Electrode Types and Their Characteristics

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Questions and Answers

Match the type of electrode with its characteristic:

Gold-plated electrodes = Most common type Silver/silver chloride electrodes = Require regular chloride bathing Modern silver/silver chloride electrodes = Do not need regular chloride bathing Gold electrodes = Oxidize over time

Match the condition when electrodes should not be used:

Chipped electrode = Direct current offset potential created Cracked electrode = Signal baseline drift likely Scratched electrode = Signal reliability increased Unblemished electrode = No issues for use

Match electrode cup types with their descriptions:

Stamped electrodes = Thinner design with larger cup Casted electrodes = Bend easily Both types = Equally reliable for bio-electrical signals

Match the type of insulation to its characteristic:

Thin Teflon® coating = Durable but tangles easily Thicker insulation = Tangles less but may be less sturdy Insulated wires = Also known as leads Electrode wires = Attached to cup electrodes Signup and view all the answers

Match the typical use of electrodes with the specific function:

EEG = Recording brain activity EOG = Recording eye movements Disposable electrodes = Convenience in use Reusable electrodes = Better for long-term monitoring Signup and view all the answers

Match the diameter of EEG cup electrodes with the appropriate category:

Adult electrodes = 10 mm diameter Pediatric electrodes = 6 mm diameter Standard electrodes = 8 mm diameter Metal electrodes = 12 mm diameter Signup and view all the answers

Match the type of electrodes with their care requirements:

Gold electrodes = Require less care Silver electrodes = Need regular re-chloridation Sintered electrodes = Do not oxidize like silver electrodes Casted electrodes = More prone to damage Signup and view all the answers

Match the types of disposable electrodes with their appropriateness:

Disposable patches = Not appropriate for EEG Reusable patches = Suitable for EEG recording Disposable electrodes = Convenient for short-term use Reusable electrodes = More economical in the long run Signup and view all the answers

Match the respiratory monitoring technique with its description:

Piezo electric crystal = Produces a charge from stress and release during breathing Diaphragmatic EMG = Used to differentiate between central and non-central respiratory events Respiratory Inductance Plethysmography (RIP) = Measures changes in cross-sectional area of rib cage and abdomen False paradoxing = A phenomenon causing inaccurate readings during patient movement Signup and view all the answers

Match the feature of RIP with its characteristic:

Linear signal = The output reflects consistent changes based on breathing Weak magnetic field = No electrical current passes through the patient Calibrated measurement = Represents actual volume of airflow Sum channel = Combines multiple signals into one output Signup and view all the answers

Match the limitations with the appropriate monitoring technique:

Piezo electric crystal = Accuracy affected by patient movement Diaphragmatic EMG = Reliability limited by proper electrode placement RIP = Requires calibration for accurate airflow measurement None = Does not produce false paradoxical breathing signals Signup and view all the answers

Match the term with its definition:

Sine wave pattern = The shape of the output from piezo electric crystals Electrode placement = Critical for accuracy in EMG monitoring Tension measurement = Used to gauge the stress on the piezo crystal False paradoxical breathing = Inaccurate readings produced by certain sensors Signup and view all the answers

Match the technique with its output characteristics:

Piezo electric crystal = Output not linear Diaphragmatic EMG = Requires precise electrode positioning RIP = Produces a waveform based on magnetic field changes None = Causes inconsistency in assessment of respiratory effort Signup and view all the answers

Match the respiratory monitoring technique with its application:

Piezo electric crystal = Analyzing breathing patterns Diaphragmatic EMG = Assessing central vs non-central respiratory events RIP = Evaluating rib cage and abdominal movements None = Identifying specific airflow rates Signup and view all the answers

Match the following components of RIP with their functions:

Belt with wire = Stretches and relaxes during respiration Magnetic field = Modifies frequency of the current Voltage output = Creates the waveform seen on PSG Calibration = Ensures accurate airflow representation Signup and view all the answers

Match the primary usage with the appropriate monitoring technique:

Piezo electric crystal = Noted for false readings during movement Diaphragmatic EMG = Helpful in differentiating respiratory events RIP = Capable of linear and accurate monitoring None = Commonly used for airflow measurement Signup and view all the answers

Match the following types of snore microphones with their descriptions:

Dynamic = Requires no power source and uses a moveable diaphragm. Electret = Uses a permanently charged diaphragm and requires a power source. Piezoelectric = Responds to vibrations near the upper airway and requires no power source. Snore Microphone = Records vibrations or sound associated with snoring. Signup and view all the answers

Match the following features with the correct type of sensor:

Body Position Sensor = Must be oriented correctly on the body for accuracy. Snore Microphone = Most widely used method for recording snoring. Dynamic Microphone = Has a diaphragm displaced by sound waves. Electret Microphone = Offers a wide frequency range and needs power. Signup and view all the answers

Match the microphone type with its specific characteristic:

Dynamic = Does not need an external power source. Electret = Forms the diaphragm with a dielectric material. Piezoelectric = Attached to the skin to detect vibrations. Snore Microphone = Interfaced with a recorder to display output. Signup and view all the answers

Match the following terms related to body position monitoring:

Recorded Manually = Body position checking via video. Automatic Recording = Utilizes body sensors for monitoring. Gravity Data = Provides information based on body orientation. Centerline Orientation = Sensor must be secured around the body properly. Signup and view all the answers

Match the microphone types with their power requirements:

Dynamic = Does not require a power source. Electret = Requires a power source. Piezoelectric = Does not require a power source. Snore Microphone = Interfaced with a recorder or output channel. Signup and view all the answers

Match the following components with their functions in snoring detection:

Transducer = Converts sound into a small analog voltage. Diaphragm in Dynamic Microphones = Creates voltage changes from sound waves. Electret Material = Permanently electrically charged for sound capture. Raised Center in Piezoelectric = Enhances sensitivity to vibrations. Signup and view all the answers

Match the characteristics with their corresponding effects on data collection:

Body Position Sensor = Important parameter in sleep study reports. Snoring Microphone = Records sounds and vibrations during snoring. Orientation of Sensor = Affects accuracy of body position data. Frequency Range = Varies between different microphone types. Signup and view all the answers

Match the microphone types with their placement or application:

Dynamic = Used without a power source. Electret = Requires proper voltage for operation. Piezoelectric = Placed adjacent to the upper airway. Snore Microphone = Utilizes transducer technology for monitoring. Signup and view all the answers

Match the following tools with their usage in sleep facility accreditation:

Scissors = Cutting materials during electrode application Ruler = Measuring distances for electrode placement Abrasive paste (Nu Prep) = Preparing skin for electrode adhesion Medical Tapes = Securing electrodes in place Signup and view all the answers

Match the following types of PPE with their purpose:

Mask = Preventing inhalation of contaminants Gloves = Protecting skin from contamination Face Shields = Protecting facial area from splashes Gowns = Protecting clothing and skin from exposure Signup and view all the answers

Match the following electrodes with their specific function:

Metal plate electrodes = EEG EOG Chin EMG Snap-on ECG electrodes = ECG and Leg EMG recording Pulse Oximetry = Monitoring blood oxygen levels Respiratory Effort Belts = Tracking breathing patterns Signup and view all the answers

Match the following electrode materials with their characteristics:

Gold-plated silver = Highly conductive and durable Silver = Cost-effective but less conductive than gold Silver/silver chloride = Commonly used for lower artifact Mixing electrodes = Results in artifact in recordings Signup and view all the answers

Match the following electrode types with their form:

Gold cup ear clip = Used for EEG Snap-on electrodes = Quick application for testing Needle electrodes = Invasive recordings EEG electrodes = Monitoring brain activity Signup and view all the answers

Match the following sensors with their application in sleep studies:

Snoring sensors = Detecting sleep apnea symptoms Airflow sensors = Monitoring breath flow Thermal sensors = Measuring temperature changes in airflow Respiratory effort belts = Assessing chest and abdominal movements Signup and view all the answers

Match the following components of sleep facility accreditation with their definitions:

Recommended rules = Preferred methods for scoring Acceptable rules = Allowed methods following discretion Optional rules = Additional methods that add no risk Accreditation = Recognition following compliance Signup and view all the answers

Match the following litigious items with their categories in PPE:

Booties = Foot protection Hair cover = Hair containment Gowns = Body protection Gloves = Hand protection Signup and view all the answers

Match the component of impedance with its definition:

Resistance = Electrical barrier created by oils, sweat, and skin cells Capacitance = Ability of a material to store an electrical charge Impedance = Combination of resistance and capacitance Balanced Impedance = Difference between electrodes should be less than 2 kiloohms Signup and view all the answers

Match the eye position change with its corresponding recording potential trend:

Left gaze = Negative-trending change Right gaze = Positive-trending change Center position = No potential difference Cornea approaching left electrode = Negative-trending change Signup and view all the answers

Match the anatomical structure with its description:

Cornea = Transparent layer forming the front of the eye Retina = Layer at the back of the eyeball that contains light-sensitive cells Optic nerve = Nerve that transmits visual information to the brain Canthus = Corner of the eye where the upper and lower eyelids meet Signup and view all the answers

Match the term with its characteristic:

Dipole = Two poles with opposite charges (anterior positive, posterior negative) Potential difference = Occurs between two electrodes when the eye moves Electrical charge = Movement of electrons contributing to capacitance Electrode balance = Required for accurate measurement of eye position Signup and view all the answers

Match the muscle with its relevant anatomical association:

Digastric muscle = Muscle related to chewing and swallowing Myohyoid muscle = Forms the floor of the mouth Chin EMG = Records electrical activity from facial muscles Eye muscles = Control eye movement including gaze direction Signup and view all the answers

Match the following sensors with their primary function:

SpO2/SaO2 sensor = Measures blood oxygen saturation Pulse oximeter = Non-invasive oxygen levels monitoring EtCO2 = Measures end-tidal carbon dioxide Transcutaneous CO2 = Measures carbon dioxide through the skin Signup and view all the answers

Match the following audiovisual monitoring components with their features:

Video = Requires infrared light source Patient-room audio = One-way communication always on Audio intercom system = Communication between control room and patient Variety of video equipment = Includes fixed-focus and pan-tilt zoom systems Signup and view all the answers

Match the following skin preparation techniques with their descriptions:

Cleaning = Removal of oils, sweat, and dead cells Lightly abrade = Removes dead skin cells for better signal Conducting agents = Substances to improve electrical conduction Impedance measurements = Assessing the quality of electrode contact Signup and view all the answers

Match the following EEG terms with their definitions:

Derivation = Recording from a pair of electrodes EEG record = Output obtained from the derivation process International 10-20 System = Standard method for electrode placement EOG = Electrooculography for eye movements Signup and view all the answers

Match the following terms with their positions in the EEG system:

T3 = Left temporal location T4 = Right temporal location M1 = Left mastoid position M2 = Right mastoid position Signup and view all the answers

Match the following recordings with their cleaning techniques:

Initial skin cleaning = Use alcohol to remove oils Abrading skin = Using Nu-prep® or Lemon-prep® Cleaning after abrasion = Do not use alcohol Electrode application = Apply conductive gel before or after placement Signup and view all the answers

Match the following components with their roles in sleep study recordings:

Hypnogram = Records sleep stages over time SpO2 and EtCO2 = Monitors oxygen and carbon dioxide levels Electrode application = Site identification using the 10-20 system Respiratory monitoring sensors = Assess breathing patterns during sleep Signup and view all the answers

Match the following descriptive elements with their relevant systems:

Fixed-focus system = Basic video equipment Pan-tilt zoom = Advanced video monitoring Two audio monitoring systems = Patient-room audio and intercom system Infrared light source = Required for nighttime video monitoring Signup and view all the answers

Study Notes

PSG 102 Foundations of Polysomnography

Essentials of Polysomnography is a training guide and reference for sleep technicians by William H. Spriggs.
Polysomnography for the Sleep Technologist by Robertson, Marshall, and Carno (2014)
The AASM Manual for the Scoring of Sleep and Associated Events Vol 2.6 by the American Academy of Sleep Medicine (2020)

Keywords

PSG Hook-up (electrodes/sensors, tools, PPE)
The International 10-20 System
Parameters to be Reported for PSG
EEG
EOG
Chin EMG
Impedance

Electrode/Sensor placement for Sleep Studies

EEG: Cup electrodes (100% signal quality) and surface electrodes with wet gel are recommended.
EMG: Surface electrodes around the eyes (EOG) and legs should be monitored.
ECG: Ambu Blue Sensor electrodes are patient-friendly with a positive lead placed on the torso, parallel to the left hip, and negative lead to the right shoulder.
Additional sensors noted include respiratory airflow, respiratory effort, body position, upper airway resistance.

Snoring

Microphones are used.
Sleepmate microphones are high-quality, durable and noise-resistant.

Respiratory Airflow

Thermal pressure unit used to detect apnea and hypopneas.

Respiratory Effort

Anbu Sleepmate bands are used for measurement of changes in chest and abdominal expansion.

Body Position

Sleepmate sensors detect different patient positions without external stabilization.

Upper Airway Resistance

Ambu Sleepmate device measures resistance associated with respiratory effort.

Limb Movement

Ambu Sleepmate limb sensors record limb movements.

Parameters to be Reported

Electroencephalogram (EEG) derivations
Electrooculogram (EOG) derivations
Chin electromyogram (EMG)
Leg electromyogram (EMG)
Airflow signals
Respiratory effort signals
Oxygen saturation
Body position
Electrocardiogram (ECG)
Synchronized PSG video

R&K 1968, AASM 2007

AASM 2007, 2016, 2017, 2018, 2020, 2023 scoring manuals are important
R&K 1968 is a manual of standardized terminology, techniques and scoring systems.

Differentiating Signal types

Bioelectrical: Summed ionic flux generated by cells, measured by applying surface electrodes. Examples are EEG, EOG, ECG, EMG.
Transduced: Converting one form of energy (mechanical) to another (electrical). Examples include body position, nasal pressure airflow, snoring, respiratory effort, movement.
Ancillary: Devices that process data independently, interfaced with the sleep recording system. Examples include end-tidal, pulse oximeter, and carbon dioxide monitors.

Bioelectrical Potentials

AC voltages
EEG, EOG, EMG, EKG

AC/DC Current

Alternating Current (AC): Periodically reverses direction; 60 Hz in the USA.
AC amplifiers are used for processing high-frequency signals.
Direct Current (DC): Derived from external diagnostic equipment (e.g., PAP device).

AASM Sleep Facility Accreditation

AASM sleep facility accreditation requires compliance with all rules, definitions, and notes in the manual.
Recommended, acceptable, and optional rules are all acceptable methods for scoring.
A specific center or laboratory may use acceptable rules in place of recommended ones without risk.

Tools

Scissors
Ruler
China Marker
Alcohol Pads
Tongue depressor
Abrasive paste
Cotton swabs
EEG conductive cream/paste
Gauzes
Hair clips
Medical Tapes
Razor
Nail polish remover
Posey tapes

PPE

Mask
Gloves
Gowns
Face Shields
Hair cover
Booties

Electrodes and Sensors

Metal plate electrodes (EEG, EOG, Chin EMG)
Snoring Sensors
Snap-on ECG electrodes (ECG and Leg EMG)
Respiratory Effort Belts
Airflow Sensors (thermal and PT)
Pulse Oximetry

PSG Equipment (Analog)

Analog equipment is used for PSG recording.

Sleep Diagnostics

Grass Comet-PLUS EEG/PSG amplifier system is a solution for EEG and sleep diagnostics.
Flexible and compact with multiple channels.

Leads/Electrodes

Gold cup Ear clip
Snap-on
Needle

EEG electrodes

Tin plated
Tin (pure)
Silver
Silver/silver chloride
Gold plated

Snap-on electrodes

Various shapes, colors

Electrode Types

Electroencephalography electrodes can be made from various materials (gold-plated silver, silver, silver/silver chloride).
Mixing electrode types creates artifacts.

Electrodes

Gold-plated electrodes are commonly used for PSG recordings.
Silver/silver chloride electrodes require adequate coating to prevent oxidation.
Modern silver/silver chloride electrodes are sintered, thus don't need regular chloride bathing.

Electrodes (Cont.)

Do not use electrodes that are chipped, cracked, or scratched.

Electrode Types (Cont.)

Electrode cups (stamped or casted) have varying thicknesses, influencing flexibility.

Electrode Wires

Wires with thin Teflon coating are durable but may tangle easily.
Thick insulation wires are less prone to tangling.

Specific Use for Electrodes

Primarily for recording EEG and EOG.
Disposable electrode patches are not suitable for EEG recording.

Cables, Connectors, and Jumpers

Transducers are devices converting energy from one form to another.
Connectors depend on the system type (1.5 mm touch proof, keyhole, phone, RCA, RJ11, DIN).
1.5mm touchproof connectors are most common, recessed-female, and FDA mandated to prevent electric shock.

Jumpers (Cont.)

Jumpers are used for linked-ear reference or common reference.
May be used to resolve electrode input capabilities and remove ECG artifacts.

Thermistor, Thermocouple, Pressure transducer, and polyvinylidene fluoride (PVDF)

Various sensors and devices are used in polysomnography.

RIP and Piezo sensors

Respiratory Inductive Plethysmography (RIP) sensors and Piezo sensors are used to measure respiratory effort.

Monitoring Respiratory Effort

Respiratory inductive plethysmography (RIP), Piezo technology, Diaphragmatic and intercostal EMG are used to measure effort.

Monitoring Respiratory Effort (Cont.)

Piezo electric crystals generate a charge with repeated stress and release during breathing.
Waveform is an approximation of movement.
Limitations include accuracy issues during patient movement and occurrence of false paradoxic signals.

Monitoring Respiratory Effort (Cont.)

Diaphragmatic and intercostal EMG measure the central vs. non-central respiratory effort.
Issues include electrode placement and difficulty in obese patients.

Respiratory Inductance plethysmography (RIP)

Measures changes in cross-sectional area of rib cage/abdomen during breathing cycle.
Band configuration: woven/sewn wire along entire length.
Detects changes in magnetic field frequency to reflect lung volume.

Respiratory Inductance plethysmography (RIP) (Cont.)

RIP produces a linear signal.
No electrical current passes only a weak magnetic field.
RIP measurements can calibrated/uncalibrated.
Calibrated RIP represents actual airflow volumes

Sine wave pattern in RIP sensor belt

Shows a sine wave pattern during respiration.

Sum Effort Channels Recorded using RIP technology

Sum effort channels based on RIP data are recorded.

Snoring sensor

Pressure sensor signals are recorded from a piezo pressure sensor on both nostrils at the same time.

Snore Microphones and Sensors

Snoring is recorded using microphones and sensors.
Converts sound waves to an analog voltage.

Snore microphone

Dynamic, electret, and piezoelectric microphones convert sound to voltage.

Dynamic

Dynamic microphones use a diaphragm that displaces with sound waves, generating voltage changes.

Electret

Electret microphones use a permanently charged diaphragm that produces voltage changes.

Piezoelectric

Piezoelectric microphones use piezoelectric effect to sense vibrations producing a voltage signal.

Body position sensor

Detects subtle position changes based on gravity for analysis.

Recording patient body position

Video monitoring and sensors are used to record patient position.

Body Position Sensors

Detect subtle position changes.
Data is based on gravity.
Accurate output requires correct orientation around the chest/abdomen.

SpO2/SaO2 sensor

Pulse oximeters provide SpO2/SaO2 readings.
Variety of sensor types exist (e.g., clip-on finger, wrist-worn).

Pulse oximeter

Device is used to measure SpO2/SaO2.

Hypnogram

The hypnogram records stages of sleep (e.g., REM, awake, movement).

EtCO2

End-tidal CO2 signal (EtCO2), correlated to respiratory events.

SpO2 and EtCO2

SpO2 and EtCO2 graphs show oxygen and carbon dioxide levels.

Transcutaneous CO2

Transcutaneous CO2 sensors are used to gather data by placing the sensor on the patient's cheek.

Audiovisual Monitoring and Recording

Essential components for sleep study recording
Includes infrared light source and varieties of video equipment.

Electrode application

Electrode site identification using the International 10-20 system.

Skin Preparation

Location identification.
Cleaning/abrading the skin.
Application of conductive agents.

AASM Technical Specifications for EEG

Recommended and acceptable EEG derivations and electrode placements.

Derivation

Recording from a pair of electrodes in an EEG channel.
EEG record obtained by this process.

International 10-20 System

System used to determine EEG electrode position.

Where are the T3 and T4?

Precise location (for electrode placement).

Mastoid Processes

Anatomy of the mastoid processes for electrode placement.

Recording with Surface Electrodes (Cont.)

Skin cleaning procedures and techniques.
Abrading procedure for removal of dead skin cells.

Impedance (Cont.)

Resistance and capacitance are part of impedance.

EOG

Eye acts as a dipole with anterior being positive and posterior negative.

Chin EMG

Electrode placement to record activity in the chin muscles (midline, 2cm right, 2cm left).

Digastric and Myohyoid Muscle—

Related anatomy for chin EMG reference.

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This quiz covers various aspects of electrodes, including their types, characteristics, applications, and care requirements. It is designed to test your knowledge on electrode types used in medical monitoring and their specific functionalities. Perfect for students and professionals in the medical field.