Pelvic EMG

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. Basic Information Specialist classification: neurological examination classification: neuroelectrophysiology Applicable gender: whether men and women apply fasting: not fasting Tips: Pay attention to the normal diet, pay attention to normal work and rest, and prevent endocrine disorders. Normal value Defecation is smooth, and the defecation time is not too long and will not be more difficult. Clinical significance Abnormal results: 1. Puborectal muscle syndrome: Slowly exacerbate the difficulty of defecation, excessive exertion of feces, and excessive defecation time, each time for 1 to 2 hours, the fecal mass is small, frequent and defecation incomplete. Some patients have pain in the anus or sputum during defecation, and the spirit is often tense. 2. Incontinence caused by external anal sphincter lesions, the main and common causes of fecal incontinence are 1 neurological disease, cerebrovascular accident, cerebral arteriosclerosis, brain trauma, spinal cord injury, spinal cord injury, spina bifida, etc.; 2 knot, rectal disease congenital Megacolon, ulcerative colitis, rectal prolapse, rectal prolapse, anorectal malformation, etc.; 3 direct rectal rectal injury, of 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 check: Patients with difficulty in defecation, excessive exertion of feces, excessive faecal discharge, and other symptoms of puborectal muscle disease, or symptoms of anal external sphincter lesions such as fecal incontinence. Precautions Forbidden before examination: pay attention to normal diet, pay attention to normal work and rest, and prevent endocrine disorders. Requirements for inspection: Actively cooperate with the doctor's request. Inspection process method: Take the left lateral position. Exposing the buttocks reveals a gluteal groove, disinfects the skin, and spreads the sterile sheet. 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: temporarily unknown.