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122 Cards in this Set

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How many napes are usually performed during the MSLT?
4 to 5 throughout the day
When does the first nap begin once the MSLT has started?
1.5 to 3 hours after the nocturnal recording
After sleep onset occurs, when is the nap terminated?
15 minutes from the 1st epoch of sleep
If there is no sleep noted, when is the nap terminated?
20 minutes from the time of "lights out"
What is the purpose of performing the MSLT?
To assess & diagnose diseases of excessive somnolence & to evaluate daytime sleepiness
Do the naps occur every 2 hours from the time the previous nap ended?
No. The naps occur every 2 hours on the hour or half-hour
How long before a nap begins should the subject cease smoking?
30 minutes
A mean sleep latence of < 5 minutes during the MSLT indicates what?
Pathological sleepiness
A normal mean sleep latency is how many minutes?
10 - 20 minutes
How many naps must have unequivocal periods of RM to arrive at a diagnosis of narcolepsy?
2 naps
What is the "narcoleptic tetrad"?
1) EDS
2) Hypnogognic hallucinations
3) Sleep paralysis
4) Cataplexy
What montage is generally used for recording the MSLT?
2 EOG
4 EEG
Chin EMG
EKG
How is the mean sleep latency calculated on an MSLT?
Sum of all sleep latencies divided by total number of naps
How is the median sleep latency calculated on an MSLT?
Align all sleep latencies in numeric order:
5 naps: it's the 3rd number
4 naps: it's the average of the middle 2 numbers
How is the man REM latency calculated on an MSLT?
Sum of all REM latencies divided by the number of REM periods that occurred
How frequent are the naps scheduled during the MSLT?
Every 2 hours
RDI is a measurement of what?
The number of apneas & hypopneas per hour of total sleep time
Reflux is identified in the distal esophagus by a drop in the pH below what?
4.0
A patient can become the pathway of least resistance and there fore susceptible to shock when what occurs?
When not all the equipment attached to the patient is connected to a common ground
What are the effects of chronic alcoholism on sleep?
Reduction of delta & REM
A sleep disturbance that lasts one to several nights in an isolated period and is most often caused by an acute situational stress or travel across multiple time zones is what?
Transient insomnia
During REM, inhibition of thermoregulatory mechanisms leads to a state of what?
Poikilothermia
What equation best expresses time constant?
TC = C x R
TC = time constant
C = capacitance
R = resistance
Impedances > 10,000 ohms allows for greater potential of electrode imbalance and the appearance of what in the recorded signal?
60 Hz interference
If the circumference measurement of the head is 60 cm, what is the distance of T4 from Fp2?
12 cm
What is the minimum paper speed recommended to allow clear visual resolution of alpha & sleep spindles?
10 mm/sec
What sleep stage has low voltage, mixed frequency EEG with a prominence of activity in the 2-7 cps range, with slow eye movements, and tends to be relatively short, ranging from 1-7 min?
Stage 1
The amplitude of this waveform is occasionally as high as 200 uV.
Vertex sharp waves
The total duration of this waveform should exceed 0.5 sec with a well-delineated negative sharp wave followed by a positive component.
K-complex
What sleep stage requires 20-50% of epoch to have waves of 2 cps or slower with amplitudes > 75 uV peak-to-peak?
Stage 3
Alpha activity in stage REM is how many cps slower than during wakefulness?
1-2 cps slower
How are eye movements recorded?
By a small electropotential difference between the cornea (+) & the retina (-); an electrode closest to the cornea registers a + deflection & an electrode close to the retina registers a - deflection
What are the 4 skull landmarks used in the 10-20 system of electrode placement?
Nasion, inion, right preauricular, & left preauricular
The degree to which an amplifier will reject a common mode signal is expressed as what?
Common mode rejection ratio
NREM sleep in the infant is know as what?
Quiet sleep
REM in the infant is known as what?
Active sleep
Other than the EEG, what else is used to differentiate sleep stages in the infant?
Observed behavior & movement patterns
At what age do sleep spindles appear in the infant?
They appear at 4 weeks of age, develop rapidly through 8 weeks of age, and clearly characterize NREM sleep by 3 months of age
An epoch that does not meet the criteria for active or quiet sleep in the infant is called what?
Indeterminate sleep
Trace Alternant pattern is associated with what stage of sleep in the infant?
Quiet sleep
Infant breathing pattern that alternates between regular breathing & 5-10 sec of apnea is called what?
Periodic breathing
REM occupies what percentage of sleep in the neonate at term?
50%
Term used for a brief superimposition of alpha activity on sleep activities during a stage of sleep.
Alpha intrusion
Thermoregulatory responses such as sweating & panting are noted in what stages of sleep?
NREM sleep (but NOT in REM)
Apnea is defined as what?
Cessation of airflow at the nostrils & mouth lasting at least 10 seconds
A function that expresses the frequency of eye movements per unit time during REM is what?
REM density
What is known as the pacemaker for mammalian circadian rhythms?
Suprachiasmatic nuclei (SCN)
A complaint of morning headaches associated with severe OSA is a result of what?
Severe oxygen desaturation & hypercapnia
What initial effect does administering supplemental oxygen have on the OSA pt?
A significant increase in apnea duration with associated hypercapnia & respiratory acidosis
What is jactatio capitis nocturna?
Headbanging
What is the recommended procedure for electrode application to record eye movements?
One electrode 1 cm above & slightly lateral to the outer canthus while the other is 1 cm below & slightly lateral to the otuer canthus of the eye
What are three potential sources of stray electrical current?
Short circuit
Leakage current
Ground loop
What is the definition of the number of pen deflections (waves) recorded within one second?
Signal frequency
What is the measurement of frequency (cycles/second)
Hertz
What refers to the response time of the polygraph pens in relation to high & low frequency filter settings during a calibration procedure?
Time constant
Reduction in size or amplitude of a signal?
Attenuation
Voltages originating from living tissue?
Bio-electrical potentials
Undesirable variations in baseline during a recording, usually caused by sweat or movement?
Baseline sway
Signals obtained by comparing voltages from 2 exploring electrodes?
Bipolar derivation
An amplifier component used for storing an electrical charge?
Capacitor
A ground connection shared by > 1 instrument or appliance?
Common ground
Any material capable of transmitting an electrical current?
Conductor
Flow of electrical force along a conductor?
Current
Signal obtained from a pair of electrodes or sensors?
Derivation
Time requred for a pen to descent to 37% of signal amplitude with a DC calibration signal is applied to an amplifier?
Fall time constant
Electronic device designed to reduce or eliminate unwanted frequencies from passing through an amplifier?
Filter
An undesirable electrical pathway between 2 separate ground connections, resulting in a possible hazard to a pt?
Ground loop
A method of measuring changes in body (or body parts) circumference?
Inductance plethysomography
Stray current generated by the proximity of electrical power cords to adjoining cables or the polygraph chassis?
Leakage current
Ratio of output voltage to input voltage, amplifier sensitivity?
Gain
Instrument used for measuring electrical resistance?
Ohmmeter
Signal obtained by comparing voltages from an exploring electrode ot a relatively inactive location?
Referential derivation
Opposition to an electrical current?
Resistance
Device used to limit the passage of electrical current?
Resistor
Time required for a pen to reach 63% of signal amplitude with a DC calibration signal is applied to an amplifier?
Rise time constant
Device containing 2 dissimilar metals, which generate an electrical signal in response to temperature variations?
Thermocouple
A sequence of tests used to verify & document appropriate amplifier & pen responses to various maneuvers performed by the pt prior to a sleep study?
Bio-calibrations
Sharp negative waves, usually within the theta frequency range which typically appear during the latter part of stage 1 sleep?
Vertex waves
A sharp negative wave, followed by a slower positive component which is seen primarily in stage 2 sleep?
K-complex
Short rhythmic waveform clusters of 12-14 Hz which often show a waxing & waning appearance and is a characteristic feature of stage 2 sleep?
Sleep spindles
Relatively low amplitude waves with a notched, sawtooth appearance & is a common feature of REM?
Sawtooth waves
REM sleep is classified into what 2 catagories?
Tonic & phasic
Artifact caused by electrodes which momentarily lift away from the skin?
Electrode popping
An interruption of sleep continuity, identified by an abrupt shift in EEG frequency?
Arousal
Rapid deep braething, resulting in reduced levels of CO2 in the blood?
Hyperventilation
Insufficient breathing volumes resulting in increased levels of CO2 in the blood?
Hypoventilation
Abnormally low blood oxygen saturation level?
Hypoxemia
Jaw muscle?
Masseter
Lower portion of the temporal bone behind the ear?
Mastoid
The progression & distribution of the various sleep stages & their quantitative relationship to each other?
Sleep architectural
A period of NREM f/b a subsequent REM period?
Sleep cycle (AKA sleep patterns; sleep stages; cyclic, alternating patterns of sleep)
A device used to convert non-electrical physiological activity into electrical signals?
Transducer
Term for the maximum amount of air the lungs can contain?
Total lung capacity
An arrangement of electrode derivations?
Montage
What is Ohm's Law?
E = IR
E = voltage
I = current
R = resistance
Three grounds found in electronic equipment?
Earth ground (bldg or power outlet)
Chassis ground
Common connection ground
Shock that involves large & quite perceptible currents passing from one external surface area to another?
Macroshock
How is the voltage of an EEG waveform calculated?
V = AS
V = voltage (uv)
A = amplitude (mm)
S = sensitivity (uV/mm)
What consideration should be given to the choice of electrodes used for recording EEG?
Use a material that has minimum drift of electrode potential and a very long time constant
Suggested solution to soak contaminated electrodes?
5% Hypochlorite solution (bleach)
Distince EEG activity appearing to be composed of one dominant frequency?
Monomorphic
EEG activity with a frequency > 13 Hz
Beta activity
Morphologically & topographically distince EEG activity seen in the central areas, frequency is ~9 Hz?
Mu rhythm
EKG shows more P-waves than QRS-complexes with no association between the two; P-R interval is variable & the QRS-complexes are the same & regular?
3rd degree AV block (complete heart block)
Normal arterial pCO2 value?
35 - 45 mmHg
Normal arterial pO2?
80 - 100 mmHg
A pt with Ondine's Curse would be expected to have what type of respiratory impairment?
Central alveolar hypoventilation
What class of drugs is know to aggrevate PLMS?
Tricyclic antidepressants
What is the effect of chronic alcoholism on REM?
Decreases REM sleep
Define sleep efficiency?
Ratio of total sleep time to total time in bed
In 1953, Aserinsky & Kleitman associated what with dreaming during sleep?
REM's
REM sleep is associated with what changes in the autonomic nervous system?
Variably HR
Irregular respirations
Decrease in tonic muscle activity
The reticular activating system is essential for what part of the sleep/wake cycle?
Initiation & maintenance of wakefulness
Ultradian rhythm refers to a period of what time?
< 24 hrs
Is paradoxical breathing noted in neonates or infants?
Neonates
Does periodic breathing in the normal infant most commonly occur in active or in quiet sleep?
Active sleep
The ultradian rhythm of alternating sleep cycles has a period of how many minutes during infancy?
30 - 70 minutes
What is the definition of periodic breathing?
Minimum of 3 central events lasting < 4 seconds within 20 seconds of each other
A person's maximum breathing ability?
Vital capacity
The content of air remaining in the lungs at the end of normal expiration?
Functional residual capacity
Leg muscle used to monitor & record myoclonic movements?
Anterior tibialis
Which type of montage is recommended in order to maximize the voltages recorded during a PSG?
Referential montage using contrlateral ear references