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.