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Details

MSK ex2
neuro-EMG
18
Medical
Professional
11/02/2011

Additional Medical Flashcards

 


 

Cards

Term
Differences between EMG and NCS
Definition

EMG records electric activity of nerves (done at rest)

 

NCS assesses the quality of the conduction and speed

Term
EMG capabilities
Definition
can localize region of injury and precise location within pathway
Term
Reasons to order EMG/NCS
Definition
  • Radiculopathy
  • Peripheral neuropathy
  • Entrapment neuropathy

- Carpal tunnel syndrome
-Ulnar neuropathy at the elbow
-Peroneal neuropathy

  • Neuromuscular junction disorder
  • Botulism
  • Myasthenia gravis
  • Neuromuscular junction disorder
  • Lambert – Eaton myasthenic syndrome
  • Myopathy
  • Plexopathy (Brachial or Lumbosacral)
  • Bell’s palsy
Term

changes occuring in action potential that lead to dz.

Definition
changes in the onset, duration, amplitude, configuration
Term
a successful dx obtained from EMGs utilizes what other dx methods
Definition
anatomic imaging.  Neither test in conclusive on its own.  MRIs can find back abnormalities in 50% of individuals who are assymptomatic.  abnormal EMG results can occur from benign processes
Term
what is essential to perform prior to facilitating an EMG?
Definition
taking a detailed hx and physical.  this will allow you to account for behaviors which could affect the results of the EMG
Term
contraindications for an EMG
Definition

cellulitis

pacemaker (if stimulating erb's point)

Term
limitations of EMG results
Definition
nThe electromyographer (biggest limitation)
nKnow your anatomy!
nCan not assess CNS (unless doing SSEPs)
nPatient tolerance
nNormal EMG
nTest done too early
nNon-neurogenic abnormality
Term
what does an negative EMG mean?
Definition

the test was done too early

not enough nerve damage to show results

incorrect interpretation

Term
what is the appropriate timing for performing an EMG?
Definition

4-5 days following traumatic event

 

1-3 weeks after event if one wishes to view spontaneous potentials

Term
some conditions that would yield normal responses
Definition
nDegenerative Joint Disease
nFacet disease
nRheumatoid Arthritis
nOsteoporosis
nFractures
nSprains
nSensory only Radiculopathy
nSpondylolisthesis
nScoliosis
nBursitis
nFibromyalgia
nMyofascial Pain
nPregnancy
nVascular disorders
nPsychogenic disorders
Term
what is measured in a nerve conduction study?
Definition

latency: the time the impulse took to reach sensor (related to distance traveled)

 

amplitude increase in millivolts (reflects the number of axons responding to the impluse)

 

conduction velocity (relates to myelin integrity)

-sensory: has no myoneural jxn so speed is directly related to distance only

-motor: has nymoneural jxn, therefore, must stimulate two nerve segments

Term
wallerian degradation
Definition

injury causes myelin degradation on axon of a schwann cell and the axon also degenerates because it has been separated from the rest of the cell (Axonotmesis)

 

degeneration of myelin takes place over ~7 days

 

effects are seen distal to site of injury

Term
importance of myelination in action potential conduction
Definition

the action potential jumps between myelin segments (nodes of ranvier) and therefore never fall too low and is never unable to propogate the signal.

 

demyelination dismantles the jumping and causes the action potential to plummet

Term
what is the best way to relax a muscle being studied by NCS?
Definition
contract the agonist muscle (the triceps if you're studying the biceps)
Term
what is neurapraxia
Definition

damage to a nerve affecting the myelin sheath but leaves the nerve intact but in a non-conducting state

 

therefore, wallerian degradation does not take place in this situation

Term
what is neurotmesis
Definition

a complete disruption of the axon, myelin, and epineurium (everything cut in half)

 

poor prognosis

 

def. needs surgery

Term
what feature of the anatomy of the PNS may give a false negative electrodiagnostic test result
Definition
the intact nature of the dorsal root sensory ganglion and its existance outside of the spinal cord
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