Eletromiography I

Neuroanatomy.

Pathophysiology of the peripheral nervous system.

The methodology used in the theoretical and theoretical-practical part is of the active, explanatory type and uses slides, videos and texts to fulfil the objectives of the curriculum unit provided to the students.

Practical teaching on the handling of electromyography equipment, with the aim of performing nerve conduction tests.

Resolution of exercises for the practical component, containing questions on theoretical, theoretical-practical and practical topics, as well as interpretation and solving of real clinical cases.

The main objective of this curricular unit is to provide students with the necessary tools and knowledge to understand the functioning of the peripheral nervous system and the electroneurographic changes that occur in specific pathologies. Therefore, students should:

– Have the ability to perform a nerve conduction study, with knowledge of the anatomophysiology of the different nerves and muscles of the body;

– Acquire critical thinking skills to adapt the protocol and conduct of the investigation according to the electrophysiological findings during the conduct of a study, and the ability to correlate the clinical history with the results obtained;

– The ability to analyse and report the results obtained and to deduce from them the main pathophysiological hypotheses of the investigation and the probable diagnosis;

– General knowledge of handling the equipment and apparatus used to perform a nerve conduction study, from operating the equipment independently to selecting the appropriate amplifiers and electrodes for the situation, to overriding or mitigating artefacts/interferences that may interfere with or prevent the study;

– They have knowledge of needle electromyography to better understand the effects and extensions of pathologies that may affect the peripheral nervous system and to monitor and assist the neurophysiologist in performing the examination.

– General concepts about the elements that make up the peripheral nervous system – triad root-nerve-muscle;
– Clinical relevance of nerve conduction studies;
– Electromyograph, register sensors and stimulators;
– Knowledge of different registration electrodes and their properties and types of stimulators;
– Safety measures when performing nerve conduction studies;
– Recording parameters of nerve conduction studies (latency, amplitude, conduction velocity);
– The main recording protocols and their characteristics (sensory and motor studies);
– Biological factors and technical artifacts affecting nerve conduction studies;
– Late responses: F-response and H-reflex;
– Characteristics of nerve injury: Neuropraxia, Axonotmesis, Neurotmesis;
– Study of peripheral nervous system pathologies and their characteristic electroneurographic findings:

             o Mononeuropathies of the upper limbs, lower limbs and cranial pairs;
             o Radiculopathies;
             o Simple polyneuropathies.

NAO

Primary

• Kimura, J. (2013). Electrodiagnosis In Diseases of Nerve and Muscle – Principles and Practice. 4th ed. Oxford University Press.
• Preston, D. and Shapiro, B. (2013). Electromyography and neuromuscular disorders. 3rd ed. Elsevier.

Secondary

• Buschbacher, R.M., Prahlow, N. (2005). Manual of Nerve Conduction Studies. 2nd ed. Demos Medical Publishing.
• Liveson, J.A., Ma, D.M. (1992) Laboratory Reference for Clinical Neurophysiology. 1st ed. F.A. Davis Company
• Netter, F.H. (2018). Atlas of Human Anatomy. 7th ed. Elsevier.
• Sethi, R.K., Thompson, L.L. (1989). The Electromyographer’s Handbook. 2nd ed. Little, Brown and Company.