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PhyMod > electrophysio exam > Flashcards

electrophysio exam Flashcards

1
Q

What is electrophysiology exam

A

Evaluate integrity of neuromuscular system

Measures electrical activity

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2
Q

Biofeedback

A

Monitoring and transforming physiologic data into understandable feedback
Enables individual to gain voluntary control over muscular or autonomic nervous system functions
Visual or auditory stimuli
Adjunct tool and not a treatment itself

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3
Q

Evoked potentials

A

Applies electricity to evoke an action potential

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4
Q

NCV

A

Peripheral, motor, and sensory neurons

Orthodromic and antidromic responses

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5
Q

Orthodromic

A

normal

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6
Q

Antidromic

A

reverse

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7
Q

SNAP

A

Provides info on sensory nerve axon

Cutaneous receptors to DRG

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8
Q

CMAP

A

Motor nerve fibers from origin in anterior horn cells to neuromuscular junction of muscle it innervates

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9
Q

NCV Answers the questions:

A 
Is there involvement of peripheral nerves?
Sensory? Motor? both?
Where?
How many?
Magnitude?
increasing/decreasing impairment?
localized/systemic disorder?
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10
Q

NCV motor components

A

Stimulating electrode coming from machine
2 small electrodes applied on nerve
2 cm apart
Handheld electrodes
Cathode distal to anode
active/recording electrode: on muscle or nerve
Reference: distally placed
Ground: over bony areas for elimination of noise

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11
Q

motor vs. sensory ncv

A

Stimulate sensory nerves distally instead of proximally

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12
Q

what info do we get from ncv test

A

distance = Distance from stimulating to recording electrode (mm)

Latency
Conduction time between stimulus and start of muscle contraction or activation of nerve
(Msec)

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13
Q

Latency

A

Conduction time between stimulus and start of muscle contraction or activation of nerve (msec)

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14
Q

ncv =

A

distance/latency

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15
Q

factors affecting ncv

A 
Body temp
UE is 7-10 m/s faster
Proximal segments are faster
Age
Less than 3-5 yr old is slower than normal adults
>40 - gradual slowing
60-70- 10 m/sec less than middle aged
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16
Q

in compression lesions, ncv is

A

reduced

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17
Q

NMJ transmission

A 
Also known as jolly test
Test for myasthenia gravis
Weakness of skeletal muscles
Affects diaphragm
Function of neuromuscular junction
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18
Q

centrally evoked potentials

A

Generated by nervous system in response to sensory stimuli
SSEP: what we feel, light touch, pressure
VEP
BAEP
Induce a stimuli and computer reflects if stimuli was received by brain

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19
Q

REACTION OF DEGENERATION

A

Faradic and galvanic test
Assessment of lower motor neuron lesions
A motorpoint is stimulated
Screening test for differentiating with normal peripheral innervation vs muscle with peripheral denervation
Not specific location
Not a standalone test
Not done at least 10 days after onset of problem
May be indicated in conditions of unexplained paralysis

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20
Q

faradic current

A

short pulse duration less than 1 msec

monophasic or asymmetrical PC

cathode is active

smooth tetanic

21
Q

galvanic current

A

long pulse duration >100 msec

monophasic or interrupted dc

cathode is active

brisk muscle twitch

22
Q

partial RD faradic vs galvanic

A

F; partial or diminished tetanic

G: partial or diminished sluggish twitches

23
Q

partial RD

A

degeneration of part of nerve fibers

24
Q

complete RD

A

degeneration of all nerve fibers

muscle tissue remains

25
Q

absolute RD

A

degeneration of all nerve fibers; muscle is non-contractile

26
Q

complete rd f vs. g

A

f: no contraction
g: very slow, sluggish twitches

27
Q

STRENGTH-DURATION CURVE AND CHRONAXIE TEST

A 
After 3 weeks of nerve injury
Used to check for improvements
Square monophasic PC / sawtooth/ triangular
Cathode is stimulating
8-10 pulse durations
28
Q

usual pulse durations in SD curve

A

100, 30, 10, 3, 1, 0.3, 0.1, 0.03, 0.01

must be strong enough to depolarize threshold

29
Q

rheobase

A

least intensity needed to elicit contraction

normal: 3-35 v/2-18 ma

30
Q

chronaxie

A

Minimum time needed to produce a muscle contraction with intensity set at twice the rheobase
Normal: 0.05-0.5 msec or <1 msec

31
Q

compute for chronaxie

A

2 x rheobase

32
Q

Factors affecting sd curve

A 
Skin resistance
Subcutaneous tissue
Skin temperature
Electrode size
Electrode placement
Age
Fatigue
33
Q

Advantages of sd curve

A

Quick and easy
Minimal training
Economical

34
Q

Disadvantages of sd curve

A

Provides qualitative data in relation to degree of denervation
Cannot locate site of lesion
Few fibers can be assessed

35
Q

emg biofeedback

A 
We are getting the muscle activity
Determines best management for pt
Can increase or decrease muscle activity
Detects electrical activities
Not a treatment
36
Q

Facilitatory feedback

A

inc muscle activity

post injury or post op

37
Q

inhibitory feedback

A

dec muscle activity

hypertonic muscles

38
Q

EMG + components

A

Electricity produced by voluntary movement
Electrical stimulator not needed
Electrodes:
Recording electrode: over muscle being tested
Avoid crosstalk: input from other muscles
Surface EMG
Needle EMG: invasive
Ground electrode: minimize noise

39
Q

Signal amplification and filtration

A

Minimize distortion

Maximize signal to noise ratio

40
Q

High pass filter

A

blocks low frequency, 5 Hz/10-20 Hz cut off

41
Q

Low pass filter

A

blocks high frequency, 500 hz cut off

42
Q

Signal rectification

A

Absolute value of all signals
Rectification + low pass filter = linear envelope
Process of traditional low pass filter = butterworth or chebyshev

43
Q

Signal smooth

A 
Moving average
Certain amount of data are averaged using sliding window technique
Root mean square
Square root calculation
Reflects mean power of signal
Preferred method
44
Q

EMG can determine

A

Muscle activation

Muscle fatigue

45
Q

Muscle fatigue index

A

Identifies weak muscles

Determines effectivity of exercise

46
Q

normal and abnormal EMG at rest

A

normal: (+) insertion activity, miniature endplate action potentials, no muscle action potentials
abnormal: (+) fibrillations/fasciculations, complex discharges, inc or dec insertional activity

47
Q

normal and abnormal EMG w mild contraction

A

normal: biphasic or triphasic muscle AP, mup from small amplitude potentions become progressively large amplitude potentials
abnormal: polyphasic, amplitude dec or inc, altered recruitment pattern

48
Q

normal and abnormal EMG with max contraction

A

normal: inc frequency, (N) step wise, inc interference patterns
abnormal: dec interference pattern, early full interference pattern

PhyMod (12 decks)

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