ABRET Certified Neurophysiologic Intraoperative Monitor (CNIM) Practice Exam

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What does the term "cortical ischemia" refer to in the context of CEA monitoring?

Increased blood flow to the brain

Reduced blood supply to the brain leading to potential damage

Cortical ischemia refers to a condition where there is a reduced blood supply to the brain, particularly affecting the cortex, which can lead to potential damage. In the context of Carotid Endarterectomy (CEA) monitoring, it is crucial to recognize this term because during the surgical procedure, there is a risk of compromising blood flow to the brain due to manipulation of the carotid artery. When the blood supply is insufficient, brain cells can become deprived of oxygen and nutrients, which may result in neurological deficits or complications. Monitoring for cortical ischemia involves using techniques such as neurophysiological assessments to detect changes in brain activity or blood flow, therefore ensuring the patient's brain remains adequately perfused throughout the procedure. This understanding is vital in proactive measures to prevent irreversible damage to the brain during surgery.

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Normal brain function during surgery

Enhanced metabolic activity in the brain

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