Compartments of leg netter3/29/2023 ![]() This tests the gastrocnemius and soleus muscles in the posterior compartment of the lower leg. Or in standing rise up onto the ball of their foot. Holding the bottom of the foot, ask the patient to press down as hard as possible. S1: Ankle plantarflexion and eversion/knee flexion. This tests the extensor halucis longus muscle. Ask the patient to move the large toe against the examiner's resistance "up towards the patient's face". This tests the muscles in the anterior compartment of the lower leg. Test dorsiflexion of the ankle by holding the top of the ankle and have the patient pull their foot up towards their face as hard as possible. Ask the patient to "kick out" or extend the lower leg at the knee. Test extension at the knee by placing one hand under the knee and the other on top of the lower leg to provide resistance. Proceeding to the lower extremities, first test the flexion of the hip by asking the patient to lie down and raise each leg separately while the examiner resists. Thumb opposition is innervated by the C8 and T1 nerve roots via the median nerve. Apply resistance to the thumb with your index finger. To complete the motor examination of the upper extremities, test the strength of the thumb opposition by telling the patient to touch the tip of their thumb to the tip of their pinky finger. Finger abduction or "fanning" is innervated by the T1 nerve root via the ulnar nerve.Ĭ8 & T1- Thumb Opposition. Normally, one can resist the examiner from replacing the fingers. Instruct the patient to not allow the examiner to compress them back in. Test the intrinsic hand muscles once again by having the patient abduct or "fan out" all of their fingers. Finger flexion is innervated by the C8 nerve root via the median nerve.Ĭ8- Finger abduction & adduction. Compare the hands for strength asymmetry. This tests the forearm flexors and the intrinsic hand muscles. Normally the examiner cannot remove their fingers. Test the patient's grip by having the patient hold the examiner's fingers in their fist tightly and instructing them not to let go while the examiner attempts to remove them. Look for intrinsic hand, thenar and hypothenar muscle wasting. Note any asymmetry in the other arm.Ĭ8- Finger Flexion. Begin their extension from a fully flexed position because this part of the movement is most sensitive to a loss in strength. Ask the patient to extend their forearm against the examiner's resistance. Repeat with the other arm.Ĭ7- Elbow extension & wrist flexion. Test the strength of wrist extension by asking the patient to extend their wrist while the examiner resists the movement. Test the strength of lower arm flexion by holding the patient's wrist from above and instructing them to "flex their hand up to their shoulder". Compare the strength of each arm.Ĭ6- Elbow flexion & wrist extension. Ask the patient to raise both their arms to the side of them simultaneously as strongly as then can while the examiner provides resistance to this movement. The muscle strength grading scale, which assigns a rating to the degree of muscle weakness, is often used.īegin by asking the client to perform a movement as per instructions and hold an isometric contraction against therapist resistance for a count of 5.Ĭ5- Shoulder abduction. Results may indicate lesion to the spinal cord nerve root, or intervertebral disc herniation pressing on the spinal nerve roots. During myotome testing, you are looking for muscle weakness of a particular group of muscles. Testing of myotomes, in the form of isometric resisted muscle testing, gives information about the level in the spine where a lesion may be present. C8 – Thumb Extension and wrist ulnar deviation.The list below details which movement(s) has the strongest association with each myotome: All three of these spinal nerve roots can be said to be associated with elbow flexion. It is innervated by the musculocutaneous nerve, which is innervated by C5, C6 and C7 nerve roots. Eg Biceps Brachii muscle flexes the elbow. Most muscles in the limbs receive innervation from more than one spinal nerve root, and are hence comprised of multiple myotomes. ![]() 16 of these 31 nerves has a specific myotome that controls voluntary muscle movement. There are 8 cervical nerves, 12 thoracic nerves, 5 lumbar nerves, 5 sacral nerves,1 coccygeal nerve. The nerves are categorized by the vertebra which house them. There are 31 spinal nerves, each vertebrae has a spinal nerve.
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