Neurological assessments Flashcards
What is meant by dermatome
Each spinal nerve carries the sensory innervation for a part of the body surface
How should dermatomes be tested
One limb at a time
Both sides should be compared
Normal to test with light touch
What is dermatome testing
Usually part of spinal assessments
Tests the integrity of the sensory nerve root of the PNS
How are dermatomes influenced by pathologies
Spinal nerve roots can be compressed at the intervertebral foramen due to osteophytes at the facet joints or intervertebral disc prolapse
What are the locations of nerves L2/L3/L4/L5/S1/S2 (Lower limb)
L2 - superior, middle and lateral aspect of anterior thigh
L3 - medial thigh and femoral epicondyle
L4 - medial malleolus, medial calf
L5 - dorsum of the foot at the third metatarsophalangeal joint
S1 - lateral aspect of the calcaneus and little toe
S2 - midpoint of popliteal fossa
What are the locations of the nerves C4/C5/C6/C7/C8/T1 (upper limb)
C4 - over the acromioclavicular joint
C5 - lateral aspect of the lower edge of the deltoid muscle
C6 - palmar side of the thumb
C7 - palmar side of the middle finger
C8 - palmar side of the little finger
T1 - medial aspect of the antecubital fossa, proximal to the medial epicondyle of the humerus
What is a myotome
A group of skeletal muscles innervated by a particular spinal nerve
What is myotome testing
Tests the integrity of the specific motor nerve root and not the strength of the specific muscle
Should be done in conjunction with other neurological tests such as dermatomes and reflexes
What happens as a result of lesions of the PNS and how are they clarified
Paralysis/weakness of muscles
Clarified by myotomal testing, strength testing, and checking muscle tone
How are myotomes tested
Muscle group should be put in mid-range position and patient should hold position against force
Force must be appropriate
Pain can influence patient ability
Which muscles relate to the nerves C4/C5/C6/C7/C8/ (upper limb)
C4 - upper fibres of trapezius
C5 - deltoid
C6 - biceps
C7 - triceps
C8 - extensor pollicis longus
Which actions relate to the nerves C4/C5/C6/C7/C8/T1 (upper limb)
C4 - shoulder elevation
C5 - shoulder abduction
C6 - elbow flexion
C7 - elbow extension
C8 - finger flexion
T1 - finger adduction
Which muscles relate to the nerves L2/L3/L4/L5/S1 (lower limb)
L2 - iliopsoas
L3 - quads
L4 - quadratus femoris
L5 - tibialis anterior
S1 - hamstrings and soleus
Which actions relate to the nerves L2/L3/L4/L5/S1 (lower limb)
L2 - hip flexion
L3 - extension
L4 - ankle dorsiflexion, inversion
L5 - dorsiflexion
S1 - plantarflexion
