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Questions and Answers

What is the location for the SSEP site V2?

Posterior to the medial malleolus of the foot

On the eyebrow

An inch below the zygomatic arch (correct)

Slightly to the side of the mandible

What should you do if the stimulation during SSEP becomes uncomfortable for the patient?

Decrease the strength of the stimulation (correct)

Change the stimulation site immediately

Continue without adjustment to complete the test

Don't stim there anymore

How can you identify the vagus nerve location for Gammacore treatment?

Below the jawline

At the center of the throat

Within the triangle formed by the sternocleidomastoid (correct)

Above the chin point

What should the sensation feel like when using the Gammacore device?

Strong with a pulling sensation Signup and view all the answers

How much gel should be applied to the electrodes before using Gammacore?

A pea-sized amount of gel on each electrode Signup and view all the answers

What should be done after the Gammacore device beeps for the first time?

Reapply gel and perform another round on the same side Signup and view all the answers

What determines the strength of the stimulation during SSEP procedures?

The turning mechanism on the prongs Signup and view all the answers

What is the function of the yellow icon labeled 'Stim' during the SSEP procedure?

Signals that stimulation is currently active Signup and view all the answers

Which area of the body is associated with the common peroneal nerve during SSEP?

Behind the proximal fibular head Signup and view all the answers

What should you do if a patient rejects hypoglossal stim?

Try to educate/convince them but accept if they don't want to Signup and view all the answers

Where is V3 located

slightly to the side of the mandible Signup and view all the answers

What is the purpose of GammaCore

Activates the parasympathetic System Signup and view all the answers

Which SSEP site corresponds to the middle of the wrist?

Median nerve Signup and view all the answers

If the chart says Gammacore (L) when you duplicate it what should you do for your visit?

Use gammacore on the right side and switch the (L) to (R) Signup and view all the answers

What should the stimulation strength feel like during a SSEP procedure?

Moderate but not painful Signup and view all the answers

What is the gammacore aiming to stim?

Vagal nerve Signup and view all the answers

When should you clean the prongs with the alcohol prep pads?

Before hypoglossal Signup and view all the answers

Which site corresponds to the hypoglossal nerve during the SSEP?

Directly on the tongue Signup and view all the answers

Study Notes

SSEP (Somatosensory Evoked Potentials)

Key electrode sites for SSEP include:
- V1: Medial top part of the eye, located on the eyebrow
- V2: Approximately one inch below the zygomatic arch
- V3: Slightly lateral to the mandible
- Hypoglossal: Directly on the tongue
- Median nerve: Center of the wrist
- Common peroneal nerve: Behind the proximal fibular head
- Tibial nerve: Posterior to the medial malleolus of the foot
Procedure steps:
- Power on the device using the switch at the bottom left of the base.
- Launch the SierraXP program and select patient “Tran, Minh”.
- Navigate to the Test Protocol and select “Median SSEP.”
- A flashing yellow “Stim” icon indicates that stimulation is active; use a probe with ultrasound gel for stimulation.
- Activate the stimulation by clicking the “Run” button located at the bottom right of the base.
- Start stimulation at a low level and gradually increase using the turning mechanism on the prongs (right for increase, left for decrease).
- Ensure the stimulation is strong but not painful; frequently check in with the patient on their comfort level.

Gammacore

Turn on the Gammacore device to view the remaining daily stimulations.
Apply a pea-sized amount of gel on each electrode for optimal contact.
Locate the vagus nerve in the neck, identifiable by its triangular positioning with the sternocleidomastoid muscle.
Position the device vertically on the patient's neck, allowing the patient to adjust the intensity. They should experience a notable pulling sensation in the neck.
The device will beep after two minutes, signaling the end of the session. Reapply gel and repeat the stimulation on the same side.

SSEP (Somatosensory Evoked Potentials)

Key electrode sites for SSEP include:
- V1: Medial top part of the eye, located on the eyebrow
- V2: Approximately one inch below the zygomatic arch
- V3: Slightly lateral to the mandible
- Hypoglossal: Directly on the tongue
- Median nerve: Center of the wrist
- Common peroneal nerve: Behind the proximal fibular head
- Tibial nerve: Posterior to the medial malleolus of the foot
Procedure steps:
- Power on the device using the switch at the bottom left of the base.
- Launch the SierraXP program and select patient “Tran, Minh”.
- Navigate to the Test Protocol and select “Median SSEP.”
- A flashing yellow “Stim” icon indicates that stimulation is active; use a probe with ultrasound gel for stimulation.
- Activate the stimulation by clicking the “Run” button located at the bottom right of the base.
- Start stimulation at a low level and gradually increase using the turning mechanism on the prongs (right for increase, left for decrease).
- Ensure the stimulation is strong but not painful; frequently check in with the patient on their comfort level.

Gammacore

Turn on the Gammacore device to view the remaining daily stimulations.
Apply a pea-sized amount of gel on each electrode for optimal contact.
Locate the vagus nerve in the neck, identifiable by its triangular positioning with the sternocleidomastoid muscle.
Position the device vertically on the patient's neck, allowing the patient to adjust the intensity. They should experience a notable pulling sensation in the neck.
The device will beep after two minutes, signaling the end of the session. Reapply gel and repeat the stimulation on the same side.

SSEP/Cadwell Overview

SSEP (Somatosensory Evoked Potentials) assess the sensory pathways in the nervous system.
Key stimulation sites include:
- V1: Medial top part of the eye (eyebrow area)
- V2: One inch below the zygomatic arch
- V3: Slightly to the side of the mandible
- Hypoglossal: Directly on the tongue
- Median Nerve: Center of the wrist
- Common Peroneal Nerve: Behind the proximal fibular head
- Tibial Nerve: Posterior to the medial malleolus of the foot

SSEP Procedure Steps

Power on the device using the switch at the bottom left of the base.
Start the SierraXP program, select the patient named Tran, Minh.
Choose "Median SSEP" from the Test Protocol menu.
Check for a flashing yellow icon labeled “Stim,” indicating that stimulation is active.
Use a probe with ultrasound gel for effective stimulation.
Press the “Run” button on the bottom right to initiate the test.
Begin stimulation at a low intensity, gradually increasing using the turning mechanism on the prongs (right for increase, left for decrease).
Ensure stimulation is strong yet not uncomfortable, continuously checking with the patient for their comfort level.

Gammacore Device Overview

Gammacore is used for vagus nerve stimulation.
Turn on the power to see the number of available stimulations for the day.
Apply a pea-sized amount of gel on each electrode for effective contact.
Locate the vagus nerve in the neck, positioned between the sternocleidomastoid muscles.
Position the Gammacore device vertically on the patient's neck and allow them to control the intensity, aiming for a strong sensation with a pulling feeling.
The device will beep after two minutes, indicating the need to reapply gel and repeat the process on the same side.

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Description

Test your knowledge on Somatosensory Evoked Potentials (SSEP) by exploring key electrode sites and procedural steps. This quiz covers important aspects of SSEP testing, including locations for electrode placement and the operation of the testing device. See how well you understand the SSEP procedure.