Measuring median nerve CV

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Comparison of recording methods

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The Medial nerve is a nerve trunk

Nerve trunk
Myelinated

Non-Myelinated
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Compound action potential (CAP):
population recording & effect of stimuli strength
Increasing stimuli strength recruits both more axons as well as those of smaller
diameter who have higher thresholds: recruitment

Stimulus
intensity

CAP

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What is a compound action potential?
Summed response of detected APs

0.20

0.15

0.10

0.05
Volts

0.00

-0.05

-0.10

-0.15

-0.20
-0.002 0.000 0.002 0.004 0.006 0.008 0.010 0.012 0.014 0.016 0.018 0.020 0.022
5
seconds
 Example EMG CAP

Artefact
EMG (Volts)

Shortest
latency

Average
latency

Peak
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Time (s)
 A few facts
• Shortest latency: Type I “slow” muscle fibres preferentially innervated by slow
CV, small diameter, low threshold motor neurons
• Average latency = average response
• Longest latency: Type II “fast” muscle fibres preferentially innervated by fast CV,
large diameter, high threshold motor neurons
• Peak: dependent on several factors
– Closeness of active muscle fibres,
– cross sectional area
– level of synchronization
– Weak dependence on number of fibres activated
– Duration hence AUC better measure of number activated
• Multiple peaks (no. of times cross baseline + 1)?
– poor synchronization, fibres activated by sprouting efferents
• Muscle fibre conduction velocity~ 4-5 m/s

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 Intro
• Just state aims and objectives

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 Methods
• As in ADI package unless you did different then state.
• Schematic diagram of stimulation and recording sites,
where the distance measurements were made and an
example calculation of CV and synaptic delay

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 Results
• Hand drawn observation of EMG with annotations
– Describe the EMG, its shape, its timing, its variation?

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 Results
• Hand drawn observation of EMG with annotations
– Describe EMG, its shape, timing variation?
• Graphs of the stimulus-response relationships for wrist:
– EMG peak amplitude, AUC (if you have it) and latency
– Describe these, not explain, see pg 5. Yellow book for advice

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Example stimulus-response relationship
Response parameter

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Stimulus parameter
 Results (40 marks)
• Hand drawn observation of EMG with annotations
– Describe the EMG, its shape, its timing, its variation?
• Graphs of the stimulus-response relationships for wrist:
– EMG peak amplitude, AUC( if you have it) and latency
– Describe, not explain, see pg 5. Yellow book intro for advice
• Appropriate description of 5 EMGs obtained on wrist and elbow
in response to 5 identical stimulations
– EMG amplitude, AUC and latency.
– Use Mean ± S.E.M, median 95% confidence intervals, maximum-
minimum range? You choose, but must give reason.
• Estimations of your CV and synaptic delay, stating what values
you used and why.
• Other observations?

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 Discussion (40 marks)
• EMG shape
– Why is that shape? See p31 Nerve & Muscle Keynes & Aidley hyperlink
• Graphs of stimulus-response relationships for EMG amplitude, AUC and
latency from wrist
– Discuss relationships in terms of underlying neurophysiology
• Estimations of your CV and NMJ delay
– How do they compare with published values? hyperlink
– What types of nerves are you characterizing?
– How do they compare with class results? See slide15
– What is the influence of the slow muscle fibre CV on NMJ delay?
• Critique of experimental methods
– Strengths and limitations of experimental protocol
– Sources of error
– Improvements
– Accuracy & Reliability
• References used

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 Class results

Unpaired t-test no significant difference (p>0.05)

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