2024 Workshop Handout Bundle-W90RFA Unusual Nerve Conduction Studies Anatomy and Procedures Upper and Lower Extremities Morris

W90RFA Unusual Nerve Conduction Studies Anatomy and Procedures Upper and Lower Extremities Morris

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The document is a comprehensive guide titled "Unusual Nerve Conduction Studies – Anatomy and Procedures – Upper and Lower Extremities" presented by Jerry Morris at the 2024 AANEM Annual Meeting. It focuses on advanced nerve conduction studies of both the upper and lower extremities, detailing anatomy, procedural techniques, and clinical applications.<br /><br />**Upper Extremity:**<br /><br />**Sensory Nerves:**<br />- **Lateral Antebrachial Cutaneous Nerve:** Sensory branch from the musculocutaneous motor nerve serving the lateral forearm, originating from C5-6 roots. Considered technically challenging.<br />- **Medial Antebrachial Cutaneous Nerve:** Pure sensory nerve from C8-T1, innervating the medial forearm; useful in diagnosing thoracic outlet syndrome.<br />- **Dorsal Ulnar Cutaneous Nerve:** Branches distal to the ulnar motor nerve, providing sensation to the medial hand area, especially tricky due to its proximity to Guyon's Canal.<br /><br />**Motor Nerves:**<br />- **Axillary Nerve:** Serves the deltoid muscle, derived from C5-6. Requires side-to-side comparison for accuracy.<br />- **Musculocutaneous Nerve:** Innervates the biceps and converts into the lateral antebrachial cutaneous nerve.<br />- **Spinal Accessory Nerve:** Innervates the trapezius muscle, noted for being painful during repetitive stimulation studies.<br /><br />**Alternative Nerve Sites and Procedures:**<br />- **Erb’s Point:** Anatomical landmark for studying the brachial plexus.<br />- **Major Nerves:** Outlined procedures for the median, ulnar, and radial nerves with extensive details on their anatomy.<br /><br />**Lower Extremity:**<br /><br />**Sensory Nerves:**<br />- **Lateral Femoral Cutaneous Nerve:** Originates from L2-3 roots, sensing the lateral thigh, associated with meralgia paresthetica.<br />- **Saphenous Nerve:** Pure sensory branch from the femoral nerve, serving the medial foreleg.<br />- **Superficial Peroneal (Fibular) Nerve:** Motor and sensory functions with L5-S1 roots.<br />- **Medial and Lateral Plantar Nerves:** Sensation to the foot, challenging to study technical aspects.<br /><br />**Motor Nerves:**<br />- **Femoral Nerve:** Innervates the quadriceps muscle group.<br />- **Fibular Nerve:** An alternative recording site if the extensor digitorum brevis shows no response.<br />- **Tibial Nerve:** Critical for tarsal tunnel syndrome studies, innervating the abductor digiti quinti pedis.<br /><br />**Other Key Points:**<br />- Detailed anatomy and procedures for the phrenic and facial nerves.<br />- Blink reflex assessment for conditions like Bell’s Palsy and Guillain-Barré syndrome.<br />- Important reminders for feedback and claiming educational credits via the AANEM app.<br /><br />The guide is highly technical, intended for medical professionals specializing in neurodiagnostics.

Keywords

Nerve Conduction Studies

ncs

Upper Extremities

Lower Extremities

Sensory Nerves

Motor Nerves

Anatomy

Procedures

Clinical Applications

AANEM Annual Meeting

Neurodiagnostics

nerve conduction studies

nerve conduction study

ncs