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Chiropractic Examination

The Role of Dermatomes and Myotomes in Nerve Function

The spinal cord and brain comprise the central nervous system, while the spinal nerves (branching to the spinal cord) and cranial nerves (branching to the brain) include the peripheral nervous system.

31 nerves extend out of the spinal cord and are connected to it by the nerve root. Each nerve branches about a half inch from the spinal cord before dividing into smaller branches. The dorsal rami are on the posterior side of the branch, while the larger ventral rami are on the anterior side.

The dorsal rami provides nerve function for the skin of the trunk and posterior muscles. The ventral rami from T1 to T12 provides nerve function to the trunk’s skin and the lateral and anterior muscles.

The anterior divisions that remain for plexuses are networks that provide nerve function to the body. Each plexus has specific areas on the body for skin sensitivity and particular muscles. The point where they exit the spine determines how they are numbered. The four primary plexuses are:

  • Cervical plexus, C1 – C4, innervates the diaphragm, shoulder, neck
  • Brachial plexus, C5 – T1, innervates the upper limbs
  • Lumbar plexus, T12/L1 – L4, innervates the thigh
  • The sacral plexus, L4 – S4, innervates the leg and foot.

These spinal nerves have two sets of fibers: motor and sensory. Motor fibers facilitate movement and provide nerve function to the muscles. Sensory fibers facilitate sensitivities to touch, temperature, and other stimuli and provide nerve function to the skin.

What are Myotomes and Dermatomes?

A group of muscles innervated by motor fibers stemming from a specific nerve root is called a myotome. An area of the skin innervated by sensory fibers stemming from a specific nerve root is called a dermatome. These patterns of myotome and dermatome are almost always identical from person to person. There are occasionally variances, but that is rare.

This consistency allows doctors to treat nerve pain in patients. If a certain area is hurting, they know that it is attributed to a certain myotome or dermatome, whichever the case may be, and its corresponding nerve root. Problems with nerve damage are often the result of stretching the nerve or compressing it.

When nerves are injured in specific areas, such as the lumbosacral or brachial plexus, sensory and motor deficits occur in the limbs that correspond to them. Myotomes and dermatomes are used to assess the extent of the damage.

How are Myotomes and Dermatomes Used to Assess Nerve Damage?

When a doctor tests for nerve root damage in a patient, he or she will often test the myotomes or dermatomes for the nerves assigned to that location. A dermatome is examined for abnormal sensation, such as hypersensitivity or lack of sensitivity.

This is done using stimulus-inducing tools such as a pen, paper clip, pinwheel, fingernails, cotton ball, or pads of the fingers. The patient is instructed to provide feedback regarding their response. Some of the abnormal sensation responses include:

  • Hypoesthesia (decreased sensation).
  • Hyperesthesia (excessive sensation).
  • Anesthesia (loss of sensation).
  • Paresthesia (numbness, tingling, burning sensation).

A myotome is tested for muscle nerve damage, which presents as weakness. This grading scale, which assigns a rating to the degree of muscle weakness, is often used:

  • 5 – Normal – Complete range of motion against gravity with full resistance
  • 4 – Good – Complete range of motion against gravity with some resistance
  • 3 – Fair – Complete range of motion against gravity with no resistance, active ROM
  • 2 – Poor – Complete range of motion with some assistance and gravity eliminated
  • 1 – Trace – Evidence of slight muscular contraction, no joint motion evident
  • 0 – Zero – No evidence of muscle contraction

During a typical chiropractic exam, your chiropractor will assess dermatomes and myotomes for potential neurological problems. This gives him or her additional insight into treating your condition, whether related to a subluxation of vertebral bodies or other disease processes.

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The information herein on "The Role of Dermatomes and Myotomes in Nerve Function" is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.

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Welcome to El Paso's Premier Wellness and Injury Care Clinic & Wellness Blog, where Dr. Alex Jimenez, DC, FNP-C, a Multi-State board-certified Family Practice Nurse Practitioner (FNP-BC) and Chiropractor (DC), presents insights on how our multidisciplinary team is dedicated to holistic healing and personalized care. Our practice aligns with evidence-based treatment protocols inspired by integrative medicine principles, similar to those on this site and on our family practice-based chiromed.com site, focusing on naturally restoring health for patients of all ages.

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email: coach@elpasofunctionalmedicine.com

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Dr. Alex Jimenez, DC, APRN, FNP-BC*, CFMP, IFMCP, ATN, CCST

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Dr. Maria Cardenas, MD
(Board Certified in Internal Medicine)
Medical Director & Collaborative Physician
NPI # 1164426749
MD License #: J2933

 

Licenses and Board Certifications:

MD: Medical Doctor
DC: Doctor of Chiropractic
APRNP: Advanced Practice Registered Nurse 
FNP-BC: Family Practice Specialization (Multi-State Board Certified)
RN: Registered Nurse (Multi-State Compact License)
CFMP: Certified Functional Medicine Provider
MSN-FNP: Master of Science in Family Practice Medicine
MSACP: Master of Science in Advanced Clinical Practice
IFMCP: Institute of Functional Medicine
CCST: Certified Chiropractic Spinal Trauma
ATN: Advanced Translational Neutrogenomics

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TCA: Texas Chiropractic Association: Member ID: 104311
AANP: American Association of Nurse Practitioners: Member  ID: 2198960
ANA: American Nurse Association: Member ID: 06458222 (District TX01)
TNA: Texas Nurse Association: Member ID: 06458222

NPI: 1205907805

National Provider Identifier

Primary Taxonomy Selected Taxonomy State License Number
No 111N00000X - Chiropractor NM DC2182
Yes 111N00000X - Chiropractor TX DC5807
Yes 363LF0000X - Nurse Practitioner - Family TX 1191402
Yes 363LF0000X - Nurse Practitioner - Family FL 11043890
Yes 363LF0000X - Nurse Practitioner - Family CO C-APN.0105610-C-NP
Yes 363LF0000X - Nurse Practitioner - Family NY N25929

 

Dr. Alex Jimenez, DC, APRN, FNP-BC*, CFMP, IFMCP, ATN, CCST
My Digital Business Card

---------

Dr. Maria Cardenas, MD
(Board Certified in Internal Medicine)
Medical Director & Collaborative Physician
NPI # 1164426749
MD License #: J2933

Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

Welcome to our multidisciplinary blog, Bienvenidos. We focus on treating severe spinal disabilities and injuries. We also treat complex personal injuries, sciatica, neck and back pain, whiplash, headaches, knee injuries, sports injuries, dizziness, poor sleep, and arthritis. Dr. Alex Jimenez, DC, APRN, FNP-BC. We use proven advanced therapies that aim to improve movement, posture, overall health, and fitness, as well as treat long-term health issues and body structure. We also integrate Wellness Nutrition, Wellness Detoxification Protocols, Functional Medicine programs for acute and chronic musculoskeletal disorders. We use effective "Patient Focused Diet Plans," Specialized Chiropractic Techniques, Mobility-Agility Training, Cross-Fit Protocols, and the Premier "PUSH Functional Fitness System" to treat patients suffering from various injuries and health problems. Our rehabilitation facilities offer physical therapy programs and protocols to triage, assess, diagnose, and treat complex clinical injuries and assist in the progressive healing processes. We offer advanced telemedicine to provide all our family practice and injured patients with clinical convenience, including medication distribution, medication drop shipping, durable medical equipment deliveries, medically integrated wearables, and home-based diagnostic assessment tools. Our live, up-to-date "Telemedicine Integrations" allow us to offer interactive and direct ways to monitor, assess, and adjust to our patients' clinical presentations and final recovery outcomes. Ultimately, we are here to serve our patients and community as premier Chiropractors, Family Practice Nurse Practitioners and medical providers passionately restoring functional life and facilitating living through increased mobility and true restored health. Blessings/Bendiciones! Connect! Call Today: 915-850-0900

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