I have learnt several routines to assess the myotomes and dermatomes of the limbs in order to perform a neurological examination. Although the American Spinal Injury Association (ASIA) had been given to me during my studies I haven’t really seen it used in a clinical setting. The routine by the ASIA simplifies and reduces the time needed to evaluate a patient’s neuromotor status. In particular the part that has been most helpful for me is the myotomes.

The ASIA suggests that the key muscles that have to be tested are: 

For the upper limb:

  • C5   Elbow flexors
  • C6   Wrist extensors
  • C7   Elbow extensors
  • C8   Finger flexors. Distal phalanx of middle finger
  • T1   Finger abductors . Little finger

For the lower limb

  • L2   Hip flexors
  • L3   Knee extensors
  • L4   Ankle dorsiflexors
  • L5   Long toe extensors
  • S1   Ankle plantar flexors

Once this routine has been performed, if weakness has been found then the practitioner can test further levels specifically.

Copyright ASIA

ASIA – Standard neurological classification of spinal cord injury