McLean EMG Guide

Description

Revised, updated, and expanded second edition of the premier learning guide for residents, McLean EMG Guide emphasizes skills and concepts required for success in mastering basic electrodiagnostic techniques. This step-by-step approach to performing and interpreting EMG and nerve conduction studies will prepare trainees, fellows, and attendings to meet the challenges encountered in daily practice with confidence. The book is broken into short formatted chapters covering instrumentation, basic nerve conduction and needle EMG techniques, interpretation, applications for common clinical problems, and a new chapter on ultrasound. The procedures are laid out as illustrated tables with specifics for lead placement, stimulation, sample waveforms, and photographs to guide electrodiagnostic set-ups. Clinical presentation, anatomy, recommended studies, normal values, pearls and tips, and key findings are presented throughout in bulleted text for a thorough, more focused guidebook. Multiple choice questions and answers with rationales reinforce learning for those wishing to review concepts through self-guided assessment. Key Features Updates to all chapters with new figures and diagrams and more multiple-choice questions with answers Brand new chapter on the use of ultrasound with electrodiagnosis Checklists with key steps and takeaways for each study Clear, easy-to-understand tables and photos illustrate each set-up and study Codifies what you need to know to make a diagnosis in the EMG laboratory Print purchase includes on-line access to the full contents for mobile or desktop use Cover Title Copyright Contents Contributors Preface Section I: Introduction Chapter 1: Introduction to Electrodiagnostics Basic Principles of Electrodiagnostics Basic Logistical Details for Your First Day Performing Electrodiagnostics Basic Construction of an Electrodiagnostic Consult Explanation of Findings Additional Readings Chapter 2: Instrumentation Introduction The Electrodes The Signals The Displays The Stimulator Questions Chapter 3: Systematic Approach to Learning and Performing Nerve Conduction Studies Introduction Nerve Conduction Study Checklist Prestudy Checklist Preshock Checklist Shock Checklist Review During the Nerve Conduction Studies After the Nerve Conduction Studies Common Nerve Conduction Study Troubleshooting Continued Learning for Nerve Conduction Studies Additional Readings Section II: Nerve Conduction Studies Chapter 4: Upper Limb Motor Studies Introduction Median Nerve Ulnar Nerve Radial Nerve Normal Value Range Questions Chapter 5: Upper Limb Sensory Studies Introduction Median to Index or Middle Finger Ulnar to Little Finger Questions Additional Readings Chapter 6: Lower Limb Motor Studies Introduction Fibular (Peroneal) to Extensor Digitorum Brevis Tibial to Abductor Hallucis Reference Values Questions Reference Chapter 7: Lower Limb Sensory Studies Introduction Sciatic Nerve Sural Nerve Superficial Fibular (Peroneal) Nerve Saphenous Lateral Femoral Cutaneous Nerve Questions Additional Readings References Chapter 8: F-Waves Introduction Anatomy Electrodiagnostic Approach Limitations Questions References Chapter 9: H-Reflexes Introduction Anatomy Electrodiagnostic Approach Questions Additional Reading Section III: Needle EMG Chapter 10: Basic EMG Technique Introduction Prestudy Checklist Reducing Anxiety and Discomfort of the Needle Examination Procedure Protocol Questions Additional Readings Chapter 11: Basic Approach to EMG Waveform Recognition Introduction Basic Approach Questions Additional Readings Chapter 12: Motor Unit Action Potential Analysis Introduction Overview of the Motor Unit Action Potential Motor Unit Morphology Changes in MUAP Characteristics and Morphology in Disease Questions Chapter 13: Recruitment Introduction Overview of Recruitment Basics of Recruitment Analysis Clinical Utility of Recruitment Analysis Stepwise Approach to Recruitment Assessment Maximal Activation-Interference Pattern Recruitment Findings in Neuropathic Processes Recruitment Findings in Myopathic Processes Questions Additional Readings Section IV: Important Concepts for Interpreting Studies Chapter 14: Orthodromic and Antidromic Nerve Conduction Studies Introduction Motor Nerve Conduction Studies Sensory Nerve Conduction Studies Considerations for Sensory Nerve Conduction Studies Questions References Chapter 15: Temporal Dispersion and Phase Cancellation Introduction Basic Concepts Questions References Chapter 16: Interpreting Studies Introduction Nerve Conduction Study Interpretation Needle EMG Interpretation Questions Chapter 17: Common Anomalies Introduction Anatomy Martin–Gruber Anastomosis Marinacci Anomaly Riche–Cannieu Anomaly All-Ulnar Hand Accessory Fibular Nerve Questions References Section V: Common Clinical Entities Chapter 18: Carpal Tunnel Syndrome Introduction Clinical Presentation Anatomy of the Carpal Tunnel Electrodiagnostic Approach Assessing the Severity of Carpal Tunnel Syndrome Questions References Chapter 19: Ulnar Neuropathy at the Elbow Introduction Clinical Presentation Anatomy Electrodiagnostic Approach Questions References Chapter 20: Radial Neuropathy Introduction Clinical Presentation Anatomy Electrodiagnostic Approach Recovery in Radial Neuropathy Questions Additional Readings References Chapter 21: Anterior Interosseous Nerve Lesions Introduction Anatomy Pathophysiology Clinical Presentation Electrodiagnostic Approach Questions References Chapter 22: Fibular (Peroneal) Neuropathy Introduction Clinical Presentation Electrodiagnostic Approach Questions Additional Readings Chapter 23: Tibial Neuropathy Introduction Clinical Presentation Basic Anatomy Electrodiagnostic Approach Trade Secrets Additional Readings References Chapter 24: Femoral Neuropathy Introduction Clinical Presentation Anatomy Electrodiagnostic Approach Questions References Chapter 25: Lumbosacral Radiculopathy Introduction Clinical Presentation Anatomy Electrodiagnostic Approach Nerve Conduction Studies Late Responses Electromyography Summary Questions References Chapter 26: Cervical Radiculopathy Introduction Clinical Presentation Anatomy of The Cervical Spine Spinal Nerves Electrodiagnostic Approach Questions References Chapter 27: Facial Nerve and Blink Studies Introduction Clinical Presentation Anatomy Electrodiagnostic Approach Questions Additional Readings References Chapter 28: Repetitive Stimulation and Neuromuscular Junction Disorders Introduction Clinical Presentation Electrodiagnostic Approach Questions Additional Reading Chapter 29: Peripheral Neuropathy Introduction Clinical Presentation Electrodiagnostic Approach Summary Questions References Chapter 30: Brachial Plexopathy Introduction Clinical Presentation Anatomy Electrodiagnostic Approach Summary Questions References Chapter 31: Motor Neuron Disease Introduction Anatomy Clinical Presentation Electrodiagnostic Approach Nerve Conduction Studies Electromyography Other Diagnostic Testing Questions References Chapter 32: Myopathy Introduction Clinical Presentation Electrodiagnostic Approach Nerve Conduction Studies Electromyography Other Diagnostic Testing Questions Chapter 33: The Use of Ultrasound With Electrodiagnosis Introduction Advantages of Using Ultrasound with Electrophysiologic Techniques Advantages of Ultrasound over Other Imaging Techniques Principles of Imaging Peripheral Nerves with Ultrasound Imaging Strategies to Improve Visualization of Peripheral Nerves Sonographic Features of Peripheral Nerve Pathology Principles of Imaging Muscle for Neuromuscular Assessment with Ultrasound When Assessing for Neuromuscular Muscle Pathology, Inspect for: Ultrasound as an Adjunct to Electrodiagnostic Techniques can be Used Questions Additional Readings Section VI: Checklists and Answers Chapter 34: Checklists Upper Limb Motor Nerve Conduction Studies Upper Limb Sensory Nerve Conduction Studies Lower Limb Motor Nerve Conduction Studies Lower Limb Sensory Nerve Conduction Studies Delayed Responses Electromyography Radiculopathy Screens Chapter 35: Answers to Multiple-Choice Questions Instrumentation (Chapter 2) Upper Limb Motor Studies (Chapter 4) Upper Limb Sensory Studies (Chapter 5) Lower Limb Motor Studies (Chapter 6) Lower Limb Sensory Studies (Chapter 7) F-Waves (Chapter 8) H-Reflexes (Chapter 9) Basic EMG Technique (Chapter 10) Basic Approach to EMG Waveform Recognition (Chapter 11) Motor Unit Action Potential Analysis (Chapter 12) Recruitment (Chapter 13) Orthodromic and Antidromic Nerve Conduction Studies (Chapter 14) Temporal Dispersion and Phase Cancellation (Chapter 15) Interpreting Studies (Chapter 16) Common Anamolies (Chapter 17) Carpal Tunnel Syndrome (Chapter 18) Ulnar Neuropathy at the Elbow (Chapter 19) Radial Neuropathy (Chapter 20) Anterior Interosseous Nerve Lesions (Chapter 21) Fibular (Peroneal) Neuropathy (Chapter 22) Femoral Neuropathy (Chapter 24) Lumbosacral Radiculopathy (Chapter 25) Cervical Radiculopathy (Chapter 26) Facial Nerve and Blink Studies (Chapter 27) Repetitive Stimulation and Neuromuscular Junction Disorders (Chapter 28) Peripheral Neuropathy (Chapter 29) Brachial Plexopathy (Chapter 30) Motor Neuron Disease (Chapter 31) Myopathy (Chapter 32) The Use of Ultrasound With Electrodiagnosis (Chapter 33) Index