Msk Myotomes Flashcards
5 types of nerve pain
Nociceptive - localised Somatic - referred Radicular - nerve root compression Myelopathic - central cord compression Peripheral - common at interfaces (cross bony point)
How to test nerves if suspected issue(3)
Sensory testing of dermatome, myotome
MRI scan
Nerve conduction tests
Describe myotomes and what indicates an issue
Myotomes are the muscles innovated by specific areas of the spinal cord nerve roots
Painless weakness indicates a nerve issue
C4 myotome innovates:
Accessory nerve. Upper traps and lev scap. Shoulder elevation
C5-6 myotome innovates: (a)
Axillary nerve. Deltoid and supraspinatus. Abduction
C5-6 myotome innovates (msc)
Musculocutaneous nerve.
Biceps brachii and brachialis.
Elbow flexion
C6-8 myotome innovates:
Radial nerve
Triceps brachii
Elbow extension
C7-8 myotome innovates
Posterior interosseous nerve
Extensor pollicis longus
Thumb extension
C7-8 t1 myotome innovates
Anterior interosseous nerve & ulnar nerve
Flexor digitorum profundus
Finger tip flexion
C8- t1 myotome innovates
Ulnar nerve
Interossei and lumbricals
Finger ab and adduction
L2-3 myotome innovates
Femoral nerve
Iliopsoas
Hip flexion
L3-4 myotome innovates
Femoral nerve
Quadriceps
Knee extension
L4-5 myotome innovates
Deep femoral nerve
Tibialis anterior
Dorsiflexion
L4-5 s1 myotome innovates
Deep femoral nerve
Extensor hallucis longus
Big toe extension
L5- s1 myotome innovates
Common peroneal nerve
Peroneus longus and brevis
Eversion
L5, S1-2 myotome innovates
Tibial nerve
Gastrocnemius and soleus
Plantarflexion
L5-S1 myotome innovates
Sciatic nerve
Hamstrings
Knee flexion
What are the 3 upper motor neurone tests to check brain and spinal cord
Babinski - run sharp edge of reflex hammer across base of foot to test plantar reflex. Abnormal if toes splay and extend
Clonus - rapid dorsiflexion. Abnormal if foot vibrates
Hoffman’s - flick middle finger. Abnormal if fingers/ thumb splay
What does hyporeflexia indicate
Peripheral nerve issue
What does hyperreflexia indicate
Issues with upper motor neurones (brain and spinal cord)
Lower limb tension tests - SLR
Aim to stretch nerve and see if their pain is replicated
Use the straight leg raise to test sciatic
Knee extension, hip flexion and hip medial rotation
Lower limb: how to adapt SLR for each nerve (sciatic, common peroneal, sural, tibial)
Sciatic: Straight leg raise with knee ext, hip flex and med rot
Common peroneal: invert and plantarflex
Sural nerve: dorsiflexion and inversion
Tibial nerve: dorsiflex and evert
Also- add neck flexion to add strain
Types of tension test LL (3)
Straight leg raise - sciatic
Slump test - sciatic
Prone knee bend - test femoral
Upper limb nerve tension tests
Median nerve : serve a plate (sh ab, elb ex, wrist ex)
Radial nerve : slip a tenner (sh ex, elb ex, pronate, wrist ex)
Ulnar nerve : spiderman (sh ab and lat rot, elb flex, wrist ex)
And and remove neck side flexion
