EMG 2

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Author:
shmvii
ID:
239802
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EMG 2
Updated:
2013-10-09 18:49:12
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EMG
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EMG
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  1. 2 examples of causes ov NMJ dysfunctions
    • myesthenia gravis
    • botox
  2. pt has myopathy.
    What's still normal?
    What's involved?
    • sensation & the motor nerve (only muscle is affected)
    • muscle fibers
  3. basic diff of presentation in myopathies vs neuropathy
    • myopathy - starts prox
    • neuropathy - start distal
  4. temporal dispersion
    slower conduction, signal is spread out -- a sign of demyelination
  5. moter NCVs are measured w what unit?
    milivolts or 1/1000 volts
  6. amplifier's job
    amplify the electrical diff btwn active and reference electrode
  7. conduction velocity revelas
    • velocity of the fastest conducting fibers (it's not an averaging thing, it's looking at the fastest fibers)
    • amount of demyelination
    • MU innervation
  8. amplitude reveals
    • number of fibers conducting the AP
    • if axons are blocked or there's degen the amp will decrease
  9. median nerve, wrist --> APB,
    ulnar nerve, W --> ADM
    normal, borderline, prolonged latencies?
    • median:
    • normal < 4.0 ms
    • bord 4-4.2
    • prol >4.2

    • ulnar:
    • norm <3.4
    • bord 3.4-3.6
    • prol >3.6
  10. velocity norm, borderline, and low for median, ulnar, and radial nerves
    • norm >50m/s
    • bord 47.5-50 m/s
    • low <47.5
  11. radial n. latency
    • not done bc of variety of locations
    • but he has the value 40m/s in that box, tho the vel should be >50 m/sec
  12. temp's affect on NCV
    cold gives slower conduction vel
  13. which muscle for median nerve testing?
    APB
  14. APB attachments
    transverse carpal ligament, the scaphoid and trapezium --> radial base of proximal phalanx of thumb
  15. elecrode placements for median and ulnar n testing
    • active: over belly of muscle
    • reference: distal to muscle belly
    • ground: back of hand
  16. 1st site of stim for median nerve / APB
    wrist, btwn FCR and PL
  17. rule on cathode (-) and anode (+) placement
    cathode is always closest to the electrode
  18. 2nd site of stim for median nerve / APB
    prox to the first -- ant and just med tothe biceps tendon
  19. 3rd site of stim for median nerve / APB
    • more pros still
    • belly of bicep and a bit medial, over the nerve
  20. physical response when you hit the median nerve
    thumb jump, writs flex and pronate
  21. muscle for ulnar nerve test
    ADM
  22. ADM attachments
    pisiform -->base of the proximal phalanx of the 5th digit on the ulnar or medial side
  23. 1st site of stim for ulnar n
    med or lat to flexor carpi ulnaris
  24. 2nd and 3rd site of stim for ulnar n
    • (must be done with elbow flexted 70-90 degrees to take the nerve off slack)
    • just distal to med condyle
    • just prox to it (bc the ulnar groove is such a common site for nerve compression, got to go right above)
  25. 4th site of stim for ulnar n
    medial upper arm
  26. main problems for median, ulnar, radial nerves
    • median: carpal tunnel, pronator teres
    • ulnar: ulnar groove in elbow
    • radial: compression in forearm, soft tissue damage, upper arm by spiral groove -- most common spot
  27. tinnel's sign when nerve is regenerating?
    positive
  28. radial nerve's test muscle?
    extensor indicis
  29. 1st site of stim for radial n
    prox forearm lat to extensor carpi ulnaris (this is vague, so we don't have a latency time norm)
  30. 2nd site of stim for radial n
    upper amr distal to spiral groove btwn brachioradialis and biceps
  31. 3rd site of stim for radial n
    axilla

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