Dermatomes and Myotomes and Deep Tendon Reflex

Question 1

What is a Neuro screen?

Answer 1

-A series of test used to evaluate if the neurological system is involved
-will look differently depending on what setting and patient population you will be working with
-part of the examination

Question 2

What is a Dermatome?

Answer 2

The area of skin supplied by a SINGLE nerve root

Question 3

What is a Myotome?

Answer 3

A muscle group of muscles served by a single nerve root , graded like MMT’s (Gross motions only)

Question 4

What is a sclerotome?

Answer 4

Are of a bone or fascia supplied by a single nerve root

Question 5

What is a Deep Tedon Reflex?

Answer 5

(DTR) a brisk contraction of muscle in response to a sudden stretch induced by a sharp tap on the tendon at the insertion of the muscle

Question 6

DERMATOME Grading

Answer 6

0=absent
1=Diminished
2=Normal
NT=Not tested

Question 7

DERMATOME
C1

Answer 7

C1= Superior / Anterior Cranium

Question 8

DERMATOME
C2

Answer 8

C2= Posterior Cranium

Question 9

DERMATOME
C3

Answer 9

C3= Lateral upper-mid cervical spine

Question 10

DERMATOME
C4

Answer 10

C4= Superior and Lateral Shoulder

Question 11

DERMATOME
C5

Answer 11

C5=Lateral Arm

Question 12

DERMATOME
C6

Answer 12

C6=Lateral Thumb

Question 13

DERMATOME
C7

Answer 13

C7=Dorsal Midline of hand

Question 14

DERMATOME
C8

Answer 14

C8=Ulnar forearm/hand

Question 15

DERMATOME

DERMATOME
T1

Answer 15

T1=Medial Elbow

Question 16

DERMATOME , Sensory testing

Answer 16

-Pain= (Sharp/dull)
-Temperature= Hot/cold w/ test tube
-Light Touch- a camel hair brush
-Vibration- Tuning fork and earphones if available
-Stereognosis- Object recognition, Great for those with CVA accident
-Two-Point Discrimination= (GOLD STANDARD)
-Recognition of Texture

Question 17

MYOTOMES

Answer 17

-A muscle or group of muscles served by a signle nerve root
-Graded the same as MMT
-0-5 Scale
-Myotomes test gross motions not specific individual muscles
-Hold for 10 seconds and test bilaterally (if applicable)

Question 18

MYOTOMES
C1-2

Answer 18

Mvmnt= Neck Flexion
Muscles= Anterior superficial/deep neck muscles

Question 19

MYOTOMES
C3

Answer 19

Mvmnt: Neck Side Flexion
Muscles: Longus capitis cervicis, trapezius (upper fibers) , annd scalenus medius

Question 20

MYOTOMES
C4

Answer 20

Mvmnt: Shoulder elevation or scapular elevation
Muscles: Trapezius (upper fibers) or levator scapulae

Question 21

MYOTOMES
C5

Answer 21

Mvmnt: Shoulder Abduction or External Rotation
Muscles: Deltoid, Supraspinatus, Infraspinatus

Question 22

MYOTOMES
C6

Answer 22

Mvmnt: Elbow Flexion or wrist extension
Muscles: Biceps, Brachialis, wrist extensors

Question 23

MYOTOMES
C7

Answer 23

Mvmnt: Elbow extension or wrist flexion
Muscles: Triceps or wrist flexors

Question 24

MYOTOMES
C8

Answer 24

Mvmnt: Thumb Extension or ulnar deviation
Muscles: EPL, EPB, Ulnar Deviators

Question 25

MYOTOMES T1

Answer 25

Mvmnt: Hand Intrinsics Muscles: Adductors or abductors of the digits

Question 26

Deep Tendon Reflex (DTR)

Answer 26

A brisk contraction of a muscle in response to a suddenn stretch induced by a sharp tap on the tendon at insertion of the muscle

Question 27

When to perfrom DTR?

Answer 27

-Perform if PT suspects a neurological involvment AFTER sensory or motor testing -Used to check the integrity of the nerve or nerve root supplyinng the reflex, tests spinal reflex -With loss/abnormality of nerve conduction, there is a reduction (HYPOREFLEXIA) or loss (AREFLEXIA) of the stretch reflex -Exercise just before testing or pateint anxiety, tenseness, may lead to accentuated reflexes Testing = use the flat end of the hammer initially Located at the correct tendon use a sharp and quick tap from wrist if you cannot feel it or see a reflex relax your patient, have them look away and distract them, TRY AGAIN

Question 28

Deep Tendon Reflex Grading

Answer 28

Grade 0-4 -Grade 0= No response, always abnormal -Grade 1=Slight but defintiely present response, may or may not be normal -Grade 2= A brisk response, normal -Grade 3= A VERY brisk response may or may not be normal -Grade 4= Hypertonic, a tap elicits a repeating refelx (clonus) always abnormal

Question 29

DTR, Hyporeflexia

Answer 29

An absent or diminished respone to DTR

Question 30

DTR, Hyperreflexia

Answer 30

the hyperactive or repeating (clonic) response to DTR

Question 31

DTR Biceps

Answer 31

C5/C6 musculocutaneous nerve Normal response= biceps contraction (PT takes top of thumb on bicep tendon and elicits taps that way)

Question 32

DTR Brachioradialis

Answer 32

C6 Radial Nerve Normal Response= flexion of the elbow and or pronation of the forearm (PT find tendon on the radial styloid process and taps)

Question 33

DTR Triceps

Answer 33

C7/C8 Radial Nerve Normal Response = Elbow extension and muscle contraction (PT holds pt arm in theirs in a hook form and palpate tendon nnear olecranon of ulna and elicits tap that way, better to stand posteriorly)