ClinicalElectromyography.pptVIP

CMAP的波幅反应了从刺激点到记录点中，轴索的数量， 它也取决于：轴索的传导速度，神经肌肉接头的完整性，肌纤维的数量 * * 潜伏期：它反映了神经轴索中快传导纤维到达肌肉的时间 它也取决于：神经阶段的长度，神经肌肉接头之间的传递时间 冲动在肌纤维上的传导时间 * * 时程：检查组成被检神经的轴索的传导速率，即如果这些轴索能够基本在同一时间同时放电的话，时程就会比较短。如果有些轴索脱髓鞘病变时，传导就比较慢，时程就会延长。 * Desynchronized slowing (differential slowing) occurs when conduction velocity reduces at the lesion site along a variable number of the medium or small nerve fibers (average- or slower-conducting axons). Here, the CMAP disperses with prolonged duration on stimulations proximal to the lesion. The speed of conduction along the injury site (latency or conduction velocity) is normal because of sparing of at least some of the fastest-conducting axons * * * * * 在正中神经走形区定12个刺激点，每点相距1cm。0是标在远端掌横纹，向上，向下。当刺激往近端走时，潜伏期呈线性增加，通常潜伏期增加的范围是0.16-0.21ms. * 这是双手患腕管综合征的患者的感觉神经电位图（SNAP），做了节段技术。旁边的图显示的是，两个相邻节段的潜伏期的差值，通常潜伏期增加的范围是0.16-0.21ms.。 * 刺激神经干运动纤维的兴奋双向传导，向下引起肌肉兴奋即M波，向上达运动神经元激起兴奋，此兴奋回返传导并引起同一肌肉的二次兴奋。主要是研究近端神经根的功能状态,但是如果神经根病变以感觉根损害为主，则F波不会出现改变。 * * S1神经跟病，H反射消失或潜伏期延长 * * * * * * * * 02 * 运动单位是指由一个前角细胞及其轴突所支配的肌纤维，是肌肉收缩的最小功能单位。 02 * Normal Insertional and Spontaneous Activity End-plate?noise?( solid arrows )?and?spikes?( dashed arrow )?representing?normal?insertional?and spontaneous?activities 02 * Abnormal Insertional and Spontaneous Activity ?Brief?spike?fibrillation?potentials Positive?waves Myotonic?discharge 02 * Fig. 32B.12 Myokymic?discharge Complex?repetitive?discharge 02 * 02 * Voluntary Motor Unit Action Potentials MUAP Morphology 02 * 02 * Main types of pathology in the motor unit A Two normal overlapping MUPs B Neuropathic motor unit with enlargement of one motor unit and some denervated muscle fibers. Large MUP C Myopathic motor units. Small MUP 02 * 谢 谢！? 03 * The Date Analysis Text your title Lorem ipsum dolor sit amet, consectetur adipisicing elit, sed do eiusmod tempor. Text your title Lorem ipsum dolor sit amet, consectetur. Text your title Lorem ipsum dolor sit amet, consectetur. Text your title Lorem ipsum dolor sit amet, co