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MODULE

ELECTRODE PLACEMENT SYSTEM FOR SLEEP

ELECTRODE PLACEMENT SYSTEM FOR SLEEP

OBJECTIVES:

At the end of this module the student must be able to:

Demonstrate proper measurement of EEG electrode sites according to the International 10-20 system

Identify proper placement of EOG electrodes

Identify proper placement of EMG electrodes

Identify proper placement of ECG electrodes

LESSON 1: EEG ELECTRODE PLACEMENT M1 M2 Summary of the International 10-20 Electrode Placement in Sleep
LESSON 1: EEG ELECTRODE PLACEMENT
M1
M2
Summary of the International 10-20 Electrode Placement in Sleep

EEG ELECTRODE PLACEMENT

The EEG records the electrical activity of the brain. The different brain wave activities identify the specific stage of sleep.

Correct EEG electrode placement is important to ensure proper location of electrodes in relation to cortical areas so that they can be reliably and precisely maintained from individual to individual.

In order to get the “exact” placement of any EEG electrode, there must always be a cross-section of two intersecting marks.

The next slides will be a step by step guide on how the EEG electrodes are attached on the scalp of the patient using the International 10-20 Electrode Placement

EEG ELECTRODE PLACEMENT

PROCEDURE: 1. Take measuring tape and use the centimeter side. Start from the "0" mark (cm
PROCEDURE: 1. Take measuring tape and use the centimeter side. Start from the "0" mark (cm

PROCEDURE:

1. Take measuring tape and use the centimeter side. Start from the "0" mark (cm side).

1. Take measuring tape and use the centimeter side. Start from the "0" mark (cm side). Measure from the Nasion (bridge of the nose) to the Inion (occipital pretuberance - if you run your finger up the back of the neck of the skull, you will encounter a depression with the ridge of the protruding inion just above it).

1. Take measuring tape and use the centimeter side. Start from the "0" mark (cm side).
 
EEG ELECTRODE PLACEMENT PROCEDURE: 1. Take measuring tape and use the centimeter side. Start from the

EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

Mark the Nasion and Inion. (As a rule of the thumb, whichever direction the numbers are facing on the measuring tape is the direction you should make your marking). Get your total (for teaching purposes, let us say it is 36 cm).

EEG ELECTRODE PLACEMENT PROCEDURE: (cont’d) Mark the Nasion and Inion. (As a rule of the thumb,

EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

2. Mark 50% of your total (i.e. 18 cm).

This is your first mark of CZ.

EEG ELECTRODE PLACEMENT PROCEDURE: (cont’d) 2. Mark 50% of your total (i.e. 18 cm). This is

EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

3. Mark 10% up from the nasion and 10% up from the inion. (i.e. 3.6 cm)

This is your first mark of FPZ and OZ.

FPZ oz
FPZ
oz

EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

4. Mark 20% up from either the first mark of FPZ or CZ. (i.e. 7.2 cm)

This will be your first mark of FZ.

FPZ
FPZ

EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

5. Measure from pre- auricular point to pre- auricular point. Have the patient open his mouth slightly. Lightly run your finger up and down just anterior to the ear; the indentation above the zygomatic notch is easily identified. Obtain your total. (i.e. 38cm)

EEG ELECTRODE PLACEMENT PROCEDURE: (cont’d) 5. Measure from pre- auricular point to pre- auricular point. Have

EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

Mark half of your total (this number should intersect with your first 50% mark). (ex. 19 cm)

This is your true CZ

EEG ELECTRODE PLACEMENT PROCEDURE: (cont’d) Mark half of your total (this number should intersect with your

EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

6. Mark 10% up from each pre-auricular point. (ex. 3.8 cm) These are your

first marks of T3, and T4.

EEG ELECTRODE PLACEMENT PROCEDURE: (cont’d) 6. Mark 10% up from each pre-auricular point. (ex. 3.8 cm)

EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

7. Measure from your first mark of T3 to your CZ and obtain your total. (ex. 15 cm)

Mark half of your total. (ex. 7.5 cm)

This is your first mark of

C3.

EEG ELECTRODE PLACEMENT PROCEDURE: (cont’d) 7. Measure from your first mark of T3 to your CZ
EEG ELECTRODE PLACEMENT PROCEDURE: (cont’d) 7. Measure from your first mark of T3 to your CZ

EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

8. Measure from your first mark of T4 to your CZ and obtain your total. (ex. 15 cm)

Mark half of your total. (ex. 7.5 cm)

This is your first mark of

C4.

EEG ELECTRODE PLACEMENT PROCEDURE: (cont’d) 8. Measure from your first mark of T4 to your CZ
EEG ELECTRODE PLACEMENT PROCEDURE: (cont’d) 8. Measure from your first mark of T4 to your CZ

EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

9. Draw a cross-section on your first mark of FPZ.

This is your true FPZ

mark.

FPZ
FPZ

EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

10. Encircle the measuring tape all across your 10% mark; obtaining your circumference total. (ex. 56 cm) Mark half of your total. (ex. 28 cm)

This will be your true mark of OZ.

EEG ELECTRODE PLACEMENT PROCEDURE: (cont’d) 10. Encircle the measuring tape all across your 10% mark; obtaining
OZ
OZ

EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

11. Mark 5%

(ex. 2.8 cm) of

the half to the left and

right of OZ.

These will be your true marks of O1 and O2

respectively.

OZ
OZ

EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

12. Mark 5% (ex. 2.8 cm) to the left and right of FPZ.

These will be your true marks of FP1 and FP2 respectively.

FPZ
FPZ

EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

13. Mark 10% further down from FP1 and FP2. (ex. 5.6 cm) These will be your marks for F7 and F8 respectively.

EEG ELECTRODE PLACEMENT PROCEDURE: (cont’d) 13. Mark 10% further down from FP1 and FP2. (ex. 5.6

EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

14. Measure from F7 to F8 and obtain your total. (ex. 32 cm)

Mark half of your total.

(ex. 16 cm). Where your first mark of FZ and this second mark of FZ intersect is your

true mark of FZ.

EEG ELECTRODE PLACEMENT PROCEDURE: (cont’d) 14. Measure from F7 to F8 and obtain your total. (ex.
EEG ELECTRODE PLACEMENT PROCEDURE: (cont’d) 14. Measure from F7 to F8 and obtain your total. (ex.

EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

15. Measure from F7 to FZ. Obtain your total. (ex. 16 cm)

Mark half. (ex. 8 cm)

This will be your first mark of F3.

EEG ELECTRODE PLACEMENT PROCEDURE: (cont’d) 15. Measure from F7 to FZ. Obtain your total. (ex. 16
EEG ELECTRODE PLACEMENT PROCEDURE: (cont’d) 15. Measure from F7 to FZ. Obtain your total. (ex. 16

EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

16. Measure from F8 to FZ. Obtain your total. (ex. 16 cm)

Mark half. (ex. 8 cm)

This will be your first mark of F4.

EEG ELECTRODE PLACEMENT PROCEDURE: (cont’d) 16. Measure from F8 to FZ. Obtain your total. (ex. 16
EEG ELECTRODE PLACEMENT PROCEDURE: (cont’d) 16. Measure from F8 to FZ. Obtain your total. (ex. 16

EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

17. Measure 20% from FP1 to F3. (ex. 7 cm)

This will be your final mark of F3.

EEG ELECTRODE PLACEMENT PROCEDURE: (cont’d) 17. Measure 20% from FP1 to F3. (ex. 7 cm) This

EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

18. Measure 20% from FP2 to F4. (ex 7 cm)

This will be your final mark of F4.

EEG ELECTRODE PLACEMENT PROCEDURE: (cont’d) 18. Measure 20% from FP2 to F4. (ex 7 cm) This

EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

19. Measure from FP1 to your first mark of C3 to your O1. Obtain your total. (ex. 28 cm)

Mark half of your total. (ex 19 cm) Where your first and second marks intersect will be your true placement of C3

EEG ELECTRODE PLACEMENT PROCEDURE: (cont’d) 19. Measure from FP1 to your first mark of C3 to
EEG ELECTRODE PLACEMENT PROCEDURE: (cont’d) 19. Measure from FP1 to your first mark of C3 to

EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

20. Measure from FP2 to your first mark of C4 to your O2. Obtain your total. (ex. 28 cm)

Mark half of your total. (ex 19 cm) Where your first and second marks intersect will be your true placement of C4

EEG ELECTRODE PLACEMENT PROCEDURE: (cont’d) 20. Measure from FP2 to your first mark of C4 to
EEG ELECTRODE PLACEMENT PROCEDURE: (cont’d) 20. Measure from FP2 to your first mark of C4 to

EEG ELECTRODE PLACEMENT

OVERVIEW:

3)

Measure Nasion to Inion. Get total.

4)

Mark 50% from the total. This is your initial mark for CZ.

5)

Mark 10% up from the Nasion and Inion. Initial mark of FPZ and OZ.

6)

Mark 20% from FPZ or CZ. Initial mark of FZ.

7)

Measure from Pre-auricular point to pre-auricular point. Get the total. Mark 50%. Where line will intersect with initial CZ, this is the FINAL mark of CZ

EEG ELECTRODE PLACEMENT

OVERVIEW: (cont’d)

6) Mark 10% up from each pre-auricular point. This is your

7)

T3, T4 Measure from first mark of T3 to your CZ. Obtain total.

8)

Mark half. This is your first mark of C3. Measure from first mark of T4 to CZ. Obtain total. Mark half. First mark of C4.

9) Draw a cross-section across FPZ. This is your FINAL FPZ mark.

EEG ELECTRODE PLACEMENT

OVERVIEW: (cont’d)

10) Measure entire circumference of head, going all across 10% marks, starting from FPZ. Get total. Mark half. TRUE mark of OZ. 11) Mark 5% of the half to the left and right of OZ. These will be your TRUE marks of O1 and O2. 12) Mark 5% of the half to the left and right of FPZ. True marks of FP1 and FP2. 13) Mark 10% further down from FP1 and FP2. Your marks for F7 and F8.

EEG ELECTRODE PLACEMENT

OVERVIEW: (cont’d)

14) Measure from F7 to F8 and obtain your total. Mark half. Where your first and second marks of FZ intersect is your FINAL mark of FZ. 15) Measure from F7 to FZ. Obtain total. Mark half. This will be your first mark of F3. 16) Measure from F8 to FZ. Obtain total. Mark half. First mark of F4. 17) Measure 20% from FP1 to F3. This will be your final mark of F3.

EEG ELECTRODE PLACEMENT

OVERVIEW: (cont’d)

18) Measure 20% from FP2 to F4. Final mark of F4. 19) Measure from FP1 to first mark of C3 to O1. Obtain total. Mark half. Where your first and second marks intersect will be your TRUE C3. 20) Measure from FP2 to first mark of C4 to O2. Obtain total. Mark half. Where first and second marks intersect will be your true placement of C4.

EEG ELECTRODE PLACEMENT

This concludes the “Modified” 10-20 Electrode Placement System for Sleep.

Next is the proper placement of EOG electrodes.

EOG ELECTRODE PLACEMENT

Electrodes are placed on each eye to determine electrical activity caused by eye movements

PROCEDURE:

On the Right, the EOG electrode is placed on the upper- outer edge of the right eye. (usually 1cm out and 1 cm up from the outer canthus of the eye)

EOG ELECTRODE PLACEMENT Electrodes are placed on each eye to determine electrical activity caused by eye

EOG ELECTRODE PLACEMENT

PROCEDURE:

On the Left, the EOG electrode is placed on the lower-outer edge of the left eye. (usually 1cm out and 1 cm down from the outer canthus of the eye) Both are referenced to the contralateral mastoid site (M1, M2)

EOG ELECTRODE PLACEMENT PROCEDURE: On the Left, the EOG electrode is placed on the lower-outer edge

EOG ELECTRODE PLACEMENT

This concludes the proper placement of Right and Left EOG electrodes.

Next is the proper placement of the Chin, Leg & Arm EMG electrodes.

EMG ELECTRODE PLACEMENT

The EMG records the electrical activity of the muscles on the chin as the face twitches, the teeth grinds and the muscle relaxes on REM sleep. Electrodes are also placed on the limb, such as leg and/or arm, to monitor excessive amount of movements during sleep.

EMG ELECTRODE PLACEMENT

PROCEDURE:

The Chin EMG electrode is placed on the mentalis and submentalis muscle

Submentalis Mentalis
Submentalis
Mentalis

EMG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

The Leg EMG electrode is placed on the anterior tibialis muscle, 2-4 cm apart vertically.

To locate the anterior tibialis muscle, palpate the shin as the patient repetitively points and flexes the foot or toes. The optimal electrode placement area is below the knee, anywhere from midpoint of the shinbone to the outer area of the upper shin.

EMG ELECTRODE PLACEMENT PROCEDURE: (cont’d) • The Leg EMG electrode is placed on the anterior tibialis

Anterior Tibialis

EMG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

The Arm EMG electrode is placed on the forearm on the extensor digitorum muscle.

To locate it, have the patient extend the forearm with palm downward. Then, feel the upper surface of the forearm as the patient bends the wrist up and down.

EMG ELECTRODE PLACEMENT PROCEDURE: (cont’d) • The Arm EMG electrode is placed on the forearm on

EMG ELECTRODE PLACEMENT

This concludes the proper placement of EMG electrode on the chin, leg and arm.

Next is the proper placement of ECG electrodes

ECG ELECTRODE PLACEMENT

ECG records the electrical activity of the heart, such as the rate and the rhythm.

PROCEDURE:

Electrodes are placed just beneath the right clavicle (collar bone) and at the midclavicular line on the left (slightly lower than the right) and the fifth intercostal space

clavicle Mid- Right ECG placement 5 th space
clavicle
Mid-
Right
ECG
placement
5
th
space

clavicular line (left)

intercostal

ECG ELECTRODE PLACEMENT

This concludes the ECG placement

ELECTRODE PLACEMENT SYSTEM FOR SLEEP

On this module you have learned to identify the proper placement of the:

EEG EOG EMG and ECG leads