Neurological testing (myotomes)

Question 1

What is a myotome?

Answer 1

This is a muscle or group of muscles supplied by a single spinal nerve.

Question 2

Positive Test

Answer 2

Less powerful force from muscles -> discrepancy in strength on one of the sides. The brain isn’t receiving the same information from both sides.

Question 3

Negative test

Answer 3

The force should feel the same on both sides -> there is no discrepancy in strength on either side

Question 4

L2 (hip flexion)

Answer 4

> Supine with hip and knee flexed to 90˚

- Support LL with one hand, place other on ant. aspect of thigh and apply progressive resistance.

Question 5

L3 (knee extension)

Answer 5

> Supine with hip and knee flexed at 90˚

- Support thigh with one hand, place other hand on ant. aspect of lower tibia and apply progressive resistance.

Question 6

L4 (foot dorsiflexion and inversion)

Answer 6

> Supine with knees and feet relaxed
- Passively dorsiflex and invert foot. Stabilise lower tib with one hand and place other hand over anteromedial aspect of the foot. Apply progressive resistance

Question 7

L5 (Great toe extension)

Answer 7

> Supine with knees and feet relaxed

- Passively extend great toe then apple progressive resistance to extension on dorsum of distal phalanx

Question 8

S1 (foot extension)

Answer 8

> Supine with knees and feet relaxed
- Passively evert foot. Stabilise lower tib with one hand, and place other hand over lateral aspect of foot.
Apply progressive resistance to eversion

Question 9

S2 (ankle plantarflexion)

Answer 9

> Standing on one leg with high plinth for balance

- Ask model to raise up onto their toes a few times