Myotomes, Dermatomes and Reflexes

Oxford Grade	Descriptor
0	No signs of activity
1	Flicker of activity, no movement
2	Full active range of motion, across gravity
3	Full active range of motion, against gravity
4	Moderate resistance
5	Maximal resistance

Movement	Nerve Root Segments
Shoulder girdle elevation	C3/4
Shoulder flexion / abduction	C5
Elbow flexion	C5/6
Elbow extension	C7/8
Wrist flexion / extension	C6/7
Finger flexion / extension	C7/8
Finger abduction / adduction	T1

Testing Upper Limb Myotomes

Movement	Nerve Root Segments
Hip flexion	L2/3
Hip extension	L4/5
Hip adduction	L2/3
Hip abduction	L4/5
Knee extension	L3/4
Knee flexion	L5/S1
Ankle Dorsiflexion	L4/5
Great toe extension	L5
Ankle plantarflexion	S1/2

Testing Lower Limb Myotomes

Chart showing where you might expect radicular pain to radiate

Charts showing areas of skin where you would expect altered sensation following nerve root lesion Upper Limb Lower Limb

Reflex	Nerve Segments
Biceps Jerk	C5/6
Triceps Jerk	C7/8
Brachioradialis Jerk	C6/7

Reflex	Nerve Root Segments
Knee Jerk	L3/4
Ankle Jerk	S1/S2

The Babinski test (“plantars”) can be abnormal in the present of upper motor neuron damage. A normal response is flexion of the toes. An abnormal response involves dorsiflexion of the great toe and fanning of the other toes