1. When it is needed?1. A patient is complaining of numbness.2. A patient is complaining of tingling (paresthesias).3. A patient has pain.4. A patient has weakness.5. A patient has a limp.6. A patient has muscle atrophy.7. A patient has depressed deep tendon reflexes.8. A patient has fatigue.

2. REACTION OF REGENERATION TEST F-G TEST Faradic response-innervated muscles Galvanic response- innervated /denervated Wallarian degeneration and degeneration 3. STRENGTH-DURATION CURVE 4. CHRONOXIE & RHEOBASE 1. The root word rheo means current and base means foundation: thus the rheobase is the foundation, or minimum, current (stimulus strength) that will produce a response. 2. The root word chrona means time and axie means axis: chronaxie, then, is measured along the time axis and, thus, is a Duration that gives a response when the nerve is stimulated at twice the rheobase strength. 5. GALVANIC TWITCH-TETANUS RATIOTEST Continuous DC used1 : 3.5to 6.5 In denervation unity occurs, both happens with same intensity 6. NERVE EXCITABILITY TEST MONOPHONIC PULSED CURRENT IS USED Between normal and affected side stimulation amplitude differencechronoxie amplitude0.3 ms3.5mA1.0 ms2mA 7. EMG-MUAP A motor unit is defined as onemotor neuron and all of the muscle fibers itinnervates. When a motor unit fires, theimpulse (called an action potential) iscarried down the motor neuron to themuscle. The area where the nerve contactsthe muscle is called the neuromuscularjunction, or the motor end plate. After theaction potential is transmitted across theneuromuscular junction, an action potentialis elicited in all of the innervated musclefibers of that particular motor unit. The sumof all this electrical activity is known as amotor unit action potential (MUAP) 8. CMRR-common mode rejectionratioS1+n - S2+n OUTPUT If output is less the CMRR is high and the machine is more reliable 9. Biphasic/triphasic(90%)WAVEFORM Polyphasic(10%) 10. EMG CIRCUIT Filters-Rectifiersnotch Preamplifier Amplifierraw to Sound/oscSignal 1mV 50xfilter, high 20-200x integrated illoscopepass,EMGlowpass 11. ELECTRODES 12. MONOPOLAR NEEDLE 13. CONCENTRIC NEEDLE 14. BIPOLAR CONCENTRIC NEEDLE 15. NORMAL EMG 16. Spontaneous activity 17. ABNORMAL EMG 18. INDICATIONS Diseases of muscle, Neuropathy nerve and NMJ Myopathy Radiculopathy Myelopathy 19. FINDINGS OF EMG fibrillation+ PSW-acute High frequency unresolved nerve injury dicharge- many causes Fasciculation problem Large MUAP-chronic in nerve cell body oraxonal injury due to new spinal cordterminal branches>5to7mV Small MUAP-myopathy< 1mV 20. FINDINGS OF EMG