Pelvic floor electromyography

The pelvic floor electromyography is an examination method used to determine the location and extent of the sphincter defect. The pelvic floor striated muscle is different in anatomy and physiology from the striated muscles in other parts of the body. It contains more type I fibers (tension fibers), especially the external sphincter and the puborectalis. Because of its small size, the action potential generated by its single muscle fiber and motor unit is relatively small. These muscles are always in a state of constant tension contraction, producing some electrical activity, even during sleep. During defecation, muscles are slack and electrical activity is reduced or disappeared. The pelvic floor EMG is to understand the functional status and innervation of the pelvic floor muscles by recording changes in the electrical activity of the pelvic floor muscles during rest and defecation. The pelvic floor electromyography examination uses the needle electrode, the columnar membrane electrode or the silk electrode to trace the myoelectric activity of the puborectalis and external sphincters, respectively. Used to understand the functional status and innervation of the pelvic floor muscles. The subjects were placed in the left lateral position, and the electromyographic activities of the puborectalis and external sphincters were recorded with needle electrodes, columnar membrane electrodes or silk electrodes, respectively. Basic Information Specialist classification: Digestive examination classification: neuroelectrophysiology Applicable gender: whether men and women apply fasting: not fasting Tips: Relax when you check, you should face it positively and actively cooperate with the inspection. Normal value The defecation is smooth, the defecation time is not too long, and it will not be particularly laborious. Clinical significance Abnormal results: 1, puborectal muscle syndrome: slow exacerbation of defecation difficulty, excessive defecation force, defecation time is too long, each time up to 1 to 2 hours, feces are small, frequent and defeated incomplete. Some patients have pain in the anus or sputum during defecation, and the spirit is often tense. 2, fecal incontinence caused by external anal sphincter lesions, the main and common causes of fecal incontinence are: 1 nervous system disorders: cerebrovascular accident cerebral arteriosclerosis, brain trauma, spinal cord injury, spinal cord, spina bifida. 2 knot, rectal disease: congenital megacolon, ulcerative colitis, knot, rectal cancer rectal prolapse, anorectal malformation. 3 Anorectal direct injury, in which surgical injury is a common cause. Surgery including anal fistula, anal fissure, and hernia, as well as sclerotherapy injections. In addition, there are perineal tears, accidental injuries, gunshot wounds and foreign bodies. Older people are weakened, and fecal impaction can also cause incontinence. People who need to be examined: patients with difficulty in defecation, excessive exertion of feces, excessive deficiencies, and symptoms of puborectal muscle lesions, or symptoms of anal external sphincter lesions such as fecal incontinence. Precautions Taboo before inspection: no special contraindications. Requirements for inspection: Check the feelings of relaxation, should face positively, and actively cooperate with the inspection. Insert an anus with a foreign body sensation during the examination and try to relax and check. Inspection process The subject took the left lateral position, exposed the buttocks to show gluteal groove, disinfect the skin, and spread the sterile single. The examiner puts the finger on the finger cot. After the paraffin oil is lubricated, it is gently inserted into the anus. The other hand will puncture the concentric electrode from the lower edge of the gluteal sulcus to the skin, and the needle is directed to the upper edge of the pubic symphysis. The tip of the anus is used to control the tip of the needle. Direction and position, the needle can be 1 ~ 1.5cm to the superanal external sphincter shallow layer, the needle 1.5 ~ 2.5cm to the internal sphincter, the needle 3 ~ 3.5cm can reach the puborectalis muscle. Rest for 3 minutes after the needle is inserted, and then wait until the electrical activity returns to normal before starting the examination. The pelvic floor myoelectric activity was recorded at rest, rectal anus and simulated defecation. Not suitable for the crowd Inappropriate crowd: people with anal skin mucosal damage. Adverse reactions and risks Nothing.