McLean EMG Guide, 2nd Edition

ISBN:

978-0-8261-7212-9

(Print)

978-0-8261-7213-6

(eBook)
DOI:

10.1891/9780826172136

Published:

Abstract

This book provides a practical and concise text for electromyography (EMG) rotations and is a great companion to the larger reference texts that successful electrodiagnosticians also need. It provides more of the practical information on EMGs that made the first edition so successful. In addition, it includes pictures, text, clinical pearls, questions, and tables and provided novel chapters such as the use of ultrasound in electrodiagnostics. These chapters are written by some of the foremost and experienced authorities in the field. This book includes 35 chapters. These chapters are organized into six sections. Section I consists of Chapters 1–3. It provides introduction to electrodiagnosis, instrumentation and systematic approach to learning and performing nerve conduction studies. Section II consists of Chapters 4–9. It discusses motor and sensory studies of upper limb and lower limb. Section II also discusses the F-waves and H-reflexes. Section III consists of Chapters 10–13. It provides basic approach to EMG technique and waveform recognition. Section III also describes motor unit action potential analysis and recruitment. Section IV consists of Chapters 14–17. It discusses orthodromic and antidromic nerve conduction studies; temporal dispersion and phase cancellation; interpreting studies; and common anomalies. Section V consists of Chapters 18–33. It discusses carpal tunnel syndrome; neuropathy of ulnar and radial; anterior interosseous nerve lesion; fibular and tibial neuropathy; lumbosacral and cervical radiculopathy; facial nerve and blink studies; repetitive stimulation and neuromuscular junction disorders; peripheral neuropathy; brachial plexopathy; motor neuron disease; myopathy; and the use of ultrasound with electrodiagnosis. Section VI includes Chapters 34 and 35 which include study checklists and the answers to the multiple choice questions located within the chapters.

14: Orthodromic and Antidromic Nerve Conduction Studies

DOI:

10.1891/9780826172136.0014

Authors

  • Goodman, Daniel A.

Abstract

This chapter discusses orthodromic and antidromic nerve conduction studies. Nerve conduction studies (NCS) typically involve mixed nerves, such that they include both sensory and motor nerve fibers. Motor nerve action potentials propagate from the anterior horn cell distally toward the neuromuscular junction. Sensory nerve action potentials propagate from the sensory nerve endings proximally toward the dorsal root ganglion. Propagation of an induced action potential during NCS travels in both directions, proximally and distally. In an orthodromic study, the recording electrodes measure the action potential traveling in the physiologic direction. In an antidromic study, the recording electrodes measure the action potential traveling opposite the physiologic direction. These orthodromic studies measure the compound motor action potential in the physiologic direction, such that the stimulation site is proximal and the recording electrode is placed distally over the muscle belly. The chapter discusses motor nerve conduction studies and sensory nerve conduction studies.