神經(jīng)肌電圖的臨床應(yīng)用課件

神經(jīng)肌電圖的臨床應(yīng)用服從真理，就能征服一切事物神經(jīng)肌電圖的臨床應(yīng)用服從真理，就能征服一切事物1神經(jīng)肌電圖原理及臨床應(yīng)用西南醫(yī)院神經(jīng)醫(yī)學(xué)中心范文輝神經(jīng)肌肉病會(huì)診中心Neuromusculardiseasecenter)神經(jīng)肌電圖原理及臨床應(yīng)用2第一部分概況概念肌電圖(EMG)獨(dú)義EMG同心圓針電極廣義EMGSCV、MCV和F波、RNS(重復(fù)電刺激)反射(H-反射、瞬目反射和交感皮膚反射)單纖維肌電圖(SFEMG)巨肌電圖誘發(fā)電位第一部分概況3目前EMG所處的地位CT、MRI等應(yīng)用,誘發(fā)電位的價(jià)值已較局限,但組織化學(xué)、生物化學(xué)及基因等檢測(cè)方法的進(jìn)展仍不能取代EMG為正?；虍惓Ｉ窠?jīng)肌肉提供的重要信息(功能學(xué)診斷)神經(jīng)肌肉疾病的診斷、預(yù)后評(píng)價(jià)和檢測(cè)中具有重要的意義;是神經(jīng)系統(tǒng)檢査的延伸目前EMG所處的地位4生物電生物電在人體組織、動(dòng)物、植物以及微生物中都存在,成為一種非常普遍而奇異的自然現(xiàn)象。在現(xiàn)代醫(yī)學(xué)中,心電、腦電、胃腸道的生物電活動(dòng)也起了人們的興趣與重視生物電生物電在人體組織、動(dòng)物、植物5AutonomicSysRecepstemSimplifiedthAdrenalinenoradrenalinecidilatorySympatheticNervousSystenParasympatheticNervousSystemGastricAcetylcholine(AchExcretionAutonomicSys6什么是運(yùn)動(dòng)單位(motorunit)運(yùn)動(dòng)單位髓前角運(yùn)動(dòng)細(xì)胞終板個(gè)運(yùn)動(dòng)單元由同個(gè)a運(yùn)動(dòng)神經(jīng)元支配的一組肌纖維組成,是肌肉肌纖維收縮的最小功能單位。運(yùn)動(dòng)單位什么是運(yùn)動(dòng)單位(motorunit)7運(yùn)動(dòng)單位電位(motorunitpotentials,MUP)n運(yùn)動(dòng)單位的單次發(fā)放沖動(dòng),可引起其軸突支配的全部肌纖維的同步收縮,通過(guò)細(xì)胞外電極所記錄的波形,即運(yùn)動(dòng)單位電位(motorunitpotentials,MUP)運(yùn)動(dòng)單位電位8MotorUnit(sMS艇制=1SimplifiedModeld-SPINALCORDGanglionCellssSensoryreceptorsPeripheralcalroAnteriorHornCellsmotorStriatedmuscMOTORUNITMotorUnit(sMS艇制=19三.EMG的主要內(nèi)容常規(guī)EMG或同心圓EMGSFEMG:了解同一MUAP內(nèi)肌纖維的分布、NMJ的傳導(dǎo)功能和神經(jīng)再生情況巨肌電圖(macroEMG)記錄整個(gè)運(yùn)動(dòng)單位的方法主要用于側(cè)枝芽生的定量分析和估計(jì)運(yùn)動(dòng)單位的數(shù)量等研究掃描肌電圖:MU的分布及解剖構(gòu)成三.EMG的主要內(nèi)容10SinglefiberemgSpecialNeedle·4-5insertionsinAthesamemuscleJitterModeratecontractionNormal8Minimum20potentialsAnalyzeon2·3musclesMCDMSDBiceps:15.659Tibialisant:32.115.0ReinnervationTrigg100msSinglefiberemg11神經(jīng)肌電圖的臨床應(yīng)用課件12神經(jīng)肌電圖的臨床應(yīng)用課件13神經(jīng)肌電圖的臨床應(yīng)用課件14神經(jīng)肌電圖的臨床應(yīng)用課件15神經(jīng)肌電圖的臨床應(yīng)用課件16神經(jīng)肌電圖的臨床應(yīng)用課件17神經(jīng)肌電圖的臨床應(yīng)用課件18神經(jīng)肌電圖的臨床應(yīng)用課件19神經(jīng)肌電圖的臨床應(yīng)用課件20神經(jīng)肌電圖的臨床應(yīng)用課件21神經(jīng)肌電圖的臨床應(yīng)用課件22神經(jīng)肌電圖的臨床應(yīng)用課件23神經(jīng)肌電圖的臨床應(yīng)用課件24神經(jīng)肌電圖的臨床應(yīng)用課件25神經(jīng)肌電圖的臨床應(yīng)用課件26神經(jīng)肌電圖的臨床應(yīng)用課件27神經(jīng)肌電圖的臨床應(yīng)用課件28神經(jīng)肌電圖的臨床應(yīng)用課件29神經(jīng)肌電圖的臨床應(yīng)用課件30神經(jīng)肌電圖的臨床應(yīng)用課件31神經(jīng)肌電圖的臨床應(yīng)用課件32神經(jīng)肌電圖的臨床應(yīng)用課件33神經(jīng)肌電圖的臨床應(yīng)用課件34神經(jīng)肌電圖的臨床應(yīng)用課件35神經(jīng)肌電圖的臨床應(yīng)用課件36神經(jīng)肌電圖的臨床應(yīng)用課件37神經(jīng)肌電圖的臨床應(yīng)用課件38神經(jīng)肌電圖的臨床應(yīng)用課件39神經(jīng)肌電圖的臨床應(yīng)用課件40神經(jīng)肌電圖的臨床應(yīng)用課件41神經(jīng)肌電圖的臨床應(yīng)用課件42神經(jīng)肌電圖的臨床應(yīng)用課件43神經(jīng)肌電圖的臨床應(yīng)用課件44神經(jīng)肌電圖的臨床應(yīng)用課件45神經(jīng)肌電圖的臨床應(yīng)用課件46神經(jīng)肌電圖的臨床應(yīng)用課件47神經(jīng)肌電圖的臨床應(yīng)用課件48神經(jīng)肌電圖的臨床應(yīng)用課件49神經(jīng)肌電圖的臨床應(yīng)用課件50神經(jīng)肌電圖的臨床應(yīng)用課件51神經(jīng)肌電圖的臨床應(yīng)用課件52神經(jīng)肌電圖的臨床應(yīng)用課件53神經(jīng)肌電圖的臨床應(yīng)用課件54神經(jīng)肌電圖的臨床應(yīng)用課件55神經(jīng)肌電圖的臨床應(yīng)用課件56神經(jīng)肌電圖的臨床應(yīng)用課件57神經(jīng)肌電圖的臨床應(yīng)用課件58神經(jīng)肌電圖的臨床應(yīng)用課件59神經(jīng)肌電圖的臨床應(yīng)用課件60神經(jīng)肌電圖的臨床應(yīng)用課件61神經(jīng)肌電圖的臨床應(yīng)用課件62神經(jīng)肌電圖的臨床應(yīng)用課件63神經(jīng)肌電圖的臨床應(yīng)用課件64神經(jīng)肌電圖的臨床應(yīng)用課件65神經(jīng)肌電圖的臨床應(yīng)用課件66神經(jīng)肌電圖的臨床應(yīng)用課件67神經(jīng)肌電圖的臨床應(yīng)用課件68神經(jīng)肌電圖的臨床應(yīng)用課件69神經(jīng)肌電圖的臨床應(yīng)用課件70神經(jīng)肌電圖的臨床應(yīng)用課件71神經(jīng)肌電圖的臨床應(yīng)用課件72神經(jīng)肌電圖的臨床應(yīng)用課件73神經(jīng)肌電圖的臨床應(yīng)用課件74神經(jīng)肌電圖的臨床應(yīng)用課件75神經(jīng)肌電圖的臨床應(yīng)用課件76神經(jīng)肌電圖的臨床應(yīng)用課件77神經(jīng)肌電圖的臨床應(yīng)用課件78神經(jīng)肌電圖的臨床應(yīng)用課件79神經(jīng)肌電圖的臨床應(yīng)用課件80神經(jīng)肌電圖的臨床應(yīng)用課件81神經(jīng)肌電圖的臨床應(yīng)用課件82神經(jīng)肌電圖的臨床應(yīng)用課件83神經(jīng)肌電圖的臨床應(yīng)用課件84神經(jīng)肌電圖的臨床應(yīng)用課件85神經(jīng)肌電圖的臨床應(yīng)用課件86神經(jīng)肌電圖的臨床應(yīng)用課件87神經(jīng)肌電圖的臨床應(yīng)用課件88神經(jīng)肌電圖的臨床應(yīng)用課件89神經(jīng)肌電圖的臨床應(yīng)用課件90神經(jīng)肌電圖的臨床應(yīng)用課件91神經(jīng)肌電圖的臨床應(yīng)用課件92神經(jīng)肌電圖的臨床應(yīng)用課件93神經(jīng)肌電圖的臨床應(yīng)用課件94神經(jīng)肌電圖的臨床應(yīng)用課件95神經(jīng)肌電圖的臨床應(yīng)用課件96神經(jīng)肌電圖的臨床應(yīng)用課件97神經(jīng)肌電圖的臨床應(yīng)用課件98神經(jīng)肌電圖的臨床應(yīng)用課件99神經(jīng)肌電圖的臨床應(yīng)用課件100神經(jīng)肌電圖的臨床應(yīng)用課件101神經(jīng)肌電圖的臨床應(yīng)用課件102神經(jīng)肌電圖的臨床應(yīng)用課件103神經(jīng)肌電圖的臨床應(yīng)用課件104神經(jīng)肌電圖的臨床應(yīng)用課件105神經(jīng)肌電圖的臨床應(yīng)用課件106神經(jīng)肌電圖的臨床應(yīng)用課件107神經(jīng)肌電圖的臨床應(yīng)用課件108神經(jīng)肌電圖的臨床應(yīng)用課件109神經(jīng)肌電圖的臨床應(yīng)用課件110神經(jīng)肌電圖的臨床應(yīng)用課件111神經(jīng)肌電圖的臨床應(yīng)用課件112神經(jīng)肌電圖的臨床應(yīng)用課件113神經(jīng)肌電圖的臨床應(yīng)用課件114神經(jīng)肌電圖的臨床應(yīng)用課件115神經(jīng)肌電圖的臨床應(yīng)用課件116神經(jīng)肌電圖的臨床應(yīng)用課件117神經(jīng)肌電圖的臨床應(yīng)用課件118神經(jīng)肌電圖的臨床應(yīng)用課件119神經(jīng)肌電圖的臨床應(yīng)用課件120神經(jīng)肌電圖的臨床應(yīng)用課件121神經(jīng)肌電圖的臨床應(yīng)用課件122神經(jīng)肌電圖的臨床應(yīng)用課件123神經(jīng)肌電圖的臨床應(yīng)用課件124神經(jīng)肌電圖的臨床應(yīng)用課件125神經(jīng)肌電圖的臨床應(yīng)用課件126神經(jīng)肌電圖的臨床應(yīng)用課件127神經(jīng)肌電圖的臨床應(yīng)用課件128神經(jīng)肌電圖的臨床應(yīng)用課件129神經(jīng)肌電圖的臨床應(yīng)用課件130神經(jīng)肌電圖的臨床應(yīng)用課件131神經(jīng)肌電圖的臨床應(yīng)用課件132神經(jīng)肌電圖的臨床應(yīng)用課件133神經(jīng)肌電圖的臨床應(yīng)用課件134神經(jī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22、業(yè)精于勤，荒于嬉；行成于思，毀于隨?！n愈

23、一