104 Questions
Which nerve root is tested by having the patient perform cervical flexion?
C1-C2
Shoulder abduction is a test for which myotome?
C5
Which of the following movements tests the C8 myotome?
Thumb extension and ulnar deviation
If a patient has difficulty with elbow extension and wrist flexion, which nerve root is likely affected?
C7
Which myotome is tested by having the patient perform finger abduction/adduction?
T1
Cervical lateral flexion tests the C______ myotome
3
Shoulder elevation tests the C______ myotome
4
Elbow flexion and wrist extension test the C______ myotome
6
Elbow extension and wrist flexion test the C______ myotome
7
Thumb extension and ulnar deviation test the T______ myotome
1
Which myotome is tested by having the patient perform finger abduction/adduction and thumb extension?
C8
If a patient has difficulty with shoulder elevation and shoulder abduction, which nerve roots are likely affected?
C4 and C5
Which of the following pairs of actions tests the same myotome?
Elbow flexion and wrist extension
If a patient has difficulty with cervical lateral flexion and shoulder elevation, which nerve roots are not affected?
C5
Which of the following actions does not test an upper limb myotome?
Hip flexion
Elbow flexion and wrist extension are tests for the C6 myotome.
True
Shoulder abduction is a test for the C5 myotome.
False
Thumb extension and ulnar deviation are tests for the T1 myotome.
False
Shoulder elevation tests the C3 myotome.
True
Cervical lateral flexion is a test for the C6 myotome.
False
Which nerve root is tested by having the patient perform ankle dorsiflexion?
L4
Which of the following actions tests the S1 myotome?
Ankle plantarflexion, ankle eversion, hip extension
Which nerve root is responsible for $great toe extension$?
L5
Which of the following actions tests the L3 myotome?
Knee extension
Which nerve root is responsible for knee flexion?
S2
Lower Limb L2 _______
Hip Flexion
Lower Limb L3 _______
Knee Extension
Lower Limb L4 _______
Ankle Dorsiflexion
Lower Limb L5 Great Toe _______
Extension
Lower Limb S1 Ankle _______
Plantarflexion
Ankle dorsiflexion tests the L5 myotome.
True
Hip extension tests the L3 myotome.
False
Knee extension tests the L2 myotome.
False
Ankle plantarflexion and ankle eversion test the S2 myotome.
True
Great toe extension tests the L4 myotome.
True
What is the main purpose of performing a myotome test?
To evaluate muscle strength related to a specific nerve root
Why does the candidate inform the patient where they will be placing their hands during a myotome test?
To indicate where resistance will be applied during the test
Which action is expected from the patient during a myotome test?
Resisting for a specific duration
Why does the candidate conduct myotome testing bilaterally?
To compare muscle innervation between the sides
What information is NOT typically conveyed by the candidate before a myotome test?
An overview of nerve anatomy
In a myotome test, if a patient has difficulty with finger abduction/adduction and thumb extension, which nerve root is likely affected?
$C7$
The candidate begins by stating that they will perform a myotome test and identifies which ______ they will be testing.
myotome
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.
radiculopathy
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 ______.
myotome
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.
bilaterally
If a patient has difficulty with elbow extension and wrist flexion, which nerve root is likely affected? ______
C7
In a myotome test, if a patient has difficulty with finger abduction/adduction and thumb extension, which nerve root is likely affected? ______
T1
In myotome testing, the candidate should always inform the patient where they will be placing their hands to resist the action being tested.
True
Shoulder elevation is a test for the C5 myotome.
False
Elbow flexion and wrist extension are tests for the C8 myotome.
False
$Knee$ $extension$ tests the L3 myotome.
False
Cervical lateral flexion tests the C6 myotome.
True
Ankle plantarflexion and ankle eversion test the S1 myotome.
False
What should the candidate do during the stabilization step of a myotome test?
Resist the action of the myotome being tested
Why is it important for myotome tests to be performed bilaterally?
To compare muscle strength on both sides
Which action is typically resisted by the candidate in a myotome test?
Patient's extension
What is the purpose of providing a countdown during a myotome test?
To inform the patient when to stop contracting
In a myotome test, what should the candidate check for during the 'Check In' step?
Any discomfort or pain experienced by the patient
In a myotome test, the candidate should perform the stabilization step after the patient has started the action.
False
Great toe extension tests the L5 myotome.
True
For a myotome test, the patient must be seated or standing to perform optimally.
False
Elbow flexion and wrist extension are tests for the C9 myotome.
False
Shoulder abduction is a test for the C7 myotome.
False
During a myotome test, the candidate should inquire about any discomfort, pain, or pressure during the stabilization step.
False
Which grade range indicates a positive result for a myotome test?
Grade 3 or less
What does a grade of 5 indicate during a myotome test?
Normal muscle strength
When providing the clinical impression from a myotome test, what should the candidate NOT identify?
The specific exercise performed during the test
If a patient scores a grade of 2 on a myotome test, what should the candidate's clinical impression be?
Positive result, indicating moderate muscle weakness
What is the main purpose of performing a myotome test?
To assess the level of muscle innervation along a specific nerve root
In a myotome test, a positive result would be a grade of __ or less.
3
In a myotome test, a negative result would be a grade of __ or __.
4 or 5
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.
3
In a myotome test, if a patient has difficulty with finger abduction/adduction and thumb extension, which nerve root is likely affected? ______
C8
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 __.
positive or negative
During a myotome test, a positive result would be a grade of 4 or 5.
False
In a myotome test, a grade of 0 indicates total paralysis.
True
A positive test result in myotome testing could indicate a muscle strain.
True
A grade of 3 in myotome testing signifies active movement against gravity and with resistance.
False
Thumb extension and ulnar deviation are tests for the T2 myotome.
False
Great toe extension tests the L3 myotome.
False
A grade of 4 on a myotome test indicates total paralysis.
False
A positive result for a myotome test would be a grade of 3 or less.
True
Elbow flexion and wrist extension test the C5 myotome.
False
Great toe extension tests the L3 myotome.
False
Ankle plantarflexion and ankle eversion test the S3 myotome.
False
Shoulder elevation tests the C4 myotome.
False
What is the purpose of performing a myotome test?
To assess muscle strength due to a C5 nerve root lesion
During a C5 myotome test, what action should the candidate ask the patient to perform?
Raise their arms
What should the candidate inform the patient during the 'Check In' step of a myotome test?
To stop if they feel pain and report it
What does a grade of 2 in myotome testing indicate?
Moderate weakness
Which nerve root is likely affected if a patient has difficulty with elbow extension and wrist flexion?
C7
What action should the patient perform during a C6 myotome test?
Elbow flexion
For a myotome test, the patient must be _______ or standing to perform optimally.
seated
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 _______.
strength
If a patient has difficulty with cervical lateral flexion and shoulder elevation, which nerve roots are not affected?
C5 and C6
If a patient has difficulty with elbow extension and wrist flexion, which nerve root is likely affected?
C7
Why does the candidate inform the patient where they will be placing their hands during a myotome test?
resist
Which myotome is tested by having the patient perform finger abduction/adduction and thumb extension?
T1
During a C5 myotome test, the candidate should resist the patient from raising their arms.
True
A grade of 4 on a myotome test signifies total paralysis.
False
The purpose of performing a myotome test is to identify muscle weakness due to nerve root lesions only.
False
Ankle plantarflexion and ankle eversion are tests for the S3 myotome.
False
Great toe extension tests the L4 myotome.
True
Shoulder abduction is a test for the C3 myotome.
False
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
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.
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