Podcast
Questions and Answers
Which nerve root is tested by having the patient perform cervical flexion?
Which nerve root is tested by having the patient perform cervical flexion?
- C5
- C1-C2 (correct)
- C3
- C4
Shoulder abduction is a test for which myotome?
Shoulder abduction is a test for which myotome?
- C6
- C7
- C5 (correct)
- C4
Which of the following movements tests the C8 myotome?
Which of the following movements tests the C8 myotome?
- Wrist extension
- Elbow flexion
- Finger abduction/adduction
- Thumb extension and ulnar deviation (correct)
If a patient has difficulty with elbow extension and wrist flexion, which nerve root is likely affected?
If a patient has difficulty with elbow extension and wrist flexion, which nerve root is likely affected?
Which myotome is tested by having the patient perform finger abduction/adduction?
Which myotome is tested by having the patient perform finger abduction/adduction?
Cervical lateral flexion tests the C______ myotome
Cervical lateral flexion tests the C______ myotome
Shoulder elevation tests the C______ myotome
Shoulder elevation tests the C______ myotome
Elbow flexion and wrist extension test the C______ myotome
Elbow flexion and wrist extension test the C______ myotome
Elbow extension and wrist flexion test the C______ myotome
Elbow extension and wrist flexion test the C______ myotome
Thumb extension and ulnar deviation test the T______ myotome
Thumb extension and ulnar deviation test the T______ myotome
Which myotome is tested by having the patient perform finger abduction/adduction and thumb extension?
Which myotome is tested by having the patient perform finger abduction/adduction and thumb extension?
If a patient has difficulty with shoulder elevation and shoulder abduction, which nerve roots are likely affected?
If a patient has difficulty with shoulder elevation and shoulder abduction, which nerve roots are likely affected?
Which of the following pairs of actions tests the same myotome?
Which of the following pairs of actions tests the same myotome?
If a patient has difficulty with cervical lateral flexion and shoulder elevation, which nerve roots are not affected?
If a patient has difficulty with cervical lateral flexion and shoulder elevation, which nerve roots are not affected?
Which of the following actions does not test an upper limb myotome?
Which of the following actions does not test an upper limb myotome?
Elbow flexion and wrist extension are tests for the C6 myotome.
Elbow flexion and wrist extension are tests for the C6 myotome.
Shoulder abduction is a test for the C5 myotome.
Shoulder abduction is a test for the C5 myotome.
Thumb extension and ulnar deviation are tests for the T1 myotome.
Thumb extension and ulnar deviation are tests for the T1 myotome.
Shoulder elevation tests the C3 myotome.
Shoulder elevation tests the C3 myotome.
Cervical lateral flexion is a test for the C6 myotome.
Cervical lateral flexion is a test for the C6 myotome.
Which nerve root is tested by having the patient perform ankle dorsiflexion?
Which nerve root is tested by having the patient perform ankle dorsiflexion?
Which of the following actions tests the S1 myotome?
Which of the following actions tests the S1 myotome?
Which nerve root is responsible for $great toe extension$?
Which nerve root is responsible for $great toe extension$?
Which of the following actions tests the L3 myotome?
Which of the following actions tests the L3 myotome?
Which nerve root is responsible for knee flexion?
Which nerve root is responsible for knee flexion?
Lower Limb L2 _______
Lower Limb L2 _______
Lower Limb L3 _______
Lower Limb L3 _______
Lower Limb L4 _______
Lower Limb L4 _______
Lower Limb L5 Great Toe _______
Lower Limb L5 Great Toe _______
Lower Limb S1 Ankle _______
Lower Limb S1 Ankle _______
Ankle dorsiflexion tests the L5 myotome.
Ankle dorsiflexion tests the L5 myotome.
Hip extension tests the L3 myotome.
Hip extension tests the L3 myotome.
Knee extension tests the L2 myotome.
Knee extension tests the L2 myotome.
Ankle plantarflexion and ankle eversion test the S2 myotome.
Ankle plantarflexion and ankle eversion test the S2 myotome.
Great toe extension tests the L4 myotome.
Great toe extension tests the L4 myotome.
What is the main purpose of performing a myotome test?
What is the main purpose of performing a myotome test?
Why does the candidate inform the patient where they will be placing their hands during a myotome test?
Why does the candidate inform the patient where they will be placing their hands during a myotome test?
Which action is expected from the patient during a myotome test?
Which action is expected from the patient during a myotome test?
Why does the candidate conduct myotome testing bilaterally?
Why does the candidate conduct myotome testing bilaterally?
What information is NOT typically conveyed by the candidate before a myotome test?
What information is NOT typically conveyed by the candidate before a myotome test?
In a myotome test, if a patient has difficulty with finger abduction/adduction and thumb extension, which nerve root is likely affected?
In a myotome test, if a patient has difficulty with finger abduction/adduction and thumb extension, which nerve root is likely affected?
The candidate begins by stating that they will perform a myotome test and identifies which ______ they will be testing.
The candidate begins by stating that they will perform a myotome test and identifies which ______ they will be testing.
The candidate identifies the purpose of performing the myotome test and explains that it is to determine whether there is any ______ along a specific nerve root by testing the strength of the group of muscles the specified nerve root innervates.
The candidate identifies the purpose of performing the myotome test and explains that it is to determine whether there is any ______ along a specific nerve root by testing the strength of the group of muscles the specified nerve root innervates.
The candidate begins by explaining the general procedure of a myotome test to the patient. The position of the patient is determined by the nerve root being assessed. The candidate should inform and show the patient how they will test the ______.
The candidate begins by explaining the general procedure of a myotome test to the patient. The position of the patient is determined by the nerve root being assessed. The candidate should inform and show the patient how they will test the ______.
The candidate should inform the patient what action they are expected to perform and that the action will be resisted for FIVE (5) seconds. The candidate should tell the patient where they will be placing their hands to resist the action of the myotome being tested. The candidate should state that they will test the myotome ______ (and simultaneously when possible) to compare the level of muscle innervation between the two sides.
The candidate should inform the patient what action they are expected to perform and that the action will be resisted for FIVE (5) seconds. The candidate should tell the patient where they will be placing their hands to resist the action of the myotome being tested. The candidate should state that they will test the myotome ______ (and simultaneously when possible) to compare the level of muscle innervation between the two sides.
If a patient has difficulty with elbow extension and wrist flexion, which nerve root is likely affected? ______
If a patient has difficulty with elbow extension and wrist flexion, which nerve root is likely affected? ______
In a myotome test, if a patient has difficulty with finger abduction/adduction and thumb extension, which nerve root is likely affected? ______
In a myotome test, if a patient has difficulty with finger abduction/adduction and thumb extension, which nerve root is likely affected? ______
In myotome testing, the candidate should always inform the patient where they will be placing their hands to resist the action being tested.
In myotome testing, the candidate should always inform the patient where they will be placing their hands to resist the action being tested.
Shoulder elevation is a test for the C5 myotome.
Shoulder elevation is a test for the C5 myotome.
Elbow flexion and wrist extension are tests for the C8 myotome.
Elbow flexion and wrist extension are tests for the C8 myotome.
$Knee$ $extension$ tests the L3 myotome.
$Knee$ $extension$ tests the L3 myotome.
Cervical lateral flexion tests the C6 myotome.
Cervical lateral flexion tests the C6 myotome.
Ankle plantarflexion and ankle eversion test the S1 myotome.
Ankle plantarflexion and ankle eversion test the S1 myotome.
What should the candidate do during the stabilization step of a myotome test?
What should the candidate do during the stabilization step of a myotome test?
Why is it important for myotome tests to be performed bilaterally?
Why is it important for myotome tests to be performed bilaterally?
Which action is typically resisted by the candidate in a myotome test?
Which action is typically resisted by the candidate in a myotome test?
What is the purpose of providing a countdown during a myotome test?
What is the purpose of providing a countdown during a myotome test?
In a myotome test, what should the candidate check for during the 'Check In' step?
In a myotome test, what should the candidate check for during the 'Check In' step?
In a myotome test, the candidate should perform the stabilization step after the patient has started the action.
In a myotome test, the candidate should perform the stabilization step after the patient has started the action.
Great toe extension tests the L5 myotome.
Great toe extension tests the L5 myotome.
For a myotome test, the patient must be seated or standing to perform optimally.
For a myotome test, the patient must be seated or standing to perform optimally.
Elbow flexion and wrist extension are tests for the C9 myotome.
Elbow flexion and wrist extension are tests for the C9 myotome.
Shoulder abduction is a test for the C7 myotome.
Shoulder abduction is a test for the C7 myotome.
During a myotome test, the candidate should inquire about any discomfort, pain, or pressure during the stabilization step.
During a myotome test, the candidate should inquire about any discomfort, pain, or pressure during the stabilization step.
Which grade range indicates a positive result for a myotome test?
Which grade range indicates a positive result for a myotome test?
What does a grade of 5 indicate during a myotome test?
What does a grade of 5 indicate during a myotome test?
When providing the clinical impression from a myotome test, what should the candidate NOT identify?
When providing the clinical impression from a myotome test, what should the candidate NOT identify?
If a patient scores a grade of 2 on a myotome test, what should the candidate's clinical impression be?
If a patient scores a grade of 2 on a myotome test, what should the candidate's clinical impression be?
What is the main purpose of performing a myotome test?
What is the main purpose of performing a myotome test?
In a myotome test, a positive result would be a grade of __ or less.
In a myotome test, a positive result would be a grade of __ or less.
In a myotome test, a negative result would be a grade of __ or __.
In a myotome test, a negative result would be a grade of __ or __.
The candidate should identify the grade assigned to the patient's tested myotome and what the assigned grade indicates. The grade range for a positive result is __ or less.
The candidate should identify the grade assigned to the patient's tested myotome and what the assigned grade indicates. The grade range for a positive result is __ or less.
In a myotome test, if a patient has difficulty with finger abduction/adduction and thumb extension, which nerve root is likely affected? ______
In a myotome test, if a patient has difficulty with finger abduction/adduction and thumb extension, which nerve root is likely affected? ______
If a patient scores a grade of 2 on a myotome test, what should the candidate's clinical impression be? The candidate should state whether the patient was __ or __.
If a patient scores a grade of 2 on a myotome test, what should the candidate's clinical impression be? The candidate should state whether the patient was __ or __.
During a myotome test, a positive result would be a grade of 4 or 5.
During a myotome test, a positive result would be a grade of 4 or 5.
In a myotome test, a grade of 0 indicates total paralysis.
In a myotome test, a grade of 0 indicates total paralysis.
A positive test result in myotome testing could indicate a muscle strain.
A positive test result in myotome testing could indicate a muscle strain.
A grade of 3 in myotome testing signifies active movement against gravity and with resistance.
A grade of 3 in myotome testing signifies active movement against gravity and with resistance.
Thumb extension and ulnar deviation are tests for the T2 myotome.
Thumb extension and ulnar deviation are tests for the T2 myotome.
Great toe extension tests the L3 myotome.
Great toe extension tests the L3 myotome.
A grade of 4 on a myotome test indicates total paralysis.
A grade of 4 on a myotome test indicates total paralysis.
A positive result for a myotome test would be a grade of 3 or less.
A positive result for a myotome test would be a grade of 3 or less.
Elbow flexion and wrist extension test the C5 myotome.
Elbow flexion and wrist extension test the C5 myotome.
Great toe extension tests the L3 myotome.
Great toe extension tests the L3 myotome.
Ankle plantarflexion and ankle eversion test the S3 myotome.
Ankle plantarflexion and ankle eversion test the S3 myotome.
Shoulder elevation tests the C4 myotome.
Shoulder elevation tests the C4 myotome.
What is the purpose of performing a myotome test?
What is the purpose of performing a myotome test?
During a C5 myotome test, what action should the candidate ask the patient to perform?
During a C5 myotome test, what action should the candidate ask the patient to perform?
What should the candidate inform the patient during the 'Check In' step of a myotome test?
What should the candidate inform the patient during the 'Check In' step of a myotome test?
What does a grade of 2 in myotome testing indicate?
What does a grade of 2 in myotome testing indicate?
Which nerve root is likely affected if a patient has difficulty with elbow extension and wrist flexion?
Which nerve root is likely affected if a patient has difficulty with elbow extension and wrist flexion?
What action should the patient perform during a C6 myotome test?
What action should the patient perform during a C6 myotome test?
For a myotome test, the patient must be _______ or standing to perform optimally.
For a myotome test, the patient must be _______ or standing to perform optimally.
The candidate begins by explaining the general procedure of a myotome test to the patient. The position of the patient is determined by the nerve root being assessed. The candidate should inform and show the patient how they will test the _______.
The candidate begins by explaining the general procedure of a myotome test to the patient. The position of the patient is determined by the nerve root being assessed. The candidate should inform and show the patient how they will test the _______.
If a patient has difficulty with cervical lateral flexion and shoulder elevation, which nerve roots are not affected?
If a patient has difficulty with cervical lateral flexion and shoulder elevation, which nerve roots are not affected?
If a patient has difficulty with elbow extension and wrist flexion, which nerve root is likely affected?
If a patient has difficulty with elbow extension and wrist flexion, which nerve root is likely affected?
Why does the candidate inform the patient where they will be placing their hands during a myotome test?
Why does the candidate inform the patient where they will be placing their hands during a myotome test?
Which myotome is tested by having the patient perform finger abduction/adduction and thumb extension?
Which myotome is tested by having the patient perform finger abduction/adduction and thumb extension?
During a C5 myotome test, the candidate should resist the patient from raising their arms.
During a C5 myotome test, the candidate should resist the patient from raising their arms.
A grade of 4 on a myotome test signifies total paralysis.
A grade of 4 on a myotome test signifies total paralysis.
The purpose of performing a myotome test is to identify muscle weakness due to nerve root lesions only.
The purpose of performing a myotome test is to identify muscle weakness due to nerve root lesions only.
Ankle plantarflexion and ankle eversion are tests for the S3 myotome.
Ankle plantarflexion and ankle eversion are tests for the S3 myotome.
Great toe extension tests the L4 myotome.
Great toe extension tests the L4 myotome.
Shoulder abduction is a test for the C3 myotome.
Shoulder abduction is a test for the C3 myotome.
Study Notes
Myotome Testing
- Myotomes are specific muscle groups that share a common nerve root, allowing that group of muscles to perform their actions.
Upper Limb Myotomes
- C1-C2: Cervical Flexion
- C3: Cervical Lateral Flexion
- C4: Shoulder Elevation
- C5: Shoulder Abduction
- C6: Elbow Flexion, Wrist Extension
- C7: Elbow Extension, Wrist Flexion
- C8: Thumb Extension, Ulnar Deviation
- T1: Finger Abduction/Adduction
Lower Limb Myotomes
- L2: Hip Flexion
- L3: Knee Extension
- L4: Ankle Dorsiflexion
- L5: Great Toe Extension
- S1: Ankle Plantarflexion, Ankle Eversion, Hip Extension
- S2: Knee Flexion
Performing a Myotome Test
- Step 1: Position the patient according to the nerve root being tested
- Step 2: Stabilize the limb before performing the myotome test
- Step 3: Perform the myotome test, providing a countdown from 5
- Step 4: Check in with the patient, inquiring about discomfort, pain, or pressure
Bilateral Assessment
- Myotome tests should be performed bilaterally, simultaneously when possible
- Ensure patient safety during bilateral testing
Findings/Clinical Impression
- Identify the grade assigned to the patient's tested myotome
- Identify the grade range and what the assigned grade indicates
- Positive Result: Grade 3 or less, indicative of nerve root lesion, compression by herniated disc, or muscle strain
- Negative Result: Grade 4 or 5
- Myotome Grading Scale:
- Grade 0: Total paralysis
- Grade 1: Palpable or visible contraction with no movement against resistance
- Grade 2: Active movement only when resistance and gravity are removed
- Grade 3: Active movement against gravity, but without resistance
- Grade 4: Active movement against gravity with some resistance
- Grade 5: Active movement against gravity and full resistance
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Description
Test your knowledge on the specific muscle groups in the upper limb that are innervated by different nerve roots. Learn about the actions performed by each myotome in the upper limb.
