MEP & EMG Electrode Placement in Upper Limbs | Intraoperative Monitoring Demo скачать в хорошем качестве

MEP & EMG Electrode Placement in Upper Limbs | Intraoperative Monitoring Demo

n this video, we demonstrate the correct technique for placing recording electrodes in two key upper limb muscles commonly monitored during intraoperative neurophysiological monitoring (IONM): the brachioradialis and abductor pollicis brevis (APB). Electrode Placement Steps: Patient Positioning: Ensure the patient is in a comfortable, supine or semi-supine position with the upper limb supported to allow easy access to the forearm and hand. Skin Preparation: Clean the skin over the target muscles using an alcohol swab to reduce impedance and improve signal quality. Brachioradialis Muscle: Anatomical Landmark: Located on the lateral aspect of the forearm, just proximal to the wrist, along the radial border. Electrode Insertion: Insert the needle electrode longitudinally into the muscle belly, approximately one-third of the way down the forearm from the elbow crease. Reference Electrode: Place a surface or needle reference electrode at a nearby electrically neutral site, such as the dorsal wrist or forearm. Abductor Pollicis Brevis (APB) Muscle: Anatomical Landmark: Found in the thenar eminence at the base of the thumb. Electrode Insertion: Insert the recording electrode into the center of the thenar eminence, perpendicular to the skin. Reference Electrode: Position the reference electrode over the proximal phalanx or lateral aspect of the wrist. Secure Electrodes: Use tape or adhesive to secure the electrode leads and minimize movement artifacts during surgery. Impedance Check: Confirm that all recording channels have impedance below the recommended threshold, typically under 5 kilo-ohms, before starting stimulation.