital conversion is the precision of the voltage measurement. The precision is described by the number of voltage levels, expressed in "bits", that the ADC has available to represent the voltage of the waveform

vertical resolution

Horizontal resolution (sampling rate) Disk or hard drive server Record Storage • Reformatted montage recording • Post acquisition setting change

verticle resolution

Should be at least 11 bits (2048 discreet voltage units); 12 bits recommended (4096 discreet voltage units) The more discreet voltage units, the better definition of waveforms

verticle resolution Vertical resolution 8 bits vs.12 bits (Less "bits" = less discreet voltage units = "choppy" waveform)

angi/o

vessel

vas/o, vascul/o

vessel

An important function of the vestibular system is coordinating eye and head movements to maintain visual attention. Most of the axons terminate in the ______

vestibular nuclei of the medulla.

These connections constitute the pathway of the _____ which compensates for head and body movement by stabilizing images on the retina, Finally, the vestibular nuclei project to the thalamus to join the proprioceptive pathway of the dorsal column system, allowing conscious perception of equilibrium

vestibulo-ocular reflex

type: sensory nerve • origin: pons • function: two branches: o vestibular: • transmits impulses for the sense of balance/equilibrium o cochlear: • transmits impulses for the sense of hearin

vestibulolarcar/auditory nerve

monitor changes via..

via sensory stimuli/input

consists of the graphics card, the monitor, and the device driver

video system

The ACNS Guidelines call for Biological Calibration. This is best done on a digital instrument by _____

viewing all the electrodes' input in a montage that pairs each of the electrodes to the system reference.

The ACNS Guidelines call for Biological Calibration. This is best done on a digital instrument by _____.

viewing all the electrodes' input in a montage that pairs each of the electrodes to the system reference.

• sensory fibers transmiRng impulses from the visceral organs

visceral sensory fibers, or visceral afferents The sensory division keeps the CNS constantly informed about events/s)muli going on both inside and outside the body

the range of incoming voltages that the ADC will accept. The yardstick example above illustrates the importance of the voltage range. Any item measured with this yardstick that is taller than 3 feet, will be described as "3 feet" - no matter how tall it is. Similarly, any voltage that is greater than the range of an AD converter will be described as the highest value in the converter, something like the blocking (aka pegging or clipping) of a pen when a high voltage signal enters an analog system.

voltage range

is a channel that responds to changes in the electrical properties of the membrane in which it is embedded. Normally, the inner portion of the membrane is at a negative voltage. When that voltage becomes less negative, the channel begins to allow ions to cross the membrane

volted gated channel

pressure (garden hose, volt pressure of water hose voltage always there) force of electrical charge

volts

is triangular-shaped and forms the posterior-inferior part of the nasal septum

vomer bone

W =

wakefullness

hydr/o

water

(kWR0-how much electricity over time or battery can store

watt hours

comb of volts and amp=voltagexamps-how much power overall

watts

-asthenia

weakness

Meaning for suffix -asthenia

weakness

leuk/o

white

leuko

white

the regions with many axons

white matter

The outermost layer is the fibrous tunic, which includes the _____.

white sclera and clear cornea

intermittent monomorphic arc shaped waves or single spike like waveforms, no after slow wave. mainly during drowsniess and sleep in temporal region

wicket spikes

Increasing the inter-electrode distances

will increase the differential amplifier's ability to record low voltage activity.

con-, sym-, syn-

with, together

en-, endo-

within

intra-

within

a

without

an

without

gynec/o

woman, female

lex/o

word, phrase

The program will engage but will not allow the collection of data a possible cause is: (select all that apply)

you may be accessing a reader only version of the program.

The ______ is the bony arch on the side of skull that spans from the area of the cheek to just above the ear canal.

zygomatic arch

is also known as the cheekbone. Each of the paired bones forms much of the lateral wall of the orbit and the lateral-inferior margins of the anterior orbital opening

zygomatic bones

what are the 31 pairs of spinal nerves?

• 8 cervical • 12 thoracic • 5 lumbar • 5 sacral • 1 coccygea

produces repsonse/motor output

• Effects or brings about a change by activating muscles/glands