RT Book, Section
A1 Halle, John
A1 Greathouse, David
A2 Prentice, William E.
SR Print(0)
ID 1182561631
T1 Principles of Electrophysiologic Evaluation and Testing
T2 Therapeutic Modalities in Rehabilitation, 6e
YR 2021
FD 2021
PB McGraw Hill
PP New York, NY
SN 9781264264551
LK accessphysiotherapy.mhmedical.com/content.aspx?aid=1182561631
RD 2024/04/19
AB OBJECTIVESFollowing  completion  of  this  chapter,  the  student  will  be  able  to:Define  and  describe  the  anatomic  and  physiologic  basis  of  clinical  electrophysiologic  testing  (neural  conduction  and  electromyographic  [EMG]  studies).Given  a  patient  with  a  neuromuscular  dysfunction,  evaluate  the  appropriateness  of  requesting  clinical  electrophysiologic  testing  (neural  conduction  and  electromyographic  studies),  and  describe  the  specific  additional  information  that  would  be  provided  by  this  testing,  if  ordered.Describe  the  basic  role  of  each  of  the  following  pieces  of  equipment  in  routine  electrophysiologic  testing:  electrodes  (needle,  reference,  and  ground),  differential  amplifiers,  oscilloscope,  audio  speakers,  stimulator,  electrophysiologic  processing  unit,  and  printer.Discuss  why  nerve  conduction  studies  (NCS)  assess  both  sensory  and  motor  fibers  within  a  nerve,  the  information  obtained  from  these  tests,  and  the  reason  why  sensory  studies  are  typically  assessed  in  microvolts,  while  motor  studies  are  typically  assessed  in  millivolts.Explain  the  role  of  latency,  shape,  amplitude,  and  nerve  conduction  velocity  (NCV)  in  an  NCS.  Within  this  explanation,  compare  and  contrast  the  information  provided  by  normal  and  abnormal  findings.Describe  a  “central  conduction  study”  (F-wave)  physiologically  and  the  information  provided  by  this  portion  of  the  examination.An  H-wave  (Hoffman’s  reflex)  can  only  be  elicited  in  select  sites  in  the  upper  and  lower  extremities.  Explain  why  this  testing  procedure  cannot  be  applied  universally,  identify  the  specific  regions  where  this  test  is  appropriate,  and  discuss  the  additional  information  that  it  provides  to  the  clinical  electrophysiologist.Identify  the  type  of  nerve  conduction  evaluation  that  is  particularly  useful  with  conditions  affecting  the  neuromuscular  junction,  such  as  myasthenia  gravis  and  myasthenia  syndrome  (Lambert—Eaton  syndrome).  For  each  of  these  conditions,  describe  the  anticipated  neurophysiologic  results.List  and  describe  the  four  basic  components  of  the  electromyographic  study  (needle  evaluation)  outlined  in  this  chapter.  Within  the  description,  identify  the  type  of  information  that  can  be  obtained  from  each  component.While  pathologic  states  often  represent  conditions  that  cause  some  damage  to  both  myelin  and  axons,  the  pattern  of  damage  is  often  predominantly  demyelinating  or  axonal.  Compare  and  contrast  the  electrophysiologic  findings  demonstrated  in  a  primarily  demyelinating  condition  (e.g.,  entrapment  syndrome  such  as  carpal  tunnel  syndrome)  with  a  primarily  axonal  condition  (e.g.,  radiculopathy).Compare  and  contrast  anterior  primary  rami  (APR)  and  posterior  primary  rami  (PPR).  Include  in  your  discussion  the  anatomic  and  functional  differences  of  the  APR  and  PPR.  In  addition,  discuss  the  importance  of  performing  needle  EMG  examination  of  the  paravertebral  muscles  (PVM)  in  a  patient  with  a  suspected  radiculopathy.Describe  the  specific  electrophysiologic  parameters  associated  with  positive  sharp  waves  (PSWs)  and  fibrillation  potentials,  and  discuss  what  these  abnormal  spontaneous  electrical  potentials  represent  physiologically.Given  a  patient  who  is  suspected  of  having  a  myopathic  disease  (e.g.,  dermatomyositis  or  muscular  dystrophy),  describe  the  type  of  electrophysiologic  findings  that  would  be  present  if  this  muscle  disease  was  validated.The  EMG  obtained  from  single  motor  units  provides  indirect  information  regarding  the  status  of  structures  such  as  the  axon,  neuromuscular  junction,  and  innervated  muscle  fibers.  Recognizing  that  there  is  variability  inherent  in  the  shape  of  single  motor  unit  EMG,  describe  what  constitutes  abnormal  findings  in  terms  of  phases,  the  prevalence  of  increased  phases,  and  the  implications  of  other  waveform  alterations  such  as  nascent  ...