Ukuhlolwa kwe-Electrodiagnostic kusiza nge-peripheral nerve and diagnosis diagnostic
I-Electromyography (EMG) kanye nezifundo zokuqhutshwa kwezinzwa (NCS) ziyizinto ezibalulekile zokuxilonga ezisiza izifo ze-neurologists ukuthola futhi zithole izimbangela zezifo ezithinta imisipha kanye nezinzwa zomzimba. E-EMG, inaliti encane ifakwe kwisisipha ukuze kutholakale umsebenzi kagesi. Ezifundweni zokuqhutshwa kwamathambo, ama-electrode afakwa esikhumbeni esiphezulu kwesibindi, kanti amanye ama-electrode okuqoshwa afakwe endaweni ehlukile phezu kwenzwa efanayo.
Ukwethuka okuncane kusetshenzisiwe, futhi umfutho wokugesi uqoshiwe.
Ngenkathi i-EMG ne-NCS zivivinywa ngokungafani, zivame ukusetshenziswa ndawonye ngoba ulwazi olutholakala ekuhlolweni ngalunye luyizinkokhelo. Lezi zivivinyo zombili ndawonye zivame ukufundisa ngaphezu kokusetshenziswa kwedwa, ngaphandle kwezimo ezithile.
Ukuqonda imiphumela ye-NCS
Isignali kagesi esithunyelwe eceleni kwe-axon ye-nerve ibizwa ngokuthi isenzo esingenzeka. Ezifundweni zokuqhutshwa kwamathambo, lezi zenzo ezinamandla zikhiqizwa ngobuciko ngokuvuselela kagesi ukuze kuhlolwe ukuthi i-axon isabela kanjani.
Kukhona izingxenye ezimbili eziyinhloko zesifundo sokuqhutshwa kwesishu sokuzivocavoca nesithuthuthu. Ukurekhoda kusuka eniswini yokuzwa kunika amandla isenzo senzwa yesisindo (SNAP), futhi ukurekhoda kusuka kumisipha kuveza isisindo semisipha yomzimba (CMAP).
Amanye amagama ongabhekana nawo kumbiko we-EMG noma we-NCS afaka lokhu okulandelayo:
- Ukulinganisa: Isignali kagesi imelelwe njengegagasi, futhi ukuphakama ukuphakama kwayo.
- Ukuqhutshwa kwe-velocity (CV): I-conduction velocity ichaza ijubane lapho umfutho wegesi uhamba khona.
- Ubude besikhathi: Lokhu kuchaza ububanzi bomsakazo kagesi.
- Ukuvimbela ukudoba: Lokhu kunciphisa isignali esiqhingini esasimweni esifanayo nesandla. Lokhu kuphakamisa ukungena kwesibindi, njengokungathi ku- carpal tunnel syndrome .
- I-F reflex: I-F wave iyinhlobo ye-echo kagesi, lapho umfutho uhamba khona ufike emgodleni bese uphinde uhambe phansi nge-fiber efanayo. Ngakho-ke unikeza umqondo wokuqhutshwa kwayo yonke ubude bezinjini.
- H reflex: I-wave ye-H iyona efana ne-electrical reflex emlenzeni. Ukuhambela umgogodla kumgogodla nge-nerve sensory, bese ubuyela emuva ngesithuthuthu sezindiza.
Lezi zinyathelo zinikeza ulwazi mayelana kokubili izingxenye zezimoto nezinzwa zesimiso sezinzwa zomzimba . Babuye basikisela ukuthi i-axon noma i-myelin sheath of nerves ibonakaliswe kakhulu yi-neuropathy. I-Myelin isiza izinyathelo zokuhamba zihambe ngokushesha, ngakho-ke ezinkingeni ze-myelin (i-myelinopathies), ukuqhutshwa kwe-velocity kwehle. Ezinkingeni nge-axon (i-axonopathies), izintambo ezingaguquki zingenza izimpawu ngokusheshisa okuvamile, kodwa kunezintambo ezimbalwa, eziholela embonini obuthakathaka futhi zinciphise amandla.
Ukuqonda imiphumela ye-EMG
Uma i-EMG yenziwa, umsebenzi wegesi ovela kumfucumfucu we-muscle uyalinganiswa futhi uboniswe njengoba amagagasi esibukweni kanye nemisindo efana ne-static edlalwa kwisipikha. Ochwepheshe bobabili balalela lezi zomsindo futhi ubukele umqapha ukuze abone ukungajwayelekile.
Lapho inzwa ivuselela imisipha ukuba ivumelane, umphumela uwukugqamile komsebenzi kagesi obizwa ngokuthi yi-unit unit action (MUP).
Ezifo zezinzwa ze-peripheral, ngezinye izikhathi imisipha iqala ukwenza imisebenzi yokuzimela eyedwa. Lokhu kungatholwa yi-EMG njenge-fibrillations namagagasi aphikisayo aphezulu ekuqapha. Ngezinye izikhathi ukungajwayelekile kuyabangela ukubonakala kwamasipha okubonakalayo okuthiwa ama- fasciculations.
Uma inzwa ilimazekile bese ibuyela emuva, le nerve ijwayele ukuphuma igxile ukufaka indawo ebanzi. Lokhu kubangelwa ama-MUPs amakhulu angavamile. Uma i-MUPs ingajwayelekile kakhulu noma imfushane ibonisa ukuba khona kwesifo sesisipha (i-myopathy).
Odokotela ukuhumusha imiphumela ye-EMG bangase bathi igama elithi "iphethini yokuqasha." Njengoba imisipha ihlanganisiwe, izintambo zezinzwa zibonisa izingxube eziningi zemisipha (okuthiwa ama-motor unit) ukujoyina futhi usize.
Enkingeni ye-neuropathic, ubukhulu bezinjini ezahlukene eziqinile, kodwa kukhona ezimbalwa ngoba inzwa ayinakukwazi ukuxhuma kumanithi amaningi. Ema-myopathies, inani lezinyunithi zamagesi livamile, kodwa ukuphakama kuncane.
Indlela yokukhishwa kwamagesi evela kumisipha inganikeza ngolwazi olwengeziwe mayelana nombangela wenkinga, futhi ingasiza ekunqumeni ukuthi kube khona inkinga isikhathi eside.
Ukuchazwa kwe-EMG kanye ne-NCS akukhona ngaso sonke isikhathi okuqondile futhi kungase kungabikho ngaso sonke isikhathi kuholela ekuxilongweni okukodwa-kodwa ukuhlolwa kunganciphisa inani lezinkinga zokuxilonga.
Imithombo:
Ukuthunyelwa kwe-AR, i-Sander HW, Indlela Yomtholampilo Yokubhekana Nezifo Nezentuthuko: Ukutholakala Kwendawo Ye-Anatomic nokuhlola Ukuhlola. Ukuqhubeka; Umqulu 18, uNgo-1, Februwari 2012.
> Blumenfeld H. Neuroanatomy Through Clinical Cases . I-Sunderland, MA: Sinauer Associates, Inc. Abashicileli; 2014.