Myotomes, Dermatomes and Reflexes

Myotomes

Oxford GradeDescriptor
0No signs of activity
1Flicker of activity, no movement
2Full active range of motion, across gravity
3Full active range of motion, against gravity
4Moderate resistance
5Maximal resistance
MovementNerve Root Segments
Shoulder girdle elevationC3/4
Shoulder flexion / abductionC5
Elbow flexionC5/6
Elbow extensionC7/8
Wrist flexion / extensionC6/7
Finger flexion / extensionC7/8
Finger abduction / adductionT1
Testing Upper Limb Myotomes
MovementNerve Root Segments
Hip flexionL2/3
Hip extensionL4/5
Hip adductionL2/3
Hip abductionL4/5
Knee extensionL3/4
Knee flexionL5/S1
Ankle DorsiflexionL4/5
Great toe extensionL5
Ankle plantarflexionS1/2
Testing Lower Limb Myotomes

Dermatomes

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

Reflexes

ReflexNerve Segments
Biceps JerkC5/6
Triceps JerkC7/8
Brachioradialis JerkC6/7
ReflexNerve Root Segments
Knee JerkL3/4
Ankle JerkS1/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