4.1 Module EMGs

Module 4.1EMGs

NOTE: THE ENCLOSED INFORMATION IS A MERE SUPPLEMENT TO ALL THE OTHER PERTINENT INFORMATION FOUND IN JOURNAL ARTICLES, TEXTBOOKS AND OTHER PROFESSIONAL LITERATURE. THIS INFORMATION IS NOT INTENDED TO REPRESENT A COMPLETE SUMMARY OF ALL THE REQUIRED LEARNING FOR THE CNIM.

Neurocat CNIM Test PreparationModule 4.1 EMGsSpring 2011

Table of Contents:


There is anatomic, histochemical and electromyographic evidence of C3 and C4 motor innervation of the trapezius muscle. However, this motor contribution varies among individuals, thus clinical significance and surgical outcomes vary from person to person. (e.g., congenital absence of trapezius). The value of intra-operative EMG monitoring of C3-4 motor nerve roots is ultimately weighed by the surgeon, the “captain of the ship”.

Interference Patterns


Electrical interference can be seen in various forms. It is the goal to have zero interference during the case. A few examples are seen below.

Pedicle Screw Stimulation:A typical response is illustrated below:


The effects of anesthesia on SEPs and EMGs can be seen. It is important to have open communication with the anesthesiologist to prevent signal obliteration during the course of the procedure.


To verify that the system is stimulating properly and an appropriate current is being transmitted to the patient, direct nerve stimulation may be performed. A typical response such as the one below will be seen.

“spike trains” such as those shown below are among the most serious and must be reported immediately.


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4.1 Module EMGs