Myotomes

From WikiMSK

Revision as of 10:54, 15 August 2020 by Jeremy (talk | contribs)

This article is still missing information.

Commonly Tested Movements

Commonly tested movements. UMN column are movements that are preferentially weak in UMN lesions[1]
Movement UMN Root Reflex Nerve Muscle
Upper Limb
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
Lower Limb
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

Complete Myotome Chart

Complete Myotome Chart
Muscle Myotome
Upper Limb [2]
Supraspinatus C5, C6
Infraspinatus C5, C6
Deltoid C5, C6
Pect major C5, C6, C7, C8
Lat dorsi C6, C7, C8
Biceps C5, C6
Triceps C6, C7, C8
Wrist extensors (radial) C6, C7
EDC C7, C8, T1
EPL C7, C8, T1
FCR C6, C7
FCU C7, C8, T1
FDP radial digits C8, T1
FDP ulnar digits C7, C8, T1
FDS C8, T1
FPL C7, C8, T1
Thenar C8, T1
Interossei C7, C8, T1
Lower Limb [1]
Iliopsoas L1, L2, L3
Quadriceps femoris L2, L3, L4
Adductor longus and magnus L2, L3, L4
Gluteus medius, minimis, tensor fascia lata L4, L5, S1
Gluteus maximus L5, S1, S2
Semitendinosus L5, S1, S2
Biceps femoris L5, S1, S2
Semimembranosus L5, S1, S2
Gastrocnemius and soleus S1, S2
Tibialis posterior L4, L5
Flexor digitorum longus L5, S1, S2
Abductor hallucis, abductor digiti minimi, interossei S1, S2
Tibialis anterior L4, L5
Extensor digitorum longus L5, S1
Extensor hallucis longus L5, S1
Extensor digitorum brevis L5, S1
Peroneus longus L5, S1
Peroneus brevis L5, S1

Myotome Dance

  • C1, 2 โ€“ I nod to you โ€“ Neck flexion/extension
  • C3 โ€“ Donโ€™t tickle me โ€“ Neck lateral flexion
  • C4 โ€“ Iโ€™m 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)

References

  1. โ†‘ 1.0 1.1 Brain. Aids to the Examination of the Peripheral Nervous System, 4th edition. 2000
  2. โ†‘ Bell et al.. Refinement of myotome values in the upper limb: Evidence from brachial plexus injuries. The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland 2017. 15:1-6. PMID: 26409623. DOI.