US5215100A
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US
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Nerve condition monitoring system and electrode supporting structure
Assignee: HEALTHSOUTH OCCUPATIONAL AND PREVENTIVE DIAGNOSTICS LP
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Filing: 1991-04-29
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Granted: 1993-06-01
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Expires: 2011-04-29
Abstract
Abstract A portable system for substantially automated monitoring of nerve conduction velocity through the carpal tunnel of a patient includes an electrode supporting structure which supports stimulating and pickup electrodes in a predetermined spatial relationship so as to contact the patient's arm and hand. The electrode supporting structure is a part of a housing which contains stimulating signal generating and response signal processing circuitry, which operates substantially automatically under control of a microprocessor. The microprocessor controls generation of stimulating pulses and determines the elapsed time until the occurrence of a predetermined response signal characteristic, such as its peak. Data relating to nerve conduction time or velocity measurements and response signal waveform are stored in a removable memory to permit later analysis and treatment recommendation by a physician. The system is useful for screening large groups of people at remote locations, such as workers at an employer's facilities, for evaluating their median nerve condition and likelihood of developing carpal tunnel syndrome.
Inventors
- 👤 Lawrence K. Spitz
- 👤 Scott Jaeger
- 👤 Scott N. Musser
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-24 05:26
CPC Classifications
A; A61; A61B; A61B5/00; A61B5/05; A61B5/40; A61B5/4029; A61B5/4041
Claims Analysis
Total Claims: 57
Claim 1
Independent Claim
185 words
Patient nerve condition monitoring apparatus comprising: a pair of stimulating electrodes adapted to apply an electrical stimulating signal to a patient; a pair of pickup electrodes adapted to receive a response electrical signal from the patient induced by a stimulating signal; and an electrode supporting structure supporting said stimulating electrodes in a location adapted to contact a portion of said patient's arm adjacent the median nerve and supporting said pickup electrodes in a location adapted to contact a portion of the patient's hand adjacent the median nerve when said stimulating electrodes are in contact with the patient's arm, so that application of an electrical stimulating signal by said stimulating electrodes to the patient's arm induces a sensory nerve conduction signal in the patient which is propagated along a median nerve conduction path extending from a location in the patient's arm adjacent said stimulating electrodes to a location in the patient's hand adjacent said pickup electrodes to produce a detectable sensory nerve response electrical signal at said pickup electrodes, and the length of the nerve conduction path is substantially permanently fixed by said electrode supporting structure.
Claim 2
Dependent Claim
185 words
Patient nerve condition monitoring apparatus comprising: a pair of stimulating electrodes adapted to apply an electrical stimulating signal to a patient; a pair of pickup electrodes adapted to receive a response electrical signal from the patient induced by a stimulating signal; and an electrode supporting structure supporting said stimulating electrodes in a location adapted to contact a portion of said patient's arm adjacent the median nerve and supporting said pickup electrodes in a location adapted to contact a portion of the patient's hand adjacent the median nerve when said stimulating electrodes are in contact with the patient's arm, so that application of an electrical stimulating signal by said stimulating electrodes to the patient's arm induces a sensory nerve conduction signal in the patient which is propagated along a median nerve conduction path extending from a location in the patient's arm adjacent said stimulating electrodes to a location in the patient's hand adjacent said pickup electrodes to produce a detectable sensory nerve response electrical signal at said pickup electrodes, and the length of the nerve conduction path is substantially permanently fixed by said electrode supporting structure.
Claim 3
Dependent Claim
31 words
Apparatus according to claim 1, wherein said electrode supporting structure includes surfaces which are shaped to locate the patient's arm and hand with respect to said stimulating and pickup electrodes respectively.
Claim 4
Dependent Claim
32 words
Apparatus according to claim 2, wherein said electrode supporting structure includes a curved surface adapted to generally conform to a human forearm, and said stimulating electrodes are mounted to said curved surface.
Claim 5
Dependent Claim
81 words
Apparatus according to claim 1, wherein said electrode supporting structure includes a first surface adapted to receive a human forearm in contact with it and a second surface adjacent said first surface and adapted to receive a human hand in contact with it, said first surface being disposed at an angle between 90° and 180° with respect to said second surface so that movement of a patient's forearm and hand when in contact with said first and second surfaces is inhibited.
Claim 6
Dependent Claim
35 words
Apparatus according to claim 1, further comprising a stimulating signal generator coupled to said stimulating electrodes and a response signal processor coupled to said pickup electrodes for processing response signals received by said pickup electrodes.
Claim 7
Dependent Claim
24 words
Apparatus according to claim 5, wherein said electrode supporting structure comprises a housing containing said stimulating signal generator and said response signal processor circuit.
Claim 8
Dependent Claim
20 words
Apparatus according to claim 1, wherein at least some of said electrodes are resiliently mounted to said electrode supporting structure.
Claim 9
Dependent Claim
31 words
Apparatus according to claim 1, further including a temperature sensor supported by said electrode supporting structure and adapted to contact said patient when said patient is in contact with said electrodes.
Claim 10
Dependent Claim
127 words
Patient nerve condition monitoring apparatus for monitoring nerve conduction through the carpal tunnel of a patient comprising: a pair of stimulating electrodes adapted to be coupled to a patient's arm; a stimulating signal generator coupled to said stimulating electrodes; a pair of pickup electrodes having a permanent predetermined spatial relationship to said stimulating electrodes, said pickup electrodes being adapted to be coupled to the patient's hand so as to receive response signals generated in response to application of a stimulating signal to the patient's arm; and a response signal processor coupled to said pickup electrodes, said processor including means for determining the elapsed time between the application of a stimulating signal to said stimulating electrodes and the receipt of a predetermined response signal by said pickup electrodes.
Claim 11
Dependent Claim
127 words
Patient nerve condition monitoring apparatus for monitoring nerve conduction through the carpal tunnel of a patient comprising: a pair of stimulating electrodes adapted to be coupled to a patient's arm; a stimulating signal generator coupled to said stimulating electrodes; a pair of pickup electrodes having a permanent predetermined spatial relationship to said stimulating electrodes, said pickup electrodes being adapted to be coupled to the patient's hand so as to receive response signals generated in response to application of a stimulating signal to the patient's arm; and a response signal processor coupled to said pickup electrodes, said processor including means for determining the elapsed time between the application of a stimulating signal to said stimulating electrodes and the receipt of a predetermined response signal by said pickup electrodes.
Claim 12
Dependent Claim
70 words
Apparatus according to claim 9, wherein said processor includes a CPU, a memory coupled to said CPU for storing data and for storing operating programs to be executed by said CPU, and an analog-to-digital converter having at least one input for receiving analog signals and an output coupled to said CPU, said converter producing at its output digital signals which are related to analog signals received at said converter input.
Claim 13
Dependent Claim
30 words
Apparatus according to claim 10, wherein said stimulating signal generator includes a control input coupled to said CPU, and said CPU controls the generation of stimulating signals by said generator.
Claim 14
Dependent Claim
17 words
Apparatus according to claim 10, wherein said pickup electrodes are coupled to an input of said converter.
Claim 15
Dependent Claim
24 words
Apparatus according to claim 12, further comprising an amplifier having inputs coupled to said pickup electrodes and an output coupled to a converter input.
Claim 16
Dependent Claim
12 words
Apparatus according to claim 13, wherein said amplifier is a bandpass amplifier.
Claim 17
Dependent Claim
24 words
Apparatus according to claim 13, further including means for inhibiting the response of said amplifier to signals which are unrelated to nerve conduction signals.
Claim 18
Dependent Claim
37 words
Apparatus according to claim 15, wherein said amplifier response inhibiting means includes means for inhibiting the response of said amplifier to input signals occurring at predetermined times with respect to the time of generation of stimulating signals.
Claim 19
Dependent Claim
28 words
Apparatus according to claim 16, wherein said amplifier response inhibiting means includes a switch coupled to said amplifier, said switch having a control input coupled to said CPU.
Claim 20
Dependent Claim
12 words
Apparatus according to claim 10, wherein said memory includes removable static memory.
Claim 21
Dependent Claim
23 words
Apparatus according to claim 10, wherein said predetermined response signal is the peak value of the response signal received by said pickup electrodes.
Claim 22
Dependent Claim
24 words
Apparatus according to claim 10 wherein said CPU stores data in said memory relating to nerve conduction through the carpal tunnel of the patient.
Claim 23
Dependent Claim
16 words
Apparatus according to claim 20, wherein said stored data includes data relating to said elapsed time.
Claim 24
Dependent Claim
31 words
Apparatus according to claim 20, wherein said stored data includes data representing the response waveform received by said pickup electrodes in response to a stimulating signal applied to said stimulating electrodes.
Claim 25
Dependent Claim
35 words
Apparatus according to claim 20, wherein said apparatus includes .a temperature sensor coupled to said patient and producing an output related to the patient's body temperature, and said stored data includes patient body temperature data.
Claim 26
Dependent Claim
19 words
Apparatus according to claim 20, wherein said CPU stores data in said memory relating to the patient being monitored.
Claim 27
Dependent Claim
23 words
Apparatus according to claim 20, wherein said CPU stores data in said memory relating to the apparatus being used in said patient monitoring.
Claim 28
Dependent Claim
27 words
Apparatus according to claim 10, wherein said processor includes one or more ports coupled to said CPU and one or more input/output devices coupled to said port(s).
Claim 29
Dependent Claim
14 words
Apparatus according to claim 26, wherein said input/output devices include a bar code reader.
Claim 30
Dependent Claim
15 words
Apparatus according to claim 26, wherein said input/output devices includes at least one alphanumeric display.
Claim 31
Dependent Claim
15 words
Apparatus according to claim 28 wherein said display displays information relating to patient nerve condition.
Claim 32
Dependent Claim
20 words
Apparatus according to claim 28, wherein said display displays information to prompt a user in proper use of the apparatus.
Claim 33
Dependent Claim
21 words
Apparatus according to claim 10, further including means for controlling the characteristics of stimulating signals produced by said stimulating signal generator.
Claim 34
Dependent Claim
14 words
Apparatus according to claim 31, wherein said signal characteristic controlling means is manually operable.
Claim 35
Dependent Claim
25 words
Apparatus according to claim 10, wherein said processor includes means for substantially automatically controlling said generation of stimulating signals and said determination of elapsed time.
Claim 36
Dependent Claim
25 words
Apparatus according to claim 33, further including a self-checking circuit for generating synthetic response signals and coupling synthetic response signals to said response signal processor.
Claim 37
Dependent Claim
23 words
Apparatus according to claim 33, wherein said control means includes means for determining the quality of contact between said patient and said electrodes.
Claim 38
Dependent Claim
27 words
Apparatus according to claim 35, wherein said contact quality determining means includes means for comparing a signal received at said pickup electrodes with a threshold signal value.
Claim 39
Dependent Claim
36 words
Apparatus according to claim 33, wherein said control means includes means for automatically and repeatedly generating stimulating electrical signals and monitoring response signals, and for terminating said generation and monitoring upon the occurrence of predetermined conditions.
Claim 40
Dependent Claim
19 words
Apparatus according to claim 37, wherein said predetermined conditions are conditions of response signals received by said pickup electrodes.
Claim 41
Dependent Claim
30 words
Apparatus according to claim 38, wherein said predetermined response signal conditions are the occurrence of a plurality of similar response signals in response to a plurality of successive stimulating signals.
Claim 42
Dependent Claim
35 words
Apparatus according to claim 39, wherein said response signals are similar in the time of occurrence of a predetermined response signal characteristic with respect to the time of the stimulating signal producing said response signal.
Claim 43
Dependent Claim
19 words
Apparatus according to claim 40, wherein said predetermined response signal characteristic is the peak amplitude of said response signal.
Claim 44
Dependent Claim
26 words
Apparatus according to claim 39, wherein said predetermined response signal conditions are the occurrence of similar response signals in response to about four successive stimulating signals.
Claim 45
Independent Claim
114 words
A method of monitoring conduction velocity of nerves passing through the carpal tunnel of a patient comprising the steps of: a. providing a pair of stimulating electrodes and a pair of pickup electrodes having a predetermined permanent spatial relationship to said stimulating electrodes; b. coupling said pickup electrodes to the hand of the patient and coupling said stimulating electrodes to the forearm of the patient; c. applying a stimulating electrical signal to said stimulating electrodes; and d. determining the elapsed time between the application of a stimulating signal to the stimulating electrodes and the occurrence of a predetermined characteristic of the response signal produced at said response electrodes in response to said stimulating signal.
Claim 46
Independent Claim
114 words
A method of monitoring conduction velocity of nerves passing through the carpal tunnel of a patient comprising the steps of: a. providing a pair of stimulating electrodes and a pair of pickup electrodes having a predetermined permanent spatial relationship to said stimulating electrodes; b. coupling said pickup electrodes to the hand of the patient and coupling said stimulating electrodes to the forearm of the patient; c. applying a stimulating electrical signal to said stimulating electrodes; and d. determining the elapsed time between the application of a stimulating signal to the stimulating electrodes and the occurrence of a predetermined characteristic of the response signal produced at said response electrodes in response to said stimulating signal.
Claim 47
Dependent Claim
34 words
A method according to claim 43, wherein said coupling step b includes bringing the arm and hand of said patient into contact with an electrode supporting structure which supports said stimulating and pickup electrodes.
Claim 48
Dependent Claim
27 words
A method according to claim 44, further comprising the step of limiting the movement of the patient's arm and hand with respect to said electrode supporting structure.
Claim 49
Dependent Claim
18 words
A method according to claim 43, further comprising the step of measuring the body temperature of said patient.
Claim 50
Dependent Claim
22 words
A method according to claim 43, further comprising the step of monitoring the quality of coupling between said patient and said electrodes.
Claim 51
Dependent Claim
23 words
A method according to claim 43, wherein steps c and d are performed automatically and repeatedly until the occurrence of a predetermined event.
Claim 52
Dependent Claim
27 words
A method according to claim 48, wherein said predetermined event is the determination of similar elapsed times in response to the application a plurality of stimulating signals.
Claim 53
Dependent Claim
20 words
A method according to claim 48, further comprising the step of storing data relating to said nerve conduction velocity monitoring.
Claim 54
Dependent Claim
20 words
A method according to claim 50, wherein said data storing step includes storage of data relating to said elapsed time.
Claim 55
Dependent Claim
15 words
A method according to claim 50, where said data storing step includes storing patient-identifying data.
Claim 56
Dependent Claim
24 words
A method according to claim 50 wherein said data storing step includes storing data relating to the circumstances under which said monitoring is performed.
Claim 57
Dependent Claim
30 words
A method according to claim 50, wherein said data storing step includes storing data representing a response signal waveform received at said response electrodes in response to said stimulating signal.
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USPTO Annuity & Maintenance Windows
| Annuity Stage | Window Opens | Payment Deadline | Surcharge Period Until | Estimated Fee | Status |
|---|---|---|---|---|---|
| 3.5 Years (Year 4) | 1996-05-31 | 1996-11-30 | 1997-06-01 | $2000.00 | Window Closed / Lapsed |
| 7.5 Years (Year 8) | 2000-05-31 | 2000-11-30 | 2001-06-01 | $3760.00 | Window Closed / Lapsed |
| 11.5 Years (Year 12) | 2004-05-31 | 2004-11-30 | 2005-06-01 | $7700.00 | Window Closed / Lapsed |