Covering both the applications and the related theory, A Concise Guide to Intraoperative Monitoring provides a general but comprehensive introduction to IOM. Unlike existing texts that typically report the results of specific studies, this book presents comprehensive coverage of the entire procedure, as well as the specific protocols used in hospital practice, examples of typical recordings, possible problems, and recommended solutions. At the end of each chapter the author poses several questions for review. These questions help technologists and medical residents in their preparation for the board exams. Taken together, these features make the book an ideal reference or training manual.A Concise Guide to Intraoperative Monitoring begins by discussing the basic principles underlying the generation of bioelectrical signals. It then describes the electronic equipment and the various electrophysiological procedures involved in IOM. From this foundation, the book gradually advances to more specific topics, such as surgical procedures, neuronal structures at risk, the optimum combinations of tests to administer, and the proper interpretation of test results. The material also provides you with a background on general anesthesia and analyzes the effects of various drugs on electrophysiological recordings. A Concise Guide to Intraoperative Monitoring also discusses the proper placement of stimulation and recording electrodes, as well as intervention strategies and equipment troubleshooting.
Author(s): George Zouridakis, Andrew C. Papanicolaou
Edition: 1
Publisher: CRC Press
Year: 2000
Language: English
Pages: 218
Tags: Медицинские дисциплины;Неврология и нейрохирургия;
Front Cover......Page 1
Preface......Page 6
About the Authors......Page 8
Contents......Page 10
1.1 Intraoperative Monitoring......Page 16
1.3 Rationale......Page 17
1.5 Affecting Factors......Page 18
1.7 Usefulness......Page 19
1.9 Personnel......Page 20
1.12 Review Questions......Page 21
2.2.1 Anatomic References......Page 24
2.2.2 Functional Groups......Page 25
2.3 Origin of Neurophysiological Signals......Page 26
2.4.1 Activity of Neural Cells......Page 27
2.4.3 Activity of the Cerebral Cortex......Page 30
2.4.5 Activity of Muscle Cells......Page 31
2.5 Evoked Responses......Page 32
2.6 Review Questions......Page 33
3.2.1 Structure of Matter......Page 36
3.2.4 Direct and Alternating Currents......Page 37
3.2.6 Connecting Resistors in Series......Page 38
3.2.9 Impedance......Page 40
3.3.1 Electrode Characteristics......Page 41
3.4 Types of Stimulation Electrodes......Page 42
3.5 Types of Recording Electrodes......Page 43
3.5.2 Placement of Stimulation Electrodes......Page 44
3.5.3 Placement of Recording Electrodes......Page 45
3.5.4 Montages......Page 46
3.6 Amplifiers......Page 47
3.7.1 Basic Operation......Page 48
3.7.2 Need for Differential Amplifiers......Page 49
3.7.4 Amplifier Performance......Page 50
3.7.5 Optimal Recordings......Page 51
3.7.6 Effects of Imbalances......Page 53
3.7.8 Multi-channel Referential Recordings......Page 54
3.8.2 Dynamic Range......Page 55
3.8.3 Sensitivity......Page 56
3.9 Review Questions......Page 57
4.2.2 Frequency......Page 60
4.3.1 The Fourier Transform......Page 62
4.3.3 Computerized EEG Analysis......Page 63
4.4 Data Processing......Page 64
4.4.2 Frequency Response......Page 65
4.4.3 Low Frequency Filters (LFF)......Page 66
4.4.5 Time Constant......Page 67
4.4.6 Notch Filter......Page 68
4.4.7 Bandwidth......Page 69
4.4.8 Effects of Filtering......Page 70
4.4.9 Analog to Digital Conversion......Page 71
4.4.10 Averaging......Page 72
4.5 Data Display......Page 73
4.6 Data Storage......Page 74
4.7 Review Questions......Page 75
5.2 Components of Anesthesia......Page 78
5.5 Intravenous Anesthetics......Page 79
5.7.2 Other Conditions......Page 80
5.9 Review Questions......Page 81
6.1 Introduction......Page 84
6.2.2 Use......Page 85
6.2.3 EEG Features......Page 86
6.2.4 Recording Procedure......Page 87
6.2.5 Effects of Anesthetic Agents......Page 88
6.2.6 Effects of Induced Neuroprotective Conditions......Page 91
6.2.8 EEG Intraoperative Interpretation......Page 92
6.3.3 EMG Features......Page 93
6.3.4 Recording Procedure......Page 94
6.3.5 Affecting Factors......Page 97
6.3.6 EMG Intraoperative Interpretation......Page 101
6.4 Review Questions......Page 102
7.2 Evoked Potentials......Page 104
7.3.1 Generation......Page 106
7.3.2 Use......Page 107
7.3.4 Recording Procedure......Page 108
Stimulation......Page 111
7.3.6 SEPs to Leg Stimulation......Page 113
7.3.7 Affecting Factors......Page 114
7.3.8 SEP Intraoperative Interpretation......Page 118
7.4.2 Use......Page 119
7.4.4 Recording Procedure......Page 120
7.5.1 Generation......Page 121
7.5.2 Use......Page 122
7.5.4 Recording Procedure......Page 123
7.5.6 BAER Intraoperative Interpretation......Page 125
7.6.2 Use......Page 126
7.6.4 Recording Procedure......Page 127
7.6.5 Affecting Factors......Page 128
7.7.1 Generation......Page 129
7.7.3 MEP Features......Page 130
7.7.4 Recording Procedure......Page 131
7.8.2 Use......Page 133
7.8.4 Recording Procedure......Page 134
7.8.6 tEMG Intraoperative Interpretation......Page 135
7.9 Review Questions......Page 136
8.1 Introduction......Page 140
8.2 Spinal Deformities......Page 143
8.3 Disc Disease......Page 146
8.4 Spinal Fractures and Instabilities......Page 149
8.6 Vascular Abnormalities......Page 153
8.7 Tethered Cord......Page 155
8.8 Selective Dorsal Rhizotomy......Page 156
8.9.1 Repair of Brachial Plexus......Page 158
8.9.2 Acetabular Fixation......Page 159
8.9.3 Patient Positioning......Page 160
8.10 Review Questions......Page 161
9.1 Introduction......Page 164
9.2 Surgery for Tumor Removal......Page 167
9.2.1 Posterior Fossa Tumors......Page 168
9.2.2 Middle Fossa Tumors......Page 170
9.2.4 Skull Base Tumors......Page 171
9.3 Neurovascular Procedures......Page 173
9.3.1 Posterior Fossa Aneurysms......Page 176
9.3.3 Supratentorial Procedures......Page 177
9.4 Cranial Nerve Surgery......Page 180
9.5 Endarterectomy......Page 182
9.6 Neuroradiological Procedures......Page 183
9.7 Central Sulcus Localization......Page 184
9.8 Review Questions......Page 185
10.2 Efficacy of Monitoring......Page 188
10.4 Precautions......Page 189
10.5 Troubleshooting......Page 191
10.6 Intervention......Page 192
10.8 Review Questions......Page 193
Closing Remarks......Page 196
References......Page 198
Further Reading......Page 204
Index......Page 206
