title: Diaphragm needle placement techniques evaluated in cadaveric specimens.
abstract: OBJECTIVE
  To evaluate the safest and most accurate method of diaphragm needle placement for electromyography.
  
  
  METHODS
  Single blinded study.
  
  
  METHODS
  University anatomy laboratory.
  
  
  METHODS
  Five cadavers.
  
  
  METHODS
  Needle placement in the diaphragm by an American Board of Electrodiagnostic Medicine physician, blinded dissection by a doctoral candidate anatomist.
  
  
  METHODS
  Accurate needle placement in the diaphragm, proximity or penetration of organs, vessels, or nerves, defined as cautions (proximity) and dangers (penetration).
  
  
  RESULTS
  The anterior axillary approach was most accurate at the above-the-seventh and eighth-rib locations. The risk of dangers of needle placement in the diaphragm was greater on the right than left side.
  
  
  CONCLUSIONS
  Needle placement in the diaphragm is safe and most accurate at the anterior axillary line superior to the eighth rib. If the side of needle placement does not matter for the study being done, the left side should be chosen because it leads to a lower risk of danger to the patient.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Michigan Hospital, Ann Arbor, 48108, USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: Chiodo
authors.forename: Craig
authors.initials: C
authors.lastname: Goodmurphy
authors.forename: Andrew
authors.initials: A
authors.lastname: Haig
mesh_terms: D002102:Cadaver; D016009:Chi-Square Distribution; D003964:Diaphragm / Q000033:anatomy & histology*; D004576:Electromyography / Q000295:instrumentation*; D006801:Humans; D009339:Needles