Anatomic Localization For Needle Electromyography

The new edition of this practical text presents a clear anatomic approach to locating the needle insertion site for EMG. Succinct descriptions are provided for 71 routinely tested muscles, and each is accompanied by a full-page drawing of the muscle and related anatomy. Many new cross-sectional drawings have been added to further delineate the anatomy. Guidelines have been expanded throughout to include more detail. There are also more pearls, additional tips on avoiding pitfalls, and anatomical and clinical descriptions. Teaching points have been expanded and replace the previous "notes" from the first edition. The text is in outline format and indicates peripheral and nerve root innervations and patient positioning.

This manual is a practical, illustrated how-to guide to the proper techniques and electrode placements for common nerve conduction studies. The first section describes each nerve conduction study, including placement of electrodes, typical electromyography equipment settings, normal values, and pearls and pitfalls. The second section provides detailed coverage of surface anatomy for needle electromyography and shows where to place the needles for each muscle. More than 200 clear photographs demonstrate correct placement of needle electrodes. Chapters in each section follow a consistent sequence and are written in outline format to help readers find information quickly.

"From residents to seasoned practitioners, a detailed knowledge of surface and functional anatomy is essential before a needle electrode can be inserted into a muscle with optimal effectiveness and minimal discomfort to the patient. This book, written by long-time experts in the field, gives the tools for conducting an accurate, well tolerated needle EMG examination - based on identifiable landmarks and a keen understanding of musculoskeletal anatomy. Highlights of this practical clinical resource: Each muscle is systematically described by its origin, insertion, innervation, and action. Optimal patient positioning and the needle electrode location, as well as the brief clinical notes, allow easy access to any relevant topics Exquisite illustrations throughout highlight clinical landmarks and aid in needle electrode placement, especially in deep muscles that may be difficult to identify Anatomic guidelines for the entire body are covered in twelve comprehensive sections Alternative methods of needle placement are discussed and compared For all electromyographers in practice and training, this book offers key information for minimizing the number of needle penetrations, reducing patient discomfort, shortening the length of the examination, and obtaining precise diagnostic information. Especially when dealing with an uncooperative or limited patient, it allows the electromyographer to visualize the underlying anatomy and electrode path for maximum results. Find these typical guidelines for muscle sampling: Work from proximal to distal in the limb, as the proximal muscles are usually less sensitive to needle insertion than the distal small muscles Test the weakest muscle first, as it has the greatest probability for revealing abnormalities. However, interpret carefully as the end stage of muscle pathology does not reveal significant findings. Examine less painful muscles first intrinsic muscles of the hands and feet are usually very sensitive. Be aware that some patients prefer needle EMG to the shocks associated with nerve conduction studies. Consult an expert before proceeding with studies on unfamiliar muscles -- and take all necessary precautions when planning the examination. "

EMG Lesion Localization and Characterization: A Case Studies Approach takes a unique approach to electrodiagnostic (EDX) medicine, using case studies and exercises to teach clinical reasoning and build technical skills. The first section presents basic principles, reviewing pertinent nerve and muscle anatomy, physiology, and pathophysiology along with study techniques, measurements, and pitfalls. The second section emphasizes how to most effectively utilize the book’s featured case studies, followed by 60 cases covering the range of disorders encountered in the EMG lab and organized by regional and multiregional disorders of the upper and lower extremities, brachial plexopathies, generalized disorders, and challenging cases. Through the EDX case studies, lesion localization and characterization are demonstrated and discussed step-by-step using a floating text box that tracks the findings for each case. Cases begin with the clinical features, which dictate the initial EDX studies performed. The results of those studies drive the next round of testing, which continues until the abnormality has been localized and characterized and a diagnosis is made. In this manner, the dynamic nature of electrodiagnostic testing and process of sequential study analysis is reinforced, just as it would be in the EMG laboratory. Authored by two leading experts in neurology and electrodiagnostic medicine, all aspects of lesion localization and characterization are extensively covered, including calculations of lesion severity for demyelinating conduction block and axon loss lesions and calculations of various types of motor unit action potential recruitment frequencies. The book features a large number of anatomical drawings, charts, and EDX images in order to illustrate the skills of lesion localization and characterization comprehensively. By conveying the “cognitive approach” to EDX medicine, EMG Lesion Localization and Characterization merges clinical knowledge with real-life cases to better instruct residents, fellows, technicians, and neuromuscular providers in the field of electrodiagnostic medicine. Key Features: Includes 60 cases covering all major neuromuscular disorders Presents basic and advanced anatomic, physiologic, pathophysiologic, and temporal principles and concepts pertinent to EDX medicine EDX studies are evaluated as they are collected, providing insight into the principles underlying electrodiagnostic medicine Through sequential step-by-step analysis of findings, the decision-making process required in the EMG laboratory is simulated Purchase includes access to the ebook for use on most mobile devices or computers

This invaluable book for the electromyographer dispenses the latest techniques detailing methods of intramuscular electrode placement. The author examines the basic principles in electromyography (EMG) and includes updated information for the appendicular and axial muscles. It is divided into 14 sections organized by anatomical region: the muscles of the hand, forearm, arm, shoulder girdle, foot, leg, thigh, pelvis, hip joint, perineal region, paraspinal region, abdominal wall, the intercostals and diaphragm regions, along with the muscles innervated by cranial nerves. This information includes the innervations and attachments of each muscle, how to position the patient for examination, the appropriate site for insertion of the electrode, the depth of insertion for the electrode, and the action that the patient should perform to activate the muscle. The descriptions of the techniques used for rarely examined muscles are sufficient for a clinician to have the confidence needed to perform the procedure. Common errors in electrode placement and clinically relevant comments are illustrated and discussed, including cross-sectional illustrations on the appendicular muscles. A particularly useful inclusion is “Pitfalls” that describes which muscle the electrode will record if the needle is placed too deep, not deep enough, or not at the location described. The text contains a useful appendix, providing dermatomes of the limb and trunk, cutaneous innervations of the head, and excellent illustrations of both the brachial plexus and the lumbo-sacral-coccygeal plexus. The appendix also contains a useful table listing all muscles that are presented in the text with innervations from the peripheral nerve to the mixed spinal nerve root. Well organized, clearly and concisely written, this book remains a learning tool and excellent reference for electromyographers and for healthcare practitioners who are expanding their practice skills to include diagnostic EMG, as well as for graduate students who use EMG as part of their research.

The only case-based guide to electromyography—back in a fully revised and updated New Edition! This practical resource examines how to approach, diagnose, and manage the most commonly encoun-tered disorders in the EMG laboratory. Based on actual cases, it correlates patient history, physical exam, EMG findings, relevant anatomy, treatment, and follow-up to help readers sharpen their clinical problem-solving skills. New cases have been added, and every case includes the latest advances in knowledge and technique. Features study questions, answers, and clinical discussions of how experts manage cases to help readers work through the problems presented. Summarizes the results of nerve conduction studies and EMG data with standardized tables. Includes more than 200 relevant imaging studies and anatomic figures. Makes information easy to find with a uniform chapter organization. Offers a consistent approach to electromyography based on Dr. Katirji's broad knowledge and clinical experience. 7 new case studies, including Hereditary Neuropathy with Liability to Pressure Palsy, Ischemic Monomelic Neuropathy, and Myotonic Dystrophy. Three new chapters on Nerve Conduction Studies, Needle EMG Examination, and Specialized Procedures. Many new and revised figures that clarify complex information.

An introductory and advanced reference for electromyography (EMG), explaining anatomic, physiologic, pathologic, and electrical concepts necessary to use EMG.

Concise and accessible, Handbook of Spasticity is the essential reference for residents and practicing physicians in the fields of PM&R and neurology. It allows readers to learn the fundamentals of spasticity management while also adding important spasticity concepts to their day-to-day practice. This high-yield resource provides current evidence-based treatment paradigms and discusses advances in the field to address assessment, treatment options, and disease management in adult and pediatric patients. Written by experts from institutions around the world, this valuable handbook fuses the fundamentals of spasticity with a case-based approach to enhance learning for those early into their career as well as practicing physiatrists, neurologists, nurses, physician assistants, and therapists who care for patients with spasticity. Assessment and evaluation measures are detailed, focusing on measurements and scales, gait assessment, and techniques for setting appropriate goals. A wide variety of treatment options available for spasticity patients are explored, including physical therapy, pharmacologic and non-pharmacologic treatments, emerging technologies, toxins, surgical options, and more. Complete with accompanying online videos, ultrasound and anatomical figures, and toxin dosing tables, Handbook of Spasticity is the premier one-stop-shop resource on how to improve spasticity management. Key Features: Succinctly covers key spasticity definitions, assessment scales, treatment options, and disease management for a wide range of conditions Provides the latest guidelines and evidence-based practices in the field Features contributions from leading clinicians and educators in physiatry and neurology Case-based chapters and accompanying online video content showcase patient assessment in real-world settings Includes images for ultrasound guidance and anatomical correlates and tables with dosing guidance for toxins