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WGU C172 NETWORK AND SECURITY
FOUNDATIONS OBJECTIVE
Berlin Questionnaire - ANSWER -series of questons designed to demonstrate the likelihood of palient having sleep apnea. Hypoventilation - ANSWER -Insufficient breathing results in increased levels of CO2 and decreased levels of 02 the blood. High Frequency Filter (HFF) - ANSWER -A tool or device on a polysomnograph which sets a Iimitation to the high frequency signals that allowed to pass through the amplifier. Histogram - ANSWER -a display of sleep stages achieved throughout the sleep period. Nasion - ANSWER -anatomical landmark on the top or bridge of the nose where the forehead and nose meet. This landmark is used in the International 10/20 System of Electrode Placement to locate electrode sites. Hyperventilation - ANSWER -A state of excessively fast breathing, resulting in decreased C02 levels and increased 02 levels in the blood. Sa02 - ANSWER -The amount of oxygen in the biood as read by an arterial biood gas. Нypоxia - ANSWER -The state low oxygen levels in the blood.
Нурохemia - ANSWER -The state of having habitually low oxygen levels the blood. Hypercapnea - ANSWER -Excess levels of carbon dioxide (CO2) in the blood. Hypnagogic Foot Tremor (HFT) - ANSWER -A sleep disorder characterized by rhythmic leg or foot movements at sleep onset. Impedance - ANSWER -Resistance to the flow of electricity. In polysomnograph, EEG electrode impedances should be kept below 5000 Ohms. Bioelectric Potentials - ANSWER -Electrical signals that originate from a living source. Histamine - ANSWER -A chemical in the brain responsible for activation of the cortex. Neurotransmitters - ANSWER -Chemicals in the brain that allow for the exchange of impulses from one neuron to the next. Sampling Rate - ANSWER -The designated number bits recorded per second in a channel. Pittsburgh Sleep Quality Index (PSQI) - ANSWER -A series of questions in which the patient provides a subjective assessment of their own sleep quality.
respiration. EPAP and IPAP are identical during CPAP and dissimilar during Bi-Level PAP. Нyросаpnea - ANSWER -Having too little carbon dioxide in the blood. Ерoch - ANSWER -In polysomnography, a page of the sleep study recording. The paper speed in is standard polysomnography 10mm/sec, which produces 30-second page. Нурopnea - ANSWER -A decrease in airflow for at least ten seconds caused by a partial obstruction in the upper airway. Epworth Sleepiness Scale (ESS) - ANSWER -An index of sleepiness during the day as perceived by patients, derived from the ANSWER s to 8 questions. V Waves - ANSWER -Sharp negative deflections seen in an EEG channel. V Waves are characteristic of the latter part of stage N1. V Waves were formerly called Vertex Waves or Vertex Sharp Waves. Esophageal Balloon - ANSWER -A device inserted into the esophagus to measure small changes in airway resistance. Volt - ANSWER -A measurement of electrical force. Sleep Related Hallucinations - ANSWER -These are hallucinations either at sleep onset or upon awakening, often associated with
sleep onset REM periods (SOREMP's), and may be frightening to the patient. These occur the absence of narcolepsy. End Tidal CO2 - ANSWER -A reading of carbon dioxide levels in the blood as measured by expired air. Suprachiasmatic Nucleus - ANSWER -A structure in the brain responsible for the 24-hour circadian rhythm. Sleep Related Eating Disorder - ANSWER -This disorder includes repeated episodes of eating and/or drinking during arousals from sleep. This often occurs on a nightly basis, or several times a night. the patient usually chooses junk foods. Environmental Sleep Disorder - ANSWER -A secondary sleep disorder caused by a sleep disorder present in a bed partner, poor sleep hygiene, or other factors. Thalamus - ANSWER -A structure in the brain responsible for relaying certain sensory information from the body to different parts of the brain. Delayed Sleep-Wake Phase Disorder - ANSWER -This is characterized by later sleep time than expected. Patients with this disorder are usually adolescents or young adults, and tend to stay up late at night and wake up late the morning. Long Sleeper - ANSWER -This symptom occurs when a person sleeps >10 hours per 24 hours, and is not explainable by another
AC signals can alternate quickly between positive and negative voltages, while DC signals change slowly and range from 0 - 1V. - ANSWER -What is the difference between an AC signal and a DC signal? The small, cup-shaped head makes it easy to be placed securely against the scalp and hold conductive paste. They are also made of a highly conductive metal, usually gold or silver silver- chloride.
- ANSWER -Why are cup electrodes used in electroencephalography? Snore microphones detect the noise from the snores and can be placed wherever snoring is heard the loudest, close to the nose or mouth or on the throat. Snore sensors record vibrations from the snores and are placed on the throat. - ANSWER -What is the difference between a snore microphone and a snore sensor? One end shines a red light through the finger while the other end detects that light. Blood that is highly saturated by oxygen is lighter in color, and allows more light to pass through it. - ANSWER -How does an oximeter estimate the blood oxygen level? Thermocouples detect the rate of temperature change by using two dissimilar metals that are sensitive to temperature change. Thermisters use a wheatstone bridge circuit to amplify the difference in temperature between expired air and room air. - ANSWER -What is the difference between a thermister and a thermocouple?
A (any 4 of these) Inductive Plethysmograph Piezo-electric Crystal Belts Mercury Strain Gauges Cardio-Pneumograph Pneumatic Respiration Transducer Intercostal EMG's Esophageal Balloon Water-filled Catheter - ANSWER -Name 4 methods or recording respiratory effort 5uV - ANSWER -A 10uV signal is detected by the exploring electrode (G1) at the same time as a 5uV signal is detected by the reference electrode (G2). What is the output voltage? <5000 (5k) Ohms - ANSWER -What is the optimal range for impedances in EEG channels? The amplifier's ability to eliminate unwanted signals through the use of filters - ANSWER -What does a Frequency Response Curve show? A CPAP Montage includes additional channels for CPAP flow, pressure, and leak. - ANSWER -What is the main difference between a Baseline/Diagnostic Montage and a CPAP Montage?
The amount of time for a calibration wave to fall from its highest point, or peak, to 37% of the peak - ANSWER -What is the Time Constant? It will cut the height of the wave in half. - ANSWER -Increasing the sensitivity setting from 10uV/mm to 20uv/mm will do what to the appearance of the wave? The mechanical baseline is the vertical positioning of the pen when the power is turned off. The electrical baseline refers to the same positioning when the power is turned on. - ANSWER -What is the difference between the mechanical baseline and the electrical baseline? Take steps to correct EKG artifact starting with moving M1 and M to the earlobes. - ANSWER -The EEG and EOG channels present an intermittent single fast wave approximately every second. What is the most appropriate course of action? Wait for the patient to stop moving, as this is most likely movement artifact. After movement has stopped, determine if any leads have detached and reapply if necessary. - ANSWER - Shortly after the patient wakes up, all the signals on the PSG show a high frequency, very high amplitude artifact obscuring all the tracings. What is the most appropriate course of action? Take steps to correct sweat artifact including cooling the patient and replacing the ground lead. - ANSWER -During physiologic calibrations, the EEG and EOG channels present a high amplitude, very slow wave artifact. What is the most appropriate course of action?
If the Run an impedance check. impedance in this channel is higher than 5k Ohms, the electrode should be reapplied or replaced. - ANSWER -During the night, the tech notices that the C3 channel appears slightly darker than the other EEG channels. What should she do first? Adjust the sensitivity setting to correct the pen blocking artifact. - ANSWER -The airflow channel squares rather than rounds at the peaks. What should the technician do? Check to see if there is a common reference between the affected channels. - ANSWER -When attempting to correct an artifact, the technician notices that the artifact appears in multiple channels. What should he do next? There must be at least 4 limb movements, each at least 8uV above the resting limb movement amplitude and at least 0. seconds long, all occurring within 5 to 90 seconds of each other. - ANSWER -What are the requirements for a series of limb movements to be scored as Periodic Limb Movements? The airflow must decrease by 30-90% of the original amplitude and be associated with an 02 desaturation of at least 3% and/or an EEG arousal. - ANSWER -What are the requirements for scoring a hypopnea? There must be at least 3 consecutive cycles of a waning-waxing pattern in the airflow with a duration of at least 10 seconds each, and at least 5 central apneas or hypopneas per hour of sleep
11-16 Hz - ANSWER -What is the frequency range for sleep spindles? 8-13 Hz - ANSWER -What is the frequency range for alpha waves? Occipital channels (01 and 02) - ANSWER -In what channels are alpha waves seen most prominently? 0.5 seconds - ANSWER -What is the duration requirement for a K Complex? REM - ANSWER -The EEG's show trains of pointed waves in the 2- 6Hz range, with a decreased chin EMG. What stage is this? N1 - ANSWER -The EEG's are a low voltage, mixed frequency pattern, and the EOG's show slow eye movements. What stage is this? The Health Insurance Portability and Accountability Act of 1996, or HIPAA - ANSWER -What patient privacy rule did the U.S. Dept of Health and Human Services initiate in 1996? Consult the lab's written emergency and disaster plan for tornadoes. - ANSWER -During the night, excessively strong winds build outside, causing the technician to worry for the safety of the patients. What should the technician do? Antibiotic soap - ANSWER -What type of soap should be used when washing hands?
Enter the patient room and replace the lead. - ANSWER -During the night, the patient awakens and kicks off one of the leg EMG leads. What should the technician do? Contact the physician to verify the accuracy of the order. If the physician is not available, contact the lab manager. - ANSWER - When reviewing the patient chart, you notice that the physician's orders call for supplemental oxygen at 10L/min. What should you do? Contact the lab manager. Do not perform a study without physician's orders. - ANSWER -A patient arrives at the lab claiming to be scheduled for a sleep study, but he is not on the schedule. You cannot find a chart for him. What should you do? Follow the lab protocol. If the lab does not have oxygen or CPAP protocols for this situation, do not apply these therapies. If the patient appears to be in danger, contact the medical director. - ANSWER -During a diagnostic study, the patient has an RDI of 80 after three hours of sleep and is desaturating below 70%. What should you do? Before and after every study, and while troubleshooting equipment problems - ANSWER -How often should amplifier calibrations be performed? Increase CPAP according to lab protocol. - ANSWER -What should be done during a CPAP titration if obstructive apneas persist?
14.3 - ANSWER -There are 64 limb movements recorded during 287 minutes of sleep. 41 of these were part of PLM series. What is the PLM Index? WASO (Wake After Sleep Onset) = TRT - TST - Sleep Latency - ANSWER -What is WASO and how is it calculated? RDI = (Apneas + Hypopneas RERA's)/TST in hours - ANSWER - How is the Respiratory Disturbance Index (RDI) calculated? AHI = (Apneas + Hypopneas)/TST in hours - ANSWER -How is the Apnea Hypopnea Index (AHI) calculated? REM Latency is the time, in minutes, from Sleep Onset to REM Onset. - ANSWER -How is REM Latency calculated? The first epoch of stage R - ANSWER -What is REM Onset? Sleep Latency is the time, in minutes, from Lights Out to Sleep Onset. - ANSWER -How is Sleep Latency calculated? The first epoch of sleep, regardless of the stage. This is usually the first epoch of stage N1. - ANSWER -What is Sleep Onset? % Stage R = Total REM Time/TST - ANSWER -How is the % of Stage R calculated? TWT = TRT - TST
Or TWT = Sleep Latency + WASO - ANSWER -How is the Total Wake Time calculated? SE = TST/TRT - ANSWER -How is Sleep Efficiency calculated? Total Sleep Time (TST) - ANSWER -Total Recording Time minus Total Wake Time equals Total Recording Time (TRT) - ANSWER -The duration in minutes from Lights Out to Lights On is called 2247 - ANSWER -The recording starts at 2232. Physiologic calibrations start 7 minutes later and last for 5 minutes. 3 minutes later, the television and lights are turned off and the patient begins trying to sleep. What time does Lights Out occur? Alcohol - ANSWER -Suppresses REM, increases stage N3 and apneas. Increases sleep fragmentation. THC - ANSWER -Suppresses REM. Increases drowsiness and N3. Morphine - ANSWER -Decreases REM and leg movements. Increases N1 and apneas. Heroin - ANSWER -Decreases REM, N1, and limb movements. Increases apneas.
Low on the left rib cage, vertically aligned with the left hip - ANSWER -Where is the exploring electrode placed on a 2-lead EKG for a sleep study? 1cm - ANSWER -How far above the inferior edge of the mandible is the first chin EMG electrode placed? 6cm - ANSWER -The distance from Fp1 to 01 (through C3) is 24cm. What is the distance from Fp1 to F3? 14.4cm - ANSWER -The distance from the left pre-auricular point to the right pre-auricular point is 36cm. What is the distance from Cz to T3? 1cm above the right outer canthus - ANSWER -Where is E located? Inion - ANSWER -What landmark in the back of the head is used to begin measuring EEG's? Nasion - ANSWER -What landmark in the front of the head is used to begin measuring EEG's? The International 10-20 Electrode Placement System - ANSWER - What system of measurements is used to locate EEG sites? EKG Artifact - ANSWER -What artifact seen in the Chin EMG channel?
Sweat Artifact - ANSWER -What artifact is seen in the EEG channels? Snore Artifact - ANSWER -What artifact is seen at the 15-second mark of the epoch? EEG Arousal - ANSWER -What event circled in this epoch? Periodic Limb Movements - ANSWER -What events are circled in this 300-second epoch? obstructive apnea - ANSWER -What event circled in this epoch? Mixed Apnea - ANSWER -What event circled in this epoch? EKG Arrhythmia - ANSWER -The absence of a rhythm in the EKG channel. Pediatric obstructive sleep apnea - ANSWER -Diagnostic criteria for this disorder include at least 1 obstructive apnea or hypopnea per hour of sleep. It may sometimes be associated with SIDS Sleep related nonobstructive alveolar hypoventilation - ANSWER - this disorder is characterized by periods of shallow breathing or decreased airflow associated with O2 desaturation. These periods last at least 10 seconds and are often associated w/ EEG arousals.
