Spinal

nerves 31
pairs,
emerging at
each
vertebral
level

Cervical Plexus

Brachial Plexus

Lumbarsacral
plexus

MYOTOMES &
DERMATOMES

Myotomes
Each muscle in the
body is supplied by a
particular level or
segment of the spinal
cord and by its
corresponding spinal
nerve.

Dermatomes
~Greek for"skin
cutting"
~An area of the
skin supplied by
specific nerve fibers.
Sensory

Dermatomes and Myotomes

Dermatome-

sensory region of skin

innervated by a nerve root
Myotome- muscles innervated by a single
nerve root

Common Dermatomal Levels

C5-

Shoulder

C6-

Lateral Arm and Digits 1&2

C7-

Middle Digit

C8-

Digits 4 & 5

Common Dermatomal Levels

L4- Anteromedial

Shin

L5- Anterolateral

Shin, dorsum of foot to

big toe

Common Dermatomal Levels

S1-

toe, lateral foot, sole and calf

ASIA, 2006

Neurologic Level C5

The muscles found

within this myotomal
pattern are the
deltoid and the
biceps brachii.
Because the latter is
also innervated by
C6, the deltoid is the
most "pure" C5
muscle.
One of the most
commonly used tests
for shoulder
abduction is to
instruct the patient
to flex the elbow at
90 degrees, then
offer gradual

Neurologic Level C6

the biceps brachii is

innervated by C5
and C6. C6 also
innervates the most
powerful wrist
extensors, carpi
radialis longus and
brevis, which do
radial extension. To
test for wrist
extension, stabilize
the patients forearm
and wrist extension

Neurologic Level C7

The muscles found

within this myotomal
pattern are the triceps,
wrist flexors. The triceps
muscle primarily does
elbow extension. A
common test for this
action is to ask the
patient to fully flex the
arm, offer firm, constant
resistance until
discerning the
maximum resistance
h/she can overcome.

Neurologic Level C8:

The muscles found

within this myotomal
pattern are finger
flexorsflexor
digitorum
superficialis, flexor
digitorum profundis,
and the lumbricals.
To test for finger
flexion, the patient
fully flexes h/her
fingers at all joints
while you curl your
fingers into them.
Ask the patient to
resist your attempt
to pull h/her fingers
out of flexion.

Neurologic level T1:

The muscles found
within this myotomal
pattern are those
involved in finger
abductiondorsal
interossei and abductor
digiti minimi, and
adductionpalmar
interossei.
To test for finger
adduction, ask the
patient to extend h/her
fingers and hold a piece
of paper (or a dollar bill)
between two of h/her
fingers. Then you pull it
out

Neurologic Levels T12 to L3:

The muscles found
within this myotomal
pattern are the
iliopsoas,
quadriceps, and the
adductors Because
this myotomal
pattern includes
multiple muscle
groups an injury to
this nerve root level
can be more easily
evaluated by sensory
testing of the
dermatomal
patterns.

Neurologic Level L4:

The muscle
predominantly
innervated at this
root nerve level is
the tibialis anterior,
which does
dorsiflexion.
Instruct the patient
to dorsiflex and
invert h/her foot.
With your free hand,
hold the patients
foot and ask h/her to
resist your attempt

Neurologic Level L5:

The muscles
found within this
myotome are the
extensor hallucis
longus (big toe
extensor) &
extensor
digitorum (heel
walk)

Neurologic Level S1:

The muscles
found within this
myotome are the
peroneus longus
(eversion) &
peroneus brevis
(eversion)