Atlas of Nerve Conduction Studies and Electromyography

by A. Arturo Leis, Michael P. Schenk

Overview

Beautifully and lavishly illustrated, Atlas of Nerve Conduction Studies and Electromyography demystifies the major conditions affecting peripheral nerves and provides electrodiagnostic strategies for confirming suspected lesions of the peripheral nervous system. Building on the success of the landmark Atlas of Electromyography, this new text is divided into sections based on the major peripheral nerves. It contains detailed illustrations of each nerve along with a discussion of its anatomy, followed by a thorough outline of the clinical conditions and entrapment syndromes that affect the nerve, including a list of the etiologies, clinical features, and electrodiagnostic strategies used for each syndrome. Routine and special motor and sensory nerve conduction studies are shown in an anatomical illustration. In addition, each muscle supplied by the peripheral nerve is illustrated showing the root, plexus, and peripheral nerve supply to the muscle and is accompanied by a corresponding human photograph. Written text provides information about the nerve conduction studies, muscle origin, tendon insertion, voluntary activation maneuver, and the site of optimum needle insertion, which is identified in the figures by a black dot or a needle electrode. Atlas of Nerve Conduction Studies and Electromyography is the perfect anatomical guide for neurologists, specialists in physical medicine and rehabilitation, and electrodiagnostic medicine consultants, while also providing support for individuals in residency training programs, critical care medicine, neurological surgery, and family practice.

Product Details

ISBN-13:	9780190454111
Publisher:	Oxford University Press
Publication date:	03/12/2013
Sold by:	Barnes & Noble
Format:	eBook
File size:	12 MB
Note:	This product may take a few minutes to download.

About the Author

A. ARTURO LEIS, M.D., Clinical Professor of Neurology, University of Mississippi Medical Center; Electrodiagnostic Consultant, Mississippi Methodist Rehabilitation Center, Jackson, Mississippi MICHAEL P. SCHENK , MS, CMI, FAMI, Director, Department of Biomedical Illustration Services, University of Mississippi Medical Center, Jackson, Mississippi

Table of Contents

1. Overview of Nerve Conduction Studies How the peripheral nervous system conveys information Stimulating and Recording Electrodes Electrode Amplifiers and Ground Electrode Reducing Artifacts and Interference Electrical Safety Temperature Effect Effect of Aging Motor Nerve Conduction Measurements of the compound muscle action potential Calculating conduction velocity Sensory Nerve Conduction Measurements of the sensory nerve action potential Role of dorsal root ganglia (DRG) in localizing lesions Late Responses: F-wave and H-reflex Types of Nerve Injury Neurapraxia Features of demyelination Axonal loss injury Features of axonal loss Wallerian degeneration Ion channel disorders (channelopathies) Features of channelopathies Due to toxins, Due to autoimmune conditions, Due to genetic mutations 2. Overview of Electromyography The motor unit Innervation ratio Muscle selection for needle EMG The needle EMG examination Insertional activity Spontaneous activity Fibrillation potentials Positive sharp waves Numeric grading scale to semi-quantify fibrillation potentials Fasciculation potentials Complex repetitive discharges Myotonic discharges Myokymic discharges Neuromyotonic discharges Isaac's syndrome and peripheral nerve hyperexcitability (PNH) syndrome Cramp discharges End-plate activity Motor unit potentials (MUPs) MUP parameters Rise time Duration Amplitude Phases and turns Firing pattern and recruitment Henneman's Size Principle In neurogenic disorders In myopathic disorders Complications related to needle electromyography 3. Brachial Plexus Upper trunk lesion Middle trunk lesion Lower trunk lesion 4. Median Nerve Carpal tunnel syndrome Anterior interosseous nerve syndrome Pronator teres syndrome Ligament of Struther's syndrome Nerve conduction studies Motor Short segment (“inching technique”) F-wave Martin-Gruber anastomosis Sensory Comparative studies for diagnosing carpal tunnel syndrome Digital branch injury Needle electromyography Abductor Pollicis Brevis Opponens Pollicis Flexor Pollicis Brevis, Superficial Head First and Second Lumbricals Pronator Quadratus Flexor Pollicis Longus Flexor Digitorum Profundus, Digits 2 and 3 Flexor Digitorum Superficialis (sublimis) Palmaris Longus Flexor Carpi Radialis Pronator Teres 5. Ulnar Nerve Ulnar neuropathy at the elbow (retrocondylar groove) Ulnar neuropathy at the elbow (cubital tunnel syndrome) Ulnar neuropathy at the wrist (Guyon's canal) Nerve conduction studies Motor Short segment (“inching technique”) F-wave Martin-Gruber anastomosis Riches-Cannieu anastomosis (“all ulnar hand”) Sensory Needle electromyography Adductor Pollicis Flexor Pollicis Brevis, Deep Head First Dorsal Interosseous Second, Third, and Fourth Dorsal Interossei Palmar Interossei Third and Fourth Lumbricals Abductor Digiti Minimi Opponens Digiti Minimi Flexor Digiti Minimi Flexor Digitorum Profundus, Digits 4 and 5 Flexor Carpi Ulnaris 6. Radial Nerve Radial nerve lesion in the arm Radial nerve lesion in the axilla Posterior interosseous nerve syndrome Superficial radial nerve lesion Nerve conduction studies Motor Sensory Anomalous innervation to ulnar dorsum of hand Needle electromyography Extensor Indicis Proprius Extensor Pollicis Brevis Extensor Pollicis Longus Abductor Pollicis Longus Extensor Digitorum Communis and Extensor Digiti Minimi Extensor Carpi Ulnaris Supinator Extensor Carpi Radialis, Longus and Brevis Brachioradialis Anconeus Triceps, Lateral Head Triceps, Long Head Triceps, Medial Head 7. Axillary Nerve Axillary nerve lesion Motor nerve conduction study Needle electromyography Deltoid, Anterior Fibers Deltoid, Middle Fibers Deltoid, Posterior Fibers Teres Minor 8. Musculocutaneous Nerve Musculocutaneous nerve lesion Nerve conduction studies Motor Sensory (lateral cutaneous nerve of the forearm) Needle electromyography Brachialis Biceps Brachii Coracobrachialis 9. Medial Cutaneous Nerve of the Forearm Lesion of the medial cutaneous nerve of the forearm Sensory nerve conduction study 10. Suprascapular Nerve Suprascapular nerve lesion Motor nerve conduction study Needle electromyography Infraspinatus Supraspinatus 11. Dorsal Scapular Nerve Dorsal scapular nerve lesion Needle electromyography Rhomboideus Major and Minor Levator Scapulae 12. Long Thoracic Nerve Long thoracic nerve lesion Motor nerve conduction study Needle electromyography Serratus Anterior 13. Subscapular Nerves and the Thoracodorsal Nerve Needle electromyography Teres Major Latissimus Dorsi 14. Medial and Lateral Pectoral Nerves Needle electromyography Pectoralis Major Pectoralis Minor 15. Cervical Plexus Needle electromyography Sternocleidomastoid Trapezius Levator Scapulae 16. Phrenic Nerve Phrenic nerve lesion Phrenic nerve conduction studies Needle electromyography Diaphragm 17. Sacral Plexus Sacral plexus lesion 18. Sciatic Nerve Sciatic nerve lesion Needle electromyography Semitendinosus Semimembranosus Biceps Femoris (Long Head) Biceps Femoris (Short Head) 19. Tibial Nerve Tarsal tunnel syndrome Nerve conduction studies Motor F-wave Sensory (sural nerve) H-Reflex Medial and lateral plantar (mixed nerve) Needle electromyography Gastrocnemius, Medial Head Gastrocnemius, Lateral Head Soleus Tibialis Posterior Flexor Digitorum Longus Flexor Hallucis Longus Popliteus Abductor Hallucis Flexor Digitorum Brevis Flexor Hallucis Brevis Abductor Digiti Minimi (Quinti) Adductor Hallucis 20. Common Peroneal Nerve Common peroneal mononeuropathy at the knee Nerve conduction studies Motor (Extensor digitorum brevis) F-wave Accessory deep peroneal nerve Motor (tibialis anterior) Short segment (“inching technique”) across the knee Sensory (superficial peroneal) Needle electromyography Tibialis Anterior Extensor Digitorum Longus Extensor Hallucis Longus Peroneus Tertius Extensor Digitorum Brevis Peroneus Longus Peroneus Brevis 21. Superior Gluteal Nerve Needle electromyography Gluteus Medius Gluteus Minimus Tensor Fasciae Latae 22. Inferior Gluteal Nerve Needle electromyography Gluteus Maximus 23. Pudendal Nerve Pudendal nerve lesion Needle electromyography Sphincter Ani Externus (External Anal Sphincter) Levator Ani 24. Lumbar Plexus Lesion of the lateral femoral cutaneous nerve (meralgia paresthetica) Lateral femoral cutaneous nerve conduction study Needle electromyography of abdominal wall muscles External Oblique, Internal Oblique and Transversus Abdominis 25. Femoral Nerve Femoral nerve lesion Nerve conduction studies Motor Sensory (saphenous nerve) Needle electromyography Iliacus (Iliopsoas) Pectineus Sartorius Rectus Femoris Vastus Lateralis Vastus Intermedius Vastus Medialis 26. Obturator Nerve Obturator nerve lesion Needle electromyography Adductor Longus Adductor Brevis Adductor Magnus Gracilis 27. Paraspinal Muscles Needle electromyography Cervical Paraspinal Thoracic Paraspinal Lumbosacral Paraspinal 28. Cranial Nerves and Muscles Facial motor conduction studies Blink reflex studies Needle electromyography Frontalis Orbicularis Oculi Orbicularis Oris Masseter Tongue 29. Dermatomes and Peripheral Nerve Cutaneous Distributions

Editorial Reviews

Review from the first edition:

"The written text with drawings and photographs for each muscle described is beautifully organized in one book page, a fact that enables a quick search of the book... This is an excellent book, classic and up to date at the same time, very easy to read with simple (but not simplified) 'take home' messages...[this] is a wonderful meeting point of three academic generations." - European Journal of Paediatric Neurology

Review from the first edition:

"All of the plexuses and peripheral nerves in the upper and lower extremities, which are commonly evaluated clinically and by EMG, have excellent diagrams and descriptions. The brief comments and clinical features, with references, add to the value of the atlas... The greatest value of this atlas is the diagrams of the root innervation of the specific muscle to be examined. These diagrams are especially important in the evaluation and diagnosis of patients with possible root-plexus syndromes. This atlas is recommended especially for the beginning resident physician or fellow in neuromuscular disease. However, it must be combined with a more complete text of neuromuscular disease and electromyography. The atlas is a worthwhile addition to the library in the EMG laboratory." - Annals of Neurology

"There is no question that Leis and Schenk's Atlas of Nerve Conduction Studies and Electromyography makes a valuable contribution to any electromyographer's library. There are numerous excellent textbooks of electromyography available but this one fills an important niche in that it provides the salient information for the trainee, novice and expert. This text condenses the theory and practical information regarding nerve conduction studies and electromyography in an easy to read format the illustrations are clear, concise and allow the reader to visualize the information that is described very well in the accompanying text... This textbook provides an excellent synthesis of anatomy, physiology, clinical applications and electromyoneurographic techniques. The authors should be commended for condensing all of this important information into a straightforward and easy to read atlas."
— Daniel L. Menkes, MD, Department of Neurology, University of Connecticut Health Center, Farmington, CT

"Drs. Leis and Schenk have produced a superb atlas in the field of electrodiagnostic medicine...The book is full of gems in terms of both practical and valuable information for the clinical neurophysiologist. For a practical guide, the book is concise, yet full of details. The clinical descriptions of various diseases affecting nerve or muscle, in particular those of the entrapment syndromes, are brief yet clear. It soon becomes obvious that the authors are true experts in their field, who like to share their long-lasting expertise with other practicing colleagues in the field of electrodiagnostic medicine. Like its predecessor, the Atlas of Electromyography, this new Atlas of Nerve Conduction Studies and Electromyography will be indispensable on the bookshelf of every practicing electromyographer, be it a novice or an advanced practitioner." — Markus Kofler, MD, Senior Neurologist, Head of Clinical Neurophysiology, Department of Neurology, Hochzirl Hospital, Zirl, Austria

"The practice of clinical electromyography remains the most important diagnostic tool for evaluation of patients with neuromuscular and musculoskeletal disorders. In the day-to-day EMG practice, even the experienced electromyographer needs to regularly review peripheral nerve and muscle anatomy. The Atlas of Nerve Conduction Studies and Electromyography by Leis and Schenk provides an excellent reference for the EMG laboratory. In addition to providing excellent illustrations of peripheral nerve and muscle anatomy, clinical disorders are discussed under the heading of each peripheral nerve. This provides a concise review of common clinical disorders of the peripheral nervous system as well as the necessary illustrations for guiding needle placement. The book can serve as a complete EMG textbook for the beginner and a great EMG reference atlas for the experienced electromyographer." — Mark Ross, MD, FAAN, Professor of Neurology, Mayo Clinic Arizona, Scottsdale, AZ

"This is a practical and valuable resource that is a must for every electrodiagnostic medicine laboratory and for anyone learning or performing clinical electromyography. It is one of those unique books that is chock full of practical and easily accessible information that will be used ever day in clinical practice." — Doody's

"As a current fellow in neurophysiology, I found this book to be very helpful as a day-to-day reference in the EMG laboratory and also as a good overview of EMG and NCS. I would recommend it to general physicians who want to refresh their peripheral neuroanatomy skills, neurology residents and other trainees who are looking to learn more about EMG, and seasoned electromyographers who need an informative desk reference." —Jennie Savage, MD, Muscle and Nerve

From the Publisher