The invention relates to apparatus and methods for stimulating living tissues to determine nerve conduction properties using a pair of stimulator probes and a plurality of detection electrodes. The invention overcomes the problem of reporting potentially inaccurate nerve conduction results by detecting a stimulator probe short or shunt condition during nerve conduction tests. Detection of a short or shunt condition between two stimulator probes is accomplished by monitoring the magnitude of the stimulus artifact waveform acquired from the detection electrodes and the voltage difference between the stimulator probes. A test is flagged when magnitude of the stimulus artifact waveform is below a first threshold and voltage difference between the two stimulator probes is below a second threshold. The first and second threshold values are determined based on the known spatial relationship between the stimulator probes and detection electrodes. Feedback is provided to the tester to alert defective test conditions.

Systems and methods for controlled sympathectomy procedures for neuromodulation are disclosed. A system for controlled micro ablation procedures is disclosed. A guidewire including one or more sensors or electrodes for accessing and recording physiologic information from one or more anatomical sites within the parenchyma of an organ as part of a physiologic monitoring session, a diagnostic test, or a neuromodulation procedure is disclosed. A guidewire including one or more sensors and/or a means for energy delivery, for performing a neuromodulation procedure within a small vessel within a body is disclosed.

A hearing implant fitting system includes a physiological database containing physiological data characterizing auditory neural tissue response to electrical stimulation. A neural action potential (NAP) measurement system measures NAP signals from cochlear tissue responding to electrical stimulation signals delivered by one or more of the electrode contacts, including: deriving a compound discharge latency distribution (CDLD) of the cochlear tissue by deconvolving: (1) a tissue response measurement signal taken responsive to the delivered electrical stimulation signals, with (2) an elementary unit response signal representing voltage change at a measurement electrode contact due to the electrical stimulation, and then comparing the CDLD to physiological data from the physiological database to detect an NAP signal from the tissue response measurement signal. A fitting display provides to the fitting audiologist a visual display representing the CDLD and the NAP signal for fitting the electrode array to an implanted patient.

A nerve integrity monitoring device includes a control module and a physical layer module. The control module is configured to generate a payload request. The payload request (i) requests a data payload from a sensor in a wireless nerve integrity monitoring network, and (ii) indicates whether a stimulation probe device is to generate a stimulation pulse. The physical layer module is configured to (i) wirelessly transmit the payload request to the sensor and the stimulation probe device, or (ii) transmit the payload request to a console interface module. The physical layer module is also configured to, in response to the payload request, (i) receive the data payload from the sensor, and (ii) receive stimulation pulse information from the stimulation probe device. The data payload includes data corresponding to an evoked response of a patient. The evoked response is generated based on the stimulation pulse.

A device, system and method for vibration sensitivity assessment are provided. The device has an attachment portion configured to detachably connect the device to a programmable vibration source and a probe configured to be applied to a test location on a test subject's skin and to convey vibrations generated by the programmable vibration source to the test location. The programmable vibration source may for example be a mobile telephone. A low-cost and widely usable device for vibration sensitivity assessment is thus provided.

Manifestation of some physiological responses (e.g., stress, mental workload, or a headache) may involve the emergence of asymmetric thermal patterns on the face. Thus, thermal measurements of the face that are indicative of thermal asymmetry can be useful to detect such physiological responses. In one embodiment, a system includes first and second inward-facing head-mounted thermal cameras (CAM1 and CAM2, respectively) that are located less than 15 cm from the user's face, which take thermal measurements of regions on the right and left sides of the face (TH.sub.ROI1 and TH.sub.ROI2, respectively) of the user. The symmetric overlapping between the regions on the right and left sides (ROI.sub.1 and ROI.sub.2, respectively) is above 60%, and CAM1 and CAM2 do not occlude ROI.sub.1 and ROI.sub.2. Optionally, the system includes a computer that detects a physiological response based on thermal asymmetry between TH.sub.ROI1 and TH.sub.ROI2.

A medical image processing apparatus according to an embodiment includes processing circuitry configured to: extract position information of innervation from subject data; convert a subject nerve region that is based on the extracted position information into atlas data; analyze a position relation between a functional area in a brain in the atlas data and the converted subject nerve region; and convert the analysis result into the subject data.

A stimulation electrode assembly configured to be positioned relative to a patient for an operative procedure is disclosed. The stimulation electrode may be a connection or self-contained component to contact a portion of a nerve. The stimulation electrode may provide or receive a signal to and/or from the nerve to assist in testing integrity of the nerve.

Devices and methods for surgical retraction are described herein, e.g., for retracting nerve tissue, blood vessels, or other obstacles to create an unobstructed, safe surgical area. In some embodiments, a surgical access device can include an outer tube that defines a working channel through which a surgical procedure can be performed. A shield, blade, arm, or other structure can be manipulated with respect to the outer tube to retract an obstacle. For example, an inner blade can protrude from a distal end of the outer tube to retract obstacles disposed distal to the outer tube. The inner blade can be movable between a radially-inward position and a radially-outward position. The radially-inward position can allow insertion of the blade to the depth of the obstacle to position the obstacle adjacent to and radially-outward from the blade. Subsequent movement of the blade to the radially-outward position can retract the obstacle in a radially-outward direction. The blade can be manipulated remotely, e.g., from a proximal end of the access device or a location disposed outside of the patient. The blade can be manipulated in various ways, such as by rotating the blade relative to the outer tube, translating the blade longitudinally relative to the outer tube, sliding an expander along the blade, driving a wedge between the blade and the outer tube, actuating a cam mechanism of the access device, and/or pivoting the blade relative to the outer tube.

Connectors for connecting or linking one instrument or object to one or more other instruments or objects are disclosed herein. In some embodiments, a connector can include a first arm with a first attachment feature for attaching to a first object, such as a surgical access device, and a second arm with a second attachment feature for attaching to a second object, such as a support. The connector can have an unlocked state, in which the position and orientation of the access device can be adjusted relative to the support, and a locked state in which movement of the access device relative to the support is prevented or limited. Locking the connector can also be effective to clamp or otherwise attach the connector to the access device and the support, or said attachment can be independent of the locking of the connector.