The
EMG Manual is a simple step-by-step approach to
the basic understanding of EMG and Nerve Conductions
studies. It is designed to familiarize the reader
with the basic aspects of nerve conduction studies
and needle examinations and can serve as a guide
to the test, a preparation for the EMG rotation,
or as a simple means for better understanding of
the indications, preparations, interpretation and
performance of EMG Nerve and Conduction studies
NERVE CONDUCTION
STUDIES | LOWER EXTREMITY NERVES |
THE SURAL, SUPERFICIAL PERONIAL, AND SAPHENOUS NERVES
Sural NervePlace the recording electrode
posterior or inferior to the lateral malleolus and the
reference electrode further down the lateral aspect of
the foot. Apply, stimulation to the posterior-lateral
aspect of the leg 14 cm above the recording electrode.
Stimulation can also be applied
at other points proximally along the nerve and conduction
velocities calculated. Distances may be short, however,
making these calculations less reliable. At times, especially
when there is a lot of edema, needle electrode recording
is needed.
Superficial Peronial Nerve
We record the action potential
with a bar electrode placed 2 fingerbreadths anterior
to the lateral malleolus at the ankle. The nerve is stimulated
12cm proximal to the recording electrode on the anterolateral
aspect of the leg overlying the fibula.
You can calculate velocities by stimulating the nerve
at two points along its course.
Saphenous NerveThe response is obtained from
a bar recording electrode placed over the medial aspect
of the tibia with the active electrode at 3 to 4 fingerbreadths
above the medial malleolus. The nerve is stimulated 14
cm proximal to the active electrode with the stimulator
probes tucked underneath the medial edge of the tibia.