Atlas of Nerve Conduction Studies and Electromyography

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

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 ; Sensory Nerve Conduction ; Role of Dorsal Root Ganglia (DRG) in Localizing Lesions ; Late Responses: F-wave and H-reflex ; Types of Nerve Injury ; Neurapraxia ; Axonal loss injury ; Ion Channel Disorders ; 2. Overview of Electromyography (EMG) ; The Motor Unit ; Needle Electrodes ; Muscle Selection for Needle EMG ; The Needle EMG Examination ; Assessment of Insetional Activity ; Assessment of Spontaneous Activity ; Assessment of Motor Unit Potentials (MUPs) ; Assessment of Firing Pattern and Recruitment ; Complications Related to Needle Electromyography ; 3. Brachial Plexus ; Upper Trunk Lesion ; Middle Trunk Lesion ; Lower Trunk Lesion ; Plexus Cord Lesions ; 4. Median Nerve ; Carpal Tunnel Syndrome ; Anterior Interosseous Nerve Syndrome ; Pronator Teres Syndrome ; Ligament of Struther's Syndrome ; Median Nerve Conduction Studies ; Median Motor Nerce Conduction Stud ; Short Segment Stimulation across the Palm ("inching technique") ; Median F-wave ; Martin-Gruber Anastomosis ; Median Sensory Nerve Conduction Study ; Median and Ulnar Digit 4 (ring finger) Comparative Study ; Median and Superficial Radial Digit 1 (thumb) Comparative Study ; Combined Sensory Index (CSI) ; Standards for Severity of Carpal Tunnel Syndrome ; Digital Branch Injury ; Needle Electromyography ; Abductor Pollicis Brevis ; Opponens Pollicis ; Flexor Pollicis Brevis ; 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) ; Ulnar Nerve Conduction Studies ; Ulnar Motor Nerve Conduction Stufy from Abductor Digiti Minimi (ADM) ; Ulnar Motor Nerve Conduction Study from First Dorsal Interosseous (FDI) ; Short Segment Stimulation across the Elbow ("inching technique") ; Ulnar F-waves ; Martin-Gruber Anastomosis ; Riches-Cannieu Anastomosis (RCA) ; Ulnar Sensory Nerve Conduction Study ; Dorsal Ulnar Cutaneous (DUC) Nerve Conduction Study ; Anomalous Superficial Radial Innervation to Ulnar Dorsum of Hand ; 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 ; Radial Nerve Conduction Studies ; Radial Motor Nerve Conduction Study ; Superficial Radial Sensory Nerve Conduction Stufy ; Needle Electromyography ; Extensor Indicis ; 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 ; Axillary 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 ; Musculocutaneous Nerve Lesion ; Lateral Cutaneous Nerve of the Forearm (Lateral Antebrachial Cutaneous) Conduction Study ; Needle Electromyography ; Brachialis ; Biceps Brachii ; Coracobrachialis ; 9. Medial Cutaneous Nerve of the Forearm (Medial Antebrachial Cutaneous Nerve) ; Lesion of the Medial Cutaneous Nerve of the Forearm Conduction Study ; 10. Suprascapular Nerve ; Suprascapular Nerve Lesion ; Needle Electromyography ; Infraspinatus ; Supraspinatus ; 11. Dorsal Scapular Nerve ; Dorsal Scapular Nerve Lesion ; Rhomboideus Major and Minor ; Levator Scapulae ; 12. Long Thoracic Nerve ; Long Thoracic Nerve Lesion ; 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 ; 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 ; Tibial Nerve Conduction Studies ; Tibial Motor Nerve Conduction Studies ; Tibial F-wave ; Sural Sensory Nerve Conduction Studies ; H-Reflex ; Medial and Lateral Plantar Nerve Conduction Studies ; 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 ; Common Peroneal Nerve Conduction Studies ; Common Peroneal Motor Nerve Conduction Study from Extensor Digitorum Brevis ; Peroneal F-waves ; Accessory Deep Peroneal Nerve ; Common Peroneal Motor Nerve Conduction Study from Tibialis Anterior ; Short Segment Stimulation across the Fibular Head ("Inching Technique") ; Superficial Peroneal Sensory Nerve Conduction Study ; 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 ; External Oblique, Internal Oblique and Transversus Abdominis ; 25. Femoral Nerve ; Femoral Nerve Lesion ; Femoral Nerve Conduction Studies ; Femoral Motor Nerve Conduction Study ; Saphenous Sensory Nerve Conduction Study ; 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 ; Spinal Accessory Nerve Conduction Study ; Facial Motor Nerve Conduction Studies ; Blink Reflex Studies ; Needle Electromyography ; Sternocleidomastoid ; Trapezius ; Frontalis ; Orbicularis Oculi ; Orbicularis Oris ; Masseter ; Tongue ; 29. Dermatomes and Peripheral Nerve Cutaneous Distributions