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Pain in the forearm 06

Topic: Adult

Created on Saturday, April 18 2009 by jdmiles

Last modified on Saturday, April 18 2009.

A 25 year-old woman presents complaining of pain and tingling in her right arm. The pain is in her wrist, forearm, and elbow. The tingling is in her thumb and index finger. She says it's been going on for about 4 weeks, and getting worse. It frequently wakes her up at night. When it does, she shakes it out, and after a few minutes it feels better. She is diabetic, has hypothyroidism, and is 9 months pregnant. She works as a cashier.
You perform a nerve conduction study (NCS) in her right upper extremity. You place ring electrodes on her index finger, and plan to stimulate the median nerve. What distance should you use between your stimulating electrode and the recording electrode?

A) 20 cm

B) 13 cm

C) 5 cm

D) The distance is irrelevant

E) 17 cm

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This question was created on April 18, 2009 by jdmiles.
This question was last modified on April 18, 2009.

ANSWERS AND EXPLANATIONS

A) 20 cm

This answer is incorrect.

In a sensory nerve conduction study of the median nerve in an adult, recording from the index finger, the recommended distance between the stimulating electrode and the recording electrode is 13 cm. Different distances may be used depending on the reference values used in a particular lab. Using distances other than those used for the lab's reference values will yield misleading peak latency values. (See References)

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B) 13 cm

This answer is correct.

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C) 5 cm

This answer is incorrect.

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D) The distance is irrelevant

This answer is incorrect.

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E) 17 cm

This answer is incorrect.

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References:

1. Preston, D.C., and Shapiro, B.E. (2005). Electromyography and Neuromuscular Disorders: Clinical-Electrophysiologic Correlations, 2nd Edition. Elsevier, Philadelphia. (ISBN:075067492X)

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adult
Pain in the forearm 06
Question ID: 041809080
Question written by J. Douglas Miles, (C) 2006-2009, all rights reserved.
Created: 04/18/2009
Modified: 04/18/2009
Estimated Permutations: 120