Rehab Cell

Physical Medicine and Rehabilitation

Myotomes Upper Limb | Peripheral Neurological Examination

Myotomes Upper Limb | Peripheral Neurological Examination


In this video we are going to look at Myotomes testing of the upper extremity Hi, welcome back to Physiotutors. Myotomes assessment is an essential part of Neurological examination when suspecting radiculopathy as changes in muscle strength within a specific Myotome may help you identify the pathological disc level in case of the cervical spine the most common causes of nerve root Pathology are herniated discs which account for about 20 to 25% of cases and Degenerative disc disease which accounts for 70 to 75% While herniated discs also known as soft disc lesions are rather seen in younger patients degenerative disc disease all hard disc lesions primarily occur in the older population and the highest incidence for cervical nerve foot Pathology is found on spinal segments C5/6 and C6/7 in their systematic review from 2017 Lemeunier et al. report that complete peripheral neurological examination when suspecting cervical radiculopathy has a sensitivity of 83% and a specificity of 28% the positive and Negative Likelihood ratios were 1.15 and 0.6 respectively Which is why we attribute this assessment a rather weak clinical value, but it is still the best tool we have C5 assess the Deltoid muscle with the patient in sitting position as the patient’s to abduct the arms to Approximately 90 degrees and then apply downward pressure to the arms look for side by side differences for C6 assess the Biceps Brachii and the wrist extensors to assess the biceps flex the patient’s forearm to 90 degrees and supinate it and Then ask your patients to resist the extension Force applied by you, check for noticeable side by side strength differences To best test the wrist extensors place the patient’s pronated forearm on the table and position the closed fist into a slight extension And apply a wrist flexed force to it ask the patient to resist and check the weakness and compare with the other side for C7 assess the triceps Brachii and the wrist flexors To test the triceps flex the patient’s forearm to 90 degrees and then ask your patient Resist the Flexion Force applied by you again check for noticeable strength differences with the forearm supinated on the table Position the closed fist into slight flexion and apply a wrist extension force to it ask the patient to resist and check for weakness comparing with the other side for C8 test the Abductor Pollicis Brevis Support the forearm and then ask the patient resist some adduction compare both thumbs and check for differences For T1 Assess the first dorsal interosseous fixate the 3 last digits and then apply an Adduction Force against the Index finger Alright guys there you have it next to my items there are also dermatomes So click the video right next to me to learn about sensory assessment of the upper Extremity as always if you like this video Please give it a thumbs up and subscribe to our channel it helps us out a lot you want to learn about other ways to support our channel click the first link in the video description as Always this was Andreas for Physiotutors. Thanks for watching and I’ll see you next time. Bye

19 thoughts on “Myotomes Upper Limb | Peripheral Neurological Examination

  1. Hey guys, where did you get the info that 75% of radiculopathy comes from DDD? Also is the full lemeunier paper available for free anywhere?

  2. مشكورين جدا حقيقة فيدوهات رائعة علمية ومفيدة…
    اين اجد نسخ مترجمة من هذه الفيديوهات.
    لدي طفل عاني من شلل ارب والان تحسن كثيرا فقط لديه مشاكل في لوحة الكتف ماهي مساعداتكم في هذا الامر…خالص الشكر…

  3. What percentage of cervical radiculopathy (nerve root pathology) comes from stenosis, If 75% is from DDD and the other 25% is from soft disc lesions?

  4. Is there a difference in testing myotomes vs a manual muscle test? If so, is the difference that MMT is a break test and myotome is a resisted isometric?

  5. Hey thanks for your work!!
    In which article I can find the SN and SP values of those tests? Was Pronation als assessed for C6 radiculopathy?

  6. Love the videos guys, very appreciative for your work. Just wanted to note that for C8 – unless it's partly inaudible or I'm mishearing it – I think the C8 myotome for FPB is resisting thumb 'ABduction' (I feel like I am hearing thumb ADDuction).

  7. Your videos are all nice and easy to follow.I can use it in my review for fsbpt and for clinical practice once i passed and get my license.Thank you and wish me luck sir.😁🙏

Leave comment

Your email address will not be published. Required fields are marked with *.