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MSK II Final > Sachen: Introduction to Electrodiagnostic Medicine > Flashcards

Sachen: Introduction to Electrodiagnostic Medicine Flashcards

1
Q

Indications for an EDX consultation

A

-suspected nm or msk disease involving the motor neuron, nerve root, plexus, peripheral nerve, nm junction, or muscle

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2
Q

complaints suggestive of nm or msk pathology

A
  • numbness or tingling
  • decreased sensation
  • pain
  • cramping or spasms
  • weakness
  • gait difficulty
  • fatigue
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3
Q

Utility of an EDX medicine consultation

A
  • clarify etiology of symptoms
  • localize a pns lesion
  • assist in therapeutic decision making
  • predict neurological prognosis
  • exclude other disorders
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4
Q

What is EDX used for?

A
  • to assess the function and integrity of the PNS
  • considered an extension of a comprehensive clinical evaluation that includes a detailed history and specialized physical examination
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5
Q

what are the components of EMG?

A
  • nerve conduction studies (NCS)
  • electromyography (EMG)
  • special tests like repetitive nerve stimulation
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6
Q

What happens with nerve conduction studies?

A
  • peripheral nerves are stimulated with a controlled electrical stimulus
  • responses are recorded: compound motor action potential, sensory nerve action potential, F wave, H reflex
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7
Q

What are the nerve conduction studies basic elements?

A
  • motor nerve conductions
  • sensory nerve conductions
  • late responses: F wave latency measures, H reflexes
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8
Q

What are the measured parameters in nerve conductino studies?

A
  • motor latency
  • motor amplitude
  • sensory latency
  • sensory amplitude
  • conduction velocity
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9
Q

Motor latency

A

-measure of conduction time from stimulation across a nerve segment through the nm junction to initial activation of muscle fibers

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10
Q

Motor amplitude

A

-measure of the number of activated muscle fibers

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11
Q

Sensory latency

A

-measure of conduction time of AP from stimulation across a nerve segment

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12
Q

Sensory amplitude

A

-meausure of the number of activated sensory axons

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13
Q

Conduction velocity

A

-measure of the velocity of the fastest conducting axons (motor and sensory)

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14
Q

What is needle electromyography?

A
  • needle electrode is inserted into the muscle
  • disposable, single use
  • multiple muscle are accessible for examination
  • combo of muscles tested
  • level of discomfort is mild which is nice
  • muscle is studid at rest and at different levels of sustained, voluntary contraction
  • at rest, the muscle should be silent, any spontaneous activity may signal a nerve or muscle abnormality
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15
Q

During activity, what can distinguishe between nerve and muscle disease?

A

-the shape and pattern of the response

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16
Q

What parameters are evaluated in needle electromyography?

A
  • insertional activity
  • spontaneous activity
  • motor unit configuration
  • motor unit recruitment
  • interference pattern
17
Q

What is insertional activity

A
  • burst of electrical activity as needle is inserted into muscle
  • due to disruption of muscle fiber membranes
  • prolonged with denervation, some muscle diseases
18
Q

What is spontaneous activity?

A
  • fibrillations, positive sharp waves, fasciculations

- hallmark of denervation, muscle membrane irritation

19
Q

How do you grad the spontaneous activity of needle electromyography?

A
  • 0: no fibs/psw’s
  • +/-: fibs/PSWs that are NOT PERSISTENT
  • 1+: persistent fibs/PSWs in AT LEAST 2 AREAS
  • 2+ persistent fibs/PSWs of moderate #’s in 3 or more areas
  • 3+: persistent fibs/PSWs of large #’s but NOT OBSCURING BASELINE
  • 4+:BASELINE OBLITERATED in all areas examined
20
Q

What do we look at when talking about motor unit configuration?

A
  • muscle is volitionally activated at different force levels
  • single motor units are assessed
  • single motor unit: a motor axon and all its muscle fibers
  • Motor unit configuration: amplitude, duration, morphology
21
Q

Motor unit recruitment

A

-pattern of motor unit activation with increasing volitional activation

22
Q

Interference patterns

A

-motor unit pattern with full voluntary activation

23
Q

Are EDX a replacement for H and P?

A

-no, just a supplement!

24
Q

Are EDX results time-dependent?

A

-yes

25
Q

Are EDX studies standardized?

A
  • no

- may be modified by the practioner to answer the diagnostic question

26
Q

What does EMG study?

A

-the integrity of the peripheral nervous system

27
Q

what direction is a positive sharp wave going in on the screen?

A

-down

28
Q

What does a fibrillation look like?

A

-kinda like an ECG reading

29
Q

what do we mean when something is poly phasic?

A

-it has a lot of turns on it

30
Q

what did he point out when he said that EMG is time dependent?

A

-if a nerve get’s severed for example at the elbow, function tests will still be ok for a little bit because nerve atrophy hasn’t happened yet

MSK II Final (13 decks)

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