• Embed Doc
  • Copy Link
  • Readcast
  • Collections
  • CommentGo Back
 
CLINICAL ELECTROPHYSIOLOGICTESTING
CONTENTS
1.
DEFINITION AND PURPOSE2.EXTRACELLULAR AND INTRACELLULAR RECORDINGTECHNIQUES3.ELECTROMYOGRAPHY AND ELECTRONEUROGRAPHY4.INSTRUMENTATION FOR ELECTROPHYSIOLOGIC ASSESSMENT
•
RECORDING ELECTODES IN ELECTRO PHYSIOLOGIC ASSESSMENT
•
COMPONENTS OF SIGNAL PROCESSORS IN
ENMG
TESTING
•
 NEUROMUSCULAR STIMULATORS IN ENMG 
5. MODERN PROCEDURES OF ELECTROPHYSIOLOGIC ASSESSMENT
•
 NERVE CONDUCTION STUDIES
•
CENTRAL EVOKED-POTENTIAL TESTING
•
SOMATOSENSORY EVOKED-POTENTIAL TESTING
6. ELECTROMYOGRAPHY AND ELECTRONEUROGRAPHY7. CLASSICAL ELECTROPHYSIOLOGIC TESTS8. CONTERAINDICATIONS AND PRECAUTIONS9. ADDITIONAL CLINICAL TEST OF NEUROMUSCULAR FUNCTION10. OBSERVATIONAL AND FUNCTIONAL ASSESSMENT
physiovipin@hotmail.comPage
1
 
CLINICAL ELECTROPHYSIOLOGIC TESTING
DEFINITION AND PURPOSE
 Definition
:
Clinical electrophysiologic testing or electroneuromyography (ENMG)consist of the observation, analysis, and interpretation of the bioelectrical activity of muscle and nerve in response to volitional activation or electrical stimulation.The results of ENMG tests are integrated with clinical measurements, laboratoryfindings, and symptomatology inorder to assist in the establishment of a diagnosis andsubsequent plans of care. The ENMG results viewed in isolation are neither characteristicnor indicative of specific diseases or disorders. That is the ENMG findings alone will notestablish the diagnosis of the underlying pathology but rather supplement the findingsfrom numerous other clinical and laboratory tests used in differential diagnosis.
 Purpose:
The main purpose of ENMG is to determine the integrity of specificcomponents of the neuromuscular system (α motoneurons and their axons, theneuromuscular junction, skeletal muscle, peripheral sensory nerve fibres, selectedreflexes, and certain central nervous system pathways). Electroneuromyographicexamination of these structures will assist the practioner in the determination of thelocation, magnitude, and chronicity of neuromuscular impairment.
EXTRACELLULAR AND INTRACELLULAR RECORDING TECHNIQUES
The bioelectrical responses of excitable tissue to volitional or electrically elicitedactivation are nerve and muscle action potentials occurring across the membrane of allsufficiently depolarized fibers. When muscle or nerve fibres are depolarized to threshold,
physiovipin@hotmail.comPage
2
 
action potentials are propagated along the membranes of these tissues. In short, sodiumions rush into these cells followed by potassium ions rushing out of each cells, and this process sweeps along the membrane. As a result of this transmembrane ionic flux,changes occur in the concentration of ions in the fluid surrounding these tissues. Thisintracellular recording technique cannot be used on the nerve and muscle cells of humansin clinical electrophysiologic testing because these cells are too small and cannot bestabilized sufficiently to perform this technique.Clinical ENMG requires the use of extracellular as opposed to intercellular recording technique. In the extracellular recording technique, one or two smallconductors are placed near but out side nerve or muscle cell. The electrodes are thenconnected by wires to an electronic device that amplifies and displays the relative voltagedifference between the two electrodes. When no action potentials are transmitted alongexcitable cells, the concentration of ions beneath each of the electrode is zero. However,when action potential currents are propagated along nerve or muscle membranes, therelative concentration of ions beneath each of the electrodes changes over time and anelectrical potential difference is recorded.
Monopolar and bipolar extracellular recording
When using the extracellular recording technique, at times both recordingelectrodes are placed close to the excitable tissue monitored. This positioning of electrodes is referred to as a
bipolar recording electrode placement
. At other times inelectrophysiologic assessment only one recording electrode will be placed near theexcitable tissue examined, and the second electrode will be placed at some distance fromthe excitable tissue. This electrode pattern is referred to as
monopolar recordingelectrode placement.
 
physiovipin@hotmail.comPage
3
of 00

Leave a Comment

You must be to leave a comment.
Submit
Characters: ...
You must be to leave a comment.
Submit
Characters: ...