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The concept of a RAC-based service was described in 2 QoS management adds the concept of a performance class A performance class consists of one or more services that share a performance objective These performance objectives are used to evaluate the quality of service being provided by the managed RAC environment For instance, you could group a variety of sales applications as one performance class, with maintenance and batch operations grouped together in another performance class

traverses only the ventral root and can be elicited from any number of muscles The combination of a normal F response and an absent H re ex is found in diseases of sensory nerves and roots Both of these late responses nd their main use as corroborative tests that must be interpreted in the context of the entire nerve conduction examination (see Wilbourn in References) The normal late response latencies are given in Table 45-1 Blink Responses This special nerve conduction test is useful in the diagnosis of certain demyelinating neuropathies and in any process that affects the trigeminal or facial nerve The supraorbital (or infraorbital) nerve is stimulated transcutaneously and the re ex closure of both orbicularis oculi muscles is recorded with surface electrodes Two CMAP bursts are observed: the rst (R1) appears ipsilaterally 10 ms after the stimulus and the second (R2) ipsilaterally at 30 ms and contralaterally up to 5 ms later The amplitudes of the responses vary considerably and are not in themselves clinically important The rst response is not visible as a muscular contraction but may serve some preparatory function by shortening the blink re ex delay R1 is mediated by an oligosynaptic pontine circuit consisting of one to three neurons located in the vicinity of the main sensory nucleus; R2 utilizes a broader re ex pathway in the pons It has been established that R1 and R2 are generated by the same facial motor neurons The elicitation of blink re exes establishes the integrity of the afferent trigeminal nerve, the efferent facial nerve, and the interneurons in the pons (R1) and caudal medulla (related to the bilateral R2 response) The test may be also be helpful in identifying a demyelinating neuropathy when the facial and oropharyngeal muscles are affected and those of the limbs are relatively spared, leaving conventional nerve studies normal In such cases, the blink responses are delayed ipsilaterally and contralaterally as a result of conduction block in the proximal facial nerve Direct facial nerve stimulation often fails to demonstrate this block because only the distal segment of the nerve is amenable to study Although this test is rarely necessary for diagnosis, most patients with hereditary neuropathy have blink response abnormalities In Bell s palsy there is a delay or absence of R1 and R2 responses only on the affected side Large acoustic neuromas may interfere with the afferent trigeminal portion of the pathway and give rise to abnormal responses on the affected side Diseases of the brainstem have yielded inconsistent responses It is noteworthy that the test is normal in patients with trigeminal neuralgia Segmental Motor, Cranial, and Somatosensory Evoked Potentials (See also Chap 2) These techniques nd use in diseases that affect spinal roots By applying a magnetic stimulus, which induces an electrical impulse, or by a directly delivered electrical stimulus over the lower cervical or lumbar spine, it is possible to activate the motor (anterior) roots and to measure the time required to elicit a muscle contraction (Cros and Chiappa) These root stimulation tests can be quite uncomfortable for the patient because of the contraction of muscles surrounding the stimulation site Transcranial magnetic stimulation of the cerebral cortex permits measurement of the latency of muscle contraction after excitation of motor neurons in the cortex Thus, the integrity of the entire corticospinal system, from the cortical motor neurons through spinal tracts, anterior horn cells, and the peripheral motor nerve can be determined By combining this technique with the previously described root stimulation, it becomes possible to measure central and peripheral motor conduction times These forms.

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Special Electrodiagnostic Studies of Nerve Roots and Spinal Segments (Late Responses, Blink Responses, Segmental Evoked Responses)

it has been programmed to manage It first checks the processor, then the RAM, and then system-critical devices such as the floppy drive, hard drive, keyboard, and monitor It then tests noncritical components such as the CD-ROM drive and sound card Next, the BIOS retrieves the resource (IRQ and I/O address) settings from the CMOS and assigns them to the appropriate devices The BIOS then processes the remaining CMOS settings, such as the time or keyboard status (for example, whether the number lock should be on or off) Finally, the BIOS searches for an operating system and hands to it control of the system The CMOS settings are no longer required at this point, but the BIOS continues to work, translating communications between the processor and other components The BIOS contains basic drivers (16-bit) for accessing the needed hardware during bootup, such as the keyboard, floppy disk, and hard disk or any other device needed during a boot

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