Archive | Upper Extremity

Radial Motor NCS Setup – above spiral groove

Setup – Radial Motor NCS

Electrode placement (use the bar electrode)

Stimulate 4-5cm proximal to E1

  • E1 (black):  Extensor indicis proprius (EIP) muscle (about 2-3 finger widths proximal to the ulnar styloid process on dorsal forearm)
  • E2 (red):  Distally along the distal forearm
  • Ground:  Dorsum of forearm (between stimulation and pickup sites)

Stimulation sites

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Ulnar Motor NCS Setup – above elbow

Setup – Ulnar Motor NCS

Electrode placement (use the bar electrode)

8-cm distance (black to black)

  • E1 (black):  Abductor digiti minimi (ADM) muscle (medial side of the hypothenar eminence)
  • E2 (red):  Distally along the little finger
  • Ground:  Dorsum of hand

Stimulation sites

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Median Motor NCS Setup – Proximal

Setup – Median Motor NCS

Electrode placement (use the bar electrode)

8-cm distance (black to black)

  • E1 (black):  Abductor pollicis brevis (APB) muscle (laterally on the thenar eminence)
  • E2 (red):  Distally along the thumb
  • Ground:  Dorsum of hand

Stimulation site

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P8 Ulnar Sensory NCS Setup

Setup – P8 Median-Ulnar Sensory NCS

Electrode placement (use the BAR electrode)

8-cm distance (black to black)

  • Two sites
    • Median nerve site
      • E1 (black):  Along the middle of the forearm (in line with the median nerve)
      • E2 (red):  3-4cm proximal to E1.
    • Ulnar nerve site
      • E1 (black):  Along the medial forearm (in line with the ulnar nerve)
      • E2 (red):  3-4cm proximal to E1.
  • Ground:  Dorsum of hand (for both)

Stimulation site

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Split Ring Ulnar Sensory NCS Setup

Setup – Split Ring Median-Ulnar Sensory NCS

Electrode placement (use the ring electrodes)

14-cm distance (black to black)

  • E1 (black):  Around the proximal interphalangeal (PIP) joint of the ring finger
  • E2 (red):  3-4cm distally from E1.
  • Ground:  Dorsum of hand

Stimulation site

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Numb Thumb Median Sensory NCS Setup

Setup – Numb Thumb Median-Radial Sensory NCS

Electrode placement (use the ring electrodes)

10-cm distance (black to black)

  • E1 (black):  Base of thumb
  • E2 (red):  3-4cm distally from E1.
  • Ground:  Dorsum of hand

Stimulation site

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Median Nerve Sensory NCS Setup

Setup – Median Sensory NCS

Electrode placement (use the ring electrodes)

14-cm distance (black to black)

  • E1 (black):  Proximal phalanx of the index finger — want to keep away from the metacarpophalangeal (MCP) joint skin, as this may pick up motor conduction artifact.
  • E2 (red):  3-4cm distally from E1.
  • Ground:  Dorsum of hand

Stimulation site

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Ulnar Nerve Sensory NCS Setup

Setup – Ulnar Sensory NCS

Electrode placement (use the ring electrodes)

14-cm distance (black to black)

  • E1 (black):  Proximal interphalangeal joint (PIP) of the little finger — want to keep away from the metacarpophalangeal (MCP) joint skin, as this will likely pick up motor artifact from the abductor digiti minimi (ADM).
  • E2 (red):  3-4cm distally from E1.  Usually almost hanging off the distal phalanx.
  • GroundDorsum of hand

Stimulation site

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