Dermatomes, Myotomes, Reflexes, ROM norms

C1

dermatome root for vortex of skull

C2

Dermatome root for temple, forehead, occiput

C3

Dermatome root for entire neck, posterior cheek, temporal area, prolongation forward under mandible

C4

dermatome root for shoulder area, clavicular area, upper scapular area

C5

dermatome root for deltoid area, anterior aspect of entire arm to base of thumb

C6

dermatome root for anterior arm, radial side of hand to thumb and index finger

C7

dermatome root for lateral arm and forearm to index, long, and ring fingers

C8

dermatome root to medial arm and forearm to long, ring, and little fingers

T1

dermatome root to medial side of forearm to base of little finger

T2

dermatome root for medial side of upper arm to medial elbow, pectoral and midscapular areas

T3-T6

dermatome root for upper thorax

T5-T7

dermatome root for costal margin

T8-T12

dermatome root for abdomen and lumbar region

L1

dermatome root for back, over trochanter and groin

L2

dermatome root for back, front of thigh to kneeL

L3

dermatome root for back, upper buttock, anterior thigh and knee, medial lower leg

L4

dermatome root for medial buttock, lateral thigh, medial leg, dorsum of foot, big toe

L5

dermatome root for buttock, posterior and lateral thigh, lateral aspect of leg, dorsum of foot, medial half of sole, first, second, and third toes

S1

dermatome root for buttock, thigh, and leg posteriorS

S2

dermatome root for buttock, thigh, and leg posterior

S3

dermatome root for groin, medial thigh to knee

S4

dermatome root for perineum, genitals, lower sacrum

C1-C2

myotome for cervical flexion

C3

myotome for cervical side flexion

C4

myotome for scapular elevation

C5

myotome for shoulder abduction

C6

myotome for elbow flexion and wrist extension

C7

myotome for elbow extension and wrist flexion

C8

myotome for thumb extension

T1

myotome for finger abduction

L1-L2

myotome for hip flexion

L3

myotome for knee extension

L4

myotome for ankle dorsiflexion

L5

myotome for big toe extension

S1

myotome for ankle eversion and plantarflexion, hip extensionS

S2

myotome for knee flexion

S3

myotome for intrinsic foot muscles (except abductor hallucis)

corneal

reflex of involuntary blinking in response to corneal stimulation

A: ophthalmic branch V1 trigeminal (CN5)

E: facial (CN7)

abdominal

reflex contraction of superficial abdominal muscles when stroking abdomen lightly, lateral to medial (T7-T12)

• looking for asymmetry (typically UMN lesion on absent side)

cremasteric

reflex for contraction of cremaster mm (pulling scrotum up) after stroking same side of superior/inner thigh

• absent w/ SCI and corticospinal lesions

plantar

reflex of PF when stroking lateral sole of foot from calcaneus to base of 5th met

• DF of great toe and fanning of smaller toes = abnormal/Babinski (corticospinal/UMN lesions)

anal

reflexive contraction of external anal sphincter upon stroking skin around anus

A: pudendal n

E: S2-S4

bulbocavernosus

reflex anal sphincter contraction in response to squeezing glans penis or tugging on an indwelling Foley, mediated by S2-S4

• 1st reflex to come after SCI (indicator that body is out of spinal shock)

0

DTR grade for no response

1+

DTR grade for slight reflex, present but depressed, low normal

2+

DTR grade for normal, typical reflex

3+

DTR grade for brisk reflex, possibly but not necessarily abnormal

4+

DTR grade for very brisk reflex, abnormal, clonus

biceps

C5-C6 DTR

brachioradialis

C5-C6 DTR

triceps

C7-C8 DTR

patellar

L2-L4 DTR

achilles tendon

S1-S3 DTR

hamstrings

L5-S2 DTR

160-180

shoulder flexion ROM

50-60

shoulder extension ROM

170-180

shoulder abduction ROM

50-75

shoulder adduction ROM

80-90

shoulder ER ROM

60-100

shoulder IR ROM

140-150

elbow flexion ROM

0-10

elbow extension ROM

90

elbow supination ROM

80-90

elbow pronation ROM

80-90

wrist flexion ROM

70-90

wrist extension ROM

15

radial deviation ROM

30-45

ulnar deviation ROM

110-120

hip flexion ROM

10-15

hip extension ROM

30-50

Hip abduction ROM

30

hip adduction ROM

30-40

hip IR ROM

40-60

hip ER ROM

0-135

knee flexion ROM

0-15

knee extension ROM

20-30

knee IR ROM

30-40

knee ER ROM

45

1st MTP flexion ROM

70

1st MTP extension ROM

40

2nd-5th MTP flexion ROM

40

2nd-5th MTP extension ROM

45-60

ankle supination ROM

15-30

ankle pronation ROM

50

PF ROM

20

DF ROM