Dermatomes, Myotomes and More. Oh MY!

Dermatomes

Why? To test for sensory pathway of nerves, while looking for symmetry

C1/C2 : Back of head towards the front, running along the lateral side of head

C3 : Above the clavicle

C4 : Below the clavicle

C5 : Lateral side of upper arm ( Shoulder to elbow)

C6 : Entire thumb

C7 : Dorsal and ventral side of middle finger

C8 : Medial side of hand

T1 : Medial elbow


L1 : PSIS to ASIS

L2 : Glute medius to inguinal region

L3 : Greater Trochanter to anterior portion of thigh

L4 : Medial patella to medial lower leg ( before malleolus)

L5 : Anterior lower leg crossing over to big toe

S1 : Lateral side of foot towards heel


Myotomes

Why? To test muscle recruitment in common nerve paths

C1/C2 : Neck flexion

C3 : Side bend of neck

C4 : Shoulder elevation

C5 : Shoulder abduction

C6 : Wrist extension plus elbow flexion

C7 : Wrist flexion plus elbow extension

C8 : Finger flexion

T1 : Finger extension


L2 : Hip flexion

L3 : Knee extension

L4 : Dorsiflexion

L5 : Big toe extension

S1 : Eversion

S2/S3 : Knee flexion


Deep Tendon Reflexes

Why? To challenge the nervous system and reflexes.

C5-C6 : Biceps reflex

C6 : Brachioradialis reflex

C7 : Triceps reflex

L4 : Patellar reflex

S1 : Achilles reflex


Peripheral Motor Tests

Axillary Nerve : Resist forward flexion of shoulder

Radial Nerve : Resist wrist extension

Musculocutaneous Nerve : Resist elbow flexion

Ulnar Nerve : Put pinky to base of thumb, creating a loop. Try to break the loop

Median Nerve : Resist thumb flexion


General ULTT

1 . Side bend neck away from side

2. Depress shoulder

3. Abduct arm 20 degree and external rotation of shoulder

4 . Extend wrist and fingers


Centralized Pain

Entrapped at spinal column (herniated disk)

– Pain travelling towards spinal cord

– Conditions may be improving

Peripheralize Pain

Muscle compresses nerve along pain

– Pain travelling farther from spine

– Condition may be worsening