What is myotome assessment?

Myotome assessment is an essential part of neurological examination when suspecting radiculopathy as changes in muscle strength within a specific myotome may help you identify the pathological disc level.

What is the meaning of myotomes?

Medical Definition of myotome 1 : the portion of an embryonic somite from which skeletal musculature is produced. — called also muscle plate. 2 : an instrument for myotomy.

What is the nature of myotomes?

In summary, a myotome is a group of muscles innervated by a single spinal nerve. This innervation allows the muscles to perform a variety of motions, such as flexion (angle decrease), extension(angle increase), abduction (movement away from the midline) and adduction (movement toward the midline).

Why do we assess myotomes?

Purpose. Testing of myotomes, in the form of isometric resisted muscle testing, gives information about the level in the spine where a lesion may be present. During myotome testing, you are looking for muscle weakness of a particular group of muscles.

What is a dermatome assessment?

Testing of dermatomes is part of the neurological examination. They are primarily used to determine whether the sensory loss on a limb corresponds to a single spinal segment, implying the lesion is of that nerve root (i.e., radiculopathy), and to assign the neurologic “level” to a spinal cord lesion.

How do you score Myotomes?

Myotomes are tested in terms of power, and graded 1-5: 1 = palpable or visible contraction. 2 = active movement, full range of motion (ROM) with gravity eliminated. 3 = active movement, full ROM against gravity. 4 = active movement, full ROM against gravity and moderate resistance in a muscle specific position.

How do you assess upper extremity tone?

Muscle tone is assessed by putting selected muscle groups through passive range of motion. The most commonly used maneuvers for the upper extremities are flexion and extension at the elbow and wrist.

What are the upper extremity reflexes?

The biceps, triceps and supinator reflexes are the major motor reflexes of the upper limb. The strength of the reflex, elicited by tapping on the appropriate tendon, can aid in localising a patient’s weakness to the upper motor neuron or lower motor neuron.

How is myotome testing of the upper extremity done?

Myotome testing of the upper extremity is done with the patient in sitting position. As with pretty much any assessment, compare your findings on both sides. With the patient in sitting position, ask the patient to abduct the arms to approximately 90° and then apply downward pressure to the arms.

What is a myotome map?

A myotome is the group of muscles on one side of the body that are enervated by one spinal nerve root. Doctors use their knowledge of the location of myotomes (and dermatomes) during the physical exam. To identify the specific spinal nerve(s) that may underlie muscle weakness, they perform isometric strength tests according to the myotome map.

How are myotomes and spinal nerves assessed?

These myotomes and spinal nerves are assessed through resisted exercises where a healthcare provider will provide resistance against a patient’s movement. If weakness is noted, or the motion is not similar on both sides, then it can indicate a spinal problem.

What are the movements for cervical and thoracic myotome testing?

Movements for cervical and thoracic myotome testing C1-C2 Flexion of the neck C3 and CN XI Lateral flexion of the neck C4 and CN XI Elevation of the shoulder C5 Abduction, lateral rotation, and flexion C5-C6 Flexion of the arm at the shoulder joint