Where should an electrode be placed to record the compound action potential (AP) of the MN intra-operatively?

Recording the compound action potential (CAP) of the median nerve is an important aspect of intraoperative monitoring and is typically conducted using electrodes placed at specific anatomical sites. Placement of the electrode at the antecubital fossa is appropriate for capturing the activity of the median nerve as it is located in close proximity to the nerve's pathway, allowing for accurate recording of the electrical signals generated by the nerve during stimulation.

The antecubital fossa is where the median nerve runs, providing a more direct measure of nerve conduction, as it is well-positioned to detect the ensemble of electrical activity produced by all the motor axons of the median nerve as they travel to the forearm and hand. The compound action potential reflects the summation of action potentials from multiple myelinated fibers in the nerve, making this location optimal for obtaining clear and reliable results during monitoring.

Other options, while they may seem reasonable, do not provide the same level of efficacy for recording the compound action potential of the median nerve. For instance, recording at the wrist would capture the resultant action potentials from the median nerve but would be further from the nerve's origin and could incorporate additional factors that obscure the data. Similarly, electrode placement over the cervical spine would not specifically target the median nerve