Surface Anatomy For Clinical Needle Electromyography

"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. "

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.

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.

The Atlas of Electromyography is a visually alluring book which provides high quality anatomical illustrations of skeletal muscles that include nerve, plexus, and root supply; photographs of each muscle in healthy subjects to enable the practitioner to identify the optimum site of EMG needle insertion; clinical features of the major conditions affecting peripheral nerves; and electrodiagnostic strategies for confirming suspected lesions of the peripheral nervous system. The atlas is divided into sections on the major peripheral nerves. Each nerve is illustrated and its anatomy reviewed in the text. The authors provide a detailed outline of the clinical conditions and entrapment syndromes that affect the nerve, including a list of etiologies, clinical features, and electrodiagnostic strategies used for each symdrome. Each muscle supplied by the peripheral nerve is shown as an anatomical illustration with a corresponding human photograph. The text provides information about the muscle origin, tendon insertion, voluntary activation maneuver, and site of optimum needle insertion. The needle insertion point is identified in both the anatomical illustration and the corresponding photographs. This assures that pertinent bone, muscular, and soft tissue landmarks can be used to guide the electromyographer to a specific point on the skin. Potential pitfalls associated with the needle insertion are added, usually noting adjacent muscles or structures that may be mistakenly entered. Clinical correlates pertinent to the muscle being examined are also provided. The tlas of Electromyography serves as an anatomical guide for practitioners of electromyography and neurologists, as well as residents i neurology, physical medicine, and rehabilitation.

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.

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 book uses high-quality color photographs to highlight surface features and the position of the underlying anatomy from head to toe. The text retains its readability but has been abridged and updated. New labeling system highlights key areas of anatomy.

Now in its Fourth Edition, this text gives physiatry and neurology residents a comprehensive, practical introduction to electromyography. Section I reviews the anatomy and physiology of nerve problems in relation to the planning and performance of electrodiagnostic procedures. Section II provides technical information on electrophysiology, instrumentation, and specific techniques, with digital photographs showing important surface anatomy. Section III guides physicians through various clinical EMG problems, beginning with the patient's symptoms and proceeding through electrodiagnostic evaluation and diagnosis. This edition includes over 500 new illustrations. A bound-in CD-ROM contains digital videoclips of EMG recordings and test questions that can be submitted for CME credit.