Concentric needle EMG was introduced in 1929 by Adrian and Bronk1 and is the traditional method of assessing EMG. The needle, which resembles a hypodermic needle, is inserted into the external anal sphincter while the patient is placed in the left lateral decubitus position. The needle can be advanced either into the EAS or deeper into the puborectalis muscle under the guidance of a finger inserted into the anal canal.
The uptake area of the electrode is quite small and includes only a few motor units; therefore, it is important to measure the activity in various locations in the muscle. The electrical activity is usually monitored during rest, squeezing, and simulated evacuation (pushing).
Figure 11.1. Normal surface elec-tromyogram (EMG). The resting activity is normal and the activity is increased at STFiAiNiNi coughing and squeezing, but not at straining.
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