Quiz: Complete block

Muscle Weakness is due to:

Increased muscle tension
The presence of contracted fibers
An “energy crisis” for the rest of the muscle fibers
A full fledged muscle spasm
All of the above

Typical EMG signals are defined by:

Muscle fiber population derived electrical activity
The ability for surface and/or needle electrode signal pick up
A useful frequency bandwidth of 10-500 Hz
The capability of the muscle fibers to generate an electrical event.
All of the above

Muscular injury can occur when:

Soft tissues are exposed to single or recurrent episodes of biomechanical overloading
Adjacent muscle fibres are collected within a spasm.
Elevated levels of active MTrP’s in remote, unaffected muscle
All of the above

Botulinum toxin’s putative success can be attributed to:

Blocking afferent sensory fibers at the site of injection
Ability to promote acetylcholine from being released at the synapse
Direct action on the muscle fibers
Blockade of neural connection with the muscles

EMG guidance will not improve treatment outcomes

True
False

EMG guidance provides:

Recognition of patterns of activation
Location of muscles
Aspects of anatomy and kinesiology
Valuable feedback for newer injectors
All of the above

When Palpation is used alone without EMG or Stim guidance the results are just as good:

True
False

How does the success rate compare between using injection guidance to not:

15% error injecting large, easily palpated muscles
50% error injecting deeper muscles
Both experienced and novice injectors benefit from using injection guidance
Relying upon specific needle lengths to help find muscles is not a reliable strategy
All of the above

Muscle palpation and anatomical landmarks to ensure the accuracy of BoNt-A injections, even for large, superficial muscles are:

Just fine
Insufficient

Stimulation guidance, or Estim can be used:

To find individual muscles that are packed together, such as in the hand and foot
To locate nerves
To locate motor endplate
To locate both surface and deep muscles
As an essential component to ultrasound guided injections, by adding another layer of confirmation before injection.
All of the above

The best practice for EMG signal pick-up can be when:

The ground electrode should be place on a boney protuberance
The position of the surface electrodes do not matter
The reference and ground electrode can be strategically placed for best results
The reference and ground electrodes are moved for each injection

EMG may, or may not, be present when the hypodermic needle electrode is inserted. What is not a true statement?

Needle insertion may result in transient insertional activity, resulting in a transient EMG signal that will disappear
Needle insertion may result in spontaneous continuous EMG
Needle insertion may result in no spontaneous EMG signals
If there is no EMG signal the injection guidance device is not working properly

Estim is useful for:

Confirming needle location inside specific muscles where they are close together, like the hand and foot.
For nerve location and finding motor endplates
Can be used as an adjunct for confirmation along with EMG guidance
Can be used to evoke a twitch response in muscle
All of the above

Estim can be used for nerve and motor endplate location, except when:

The stimulator can be adjusted in 0.1mA steps
When the stimulation can be paused for more convenient needle repositioning
When there are a wide variety of pulse widths and stimulation frequencies available
The stimulator can only be adjusted in 1.0mA steps

Quiz: Complete block

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