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Myotomes
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Commonly Tested Movements
Movement | UMN | Root | Reflex | Nerve | Muscle |
---|---|---|---|---|---|
Shoulder abduction | ++ | C5 | Axillary | Deltoid | |
Elbow flexion | C5/6 C6 |
+ + |
Musculocutaneous Radial |
Biceps Brachioradialis | |
Elbow extension | + | C7 | + | Radial | Triceps |
Radial wrist extension | + | C6 | Radial | Extensor carpi radialis longus | |
Finger extension | + | C7 | Posterior interosseous nerve | Extensor digitorum communis | |
Finger flexion | C8 |
+ |
Anterior interosseous nerve Ulnar |
Flexor pollicis longus and flexor digitorum profundus (index) Flexor digitorum profundus (ring and little) | |
Finger abduction | ++ |
T1 T1 |
Ulnar Median |
First dorsal interosseous Abductor pollicis brevis | |
Hip flexion | ++ | L1/2 | Iliopsoas | ||
Hip adduction | L2/3 | + | Obturator | Adductors | |
Hip extension | L5/S1 | Sciatic | Gluteus Maximus | ||
Knee flexion | + | S1 | Sciatic | Hamstrings | |
Knee extension | L3/4 | + | Femoral | Quadriceps | |
Ankle dorsiflexion | ++ | L4 | Deep peroneal | Tibialis anterior | |
Ankle eversion | L5/S1 | Superficial peroneal | Peronei | ||
Ankle plantarflexion | S1/S2 | + | Tibial | Gastrocnemius, soleus | |
Big toe extension | L5 | Deep peroneal | Extensor hallucis longus |
Myotome Dance
- C1, 2 โ I nod to you โ Neck flexion/extension
- C3 โ Donโt tickle me โ Neck lateral flexion
- C4 โ Iโm not sure โ Shoulder elevation
- C5 โ Feel alive โ Shoulder flexion, abduction, & lateral rotation
- C6, 7, 8 โ Close the gate โ Shoulder extension, adduction & medial rotation
- C5, 6 โ Pick up sticks โ Elbow flexion
- C7, 8 โ Lay them straight โ Elbow extension
- C5, 6 โ Flick my wrists โ Forearm supination
- C7, 8 โ The time is late โ Forearm pronation
- C6, 7 โ Fly up to heaven โ Wrist flexion & extension
- C7 โ Paper โ Finger extension
- C8 โ Rock โ Finger flexion (though some sources say C7, 8 does both finger extension and flexion)
- T1 โ Scissors โ Finger abduction & adduction
- (T1-12 โ Supplies chest wall and abdominal muscles)
- (L1 โ Contributes to hip flexion & adduction)
Kicking a ball:
- L2, 3 โ Lift my knee โ Hip flexion
- L3, 4 โ Kick the door โ Knee extension (& knee-jerk reaction)
- L4, 5 โ Foot points to the sky โ Ankle dorsiflexion
Bringing foot back to the floor:
- L4, 5 โ Extend my thigh โ Hip extension
- L5, S1, (S2) โ Kick my bum (Run to poo) โ Knee flexion
- S1, 2 โ Stand on my shoes โ Ankle plantarflexion (& ankle jerk)
- (Babinski plantar reflex/extensor response in UMN lesion is L5, S1, S2)
- L2, 3, 4 โ Modestly close the door โ Hip adduction & internal/medial rotation
- L4 - S2 โ The opposite is true โ Hip abduction & external/lateral rotation
- C3, 4, 5 - Keeps the diaphragm alive โ Innervates the diaphragm
- S2, 3, 4 โ Keeps poo off the floor โ Innervates bowel, bladder, sex organs, anal sphincter, pelvic muscles. (& anal wink reflex)
- โ Brain. Aids to the Examination of the Peripheral Nervous System, 4th edition. 2000