Nerve Root Testing Flashcards
What are the testing?
- Deep tendon reflexes
- Myotomes
- Dermatomes
What is an indication of the state of the nerve or nerve roots supplying the reflex?
Deep tendon reflexes
What is the process for deep tendon reflex?
- examiner puts the tendon on slight stretch and drops the reflex hammer onto the tendon
- clients must be relaxed
- note the client response and grade from 0-4
Upper Deep Tendon Reflexes :
Mandible
CNV
Upper Deep Tendon Reflexes :
Biceps Brachii
C5-6
Upper Deep Tendon Reflexes :
Brachioradialis
C5-6
Upper Deep Tendon Reflexes :
Triceps
C7-8
Lower Deep Tendon Reflexes :
Patellar Tendon
L3-4
Lower Deep Tendon Reflexes :
Medial Hamstring
L5, S1
Lower Deep Tendon Reflexes :
Tibialis Posterior
L4-5
Lower Deep Tendon Reflexes :
Achilles or lateral hamstring
S1-2
What are groups of muscles supplied by a single nerve root?
- tested via isometric contraction
- held for at least 5 seconds
- each myotome has a specific movement correlated with it
- note the strength of contraction on a scale of 0-5
Myotomes
Upper Myotomes : C1/C2
Neck Flexion
Upper Myotomes : C3
Neck lateral flexion
Upper Myotomes : C4
Shoulder elevation
Upper Myotomes : C5
Shoulder abduction
Upper Myotomes : C6
Elbow Flexion
Upper Myotomes : C7
Elbow extension
Upper Myotomes : C8
Wrist ulnar deviation
Upper Myotomes : T1
Finger Abduction
Lower Myotomes : L2
Hip Flexion
Lower Myotomes : L3
Knee Extension
Lower Myotomes : L4
Ankle dorsiflexion
Lower Myotomes : L5
1st toe dorsiflexion/extension
Lower Myotomes : S1
Ankle Eversion/Plantarflexion
What is area of skin supplied by a single nerve root
- examiner runs relaxed hands relatively firmly over the skin to be tested bilaterally
- client’s eyes are closed, as with all sensory testing
- “Any difference in sensation”
Dermatomes
Dermatomes : Upper
C2-T2
Dermatomes : Lower
L1-S1