Dermatome chart leg. Dermatome Chart: Understanding Skin Innervation Patterns and Clinical Significance
What are dermatomes and how do they relate to spinal nerve roots. How are dermatomes tested clinically. Why are dermatome maps important for diagnosing neurological conditions.
The Fundamentals of Dermatomes: Mapping Skin Sensation
Dermatomes are distinct areas of skin innervated by specific spinal nerve roots. The term “dermatome” combines the Greek words “derma” (skin) and “tome” (cutting or thin segment). These sensory distribution patterns play a crucial role in neurological assessments and diagnoses.
There are 30 dermatomes in total, corresponding to:
- 8 cervical nerves (C1 has no dermatome)
- 12 thoracic nerves
- 5 lumbar nerves
- 5 sacral nerves
Each dermatome relays sensory information from a particular region of skin to the brain. Understanding these patterns is essential for healthcare professionals when evaluating nerve function and localizing potential spinal cord or nerve root issues.
The Evolution of Dermatome Mapping: Historical Perspectives
The concept of dermatomes emerged from early attempts to link anatomical structures with sensory physiology. Over time, various dermatome maps have been developed, each with its own nuances and applications.
Two primary dermatome maps have gained widespread recognition in the medical field:
- The Keegan and Garret Map (1948): Illustrates dermatomes in alignment with limb segment development.
- The Foerster Map (1933): Depicts the medial upper limb innervation by T1-T3, crucial for understanding pain distribution in conditions like angina or myocardial infarction.
The Foerster Map remains the most commonly used in healthcare settings and forms the basis for dermatome assessments in the American Spinal Cord Injury Association (ASIA) Impairment Scale.
Modern Approaches to Dermatome Mapping
In recent years, researchers have revisited and refined dermatome maps. Lee et al. conducted a comprehensive review of existing maps, proposing an “evidence-based” dermatome map that synthesizes the most reliable data available. While the term “evidence-based” may be debated, this effort represents a significant step towards more accurate dermatome representation.
Clinical Applications: Dermatome Testing in Neurological Examinations
Dermatome testing is an integral component of neurological examinations. Healthcare professionals use this technique to:
- Determine if sensory loss in a limb corresponds to a single spinal segment
- Identify potential radiculopathy (nerve root lesions)
- Assign a neurological “level” to spinal cord injuries
How is dermatome testing performed? The procedure typically involves the following steps:
- The patient is asked to close their eyes
- The examiner uses a pin and cotton wool to test sensation in different skin areas
- The patient provides feedback on their sensory perceptions
- The examiner maps out areas of altered sensation to identify affected dermatomes
Dermatome Patterns: A Comprehensive Overview
Understanding specific dermatome patterns is crucial for accurate neurological assessments. Here’s a breakdown of key dermatome distributions:
Cervical Dermatomes (C2-C8)
- C2: Temple, forehead, occiput
- C3: Neck, posterior cheek, temporal area
- C4: Shoulder and clavicular areas
- C5: Deltoid area, anterior arm to base of thumb
- C6: Anterior arm, radial side of hand to thumb and index finger
- C7: Lateral arm and forearm to index, long, and ring fingers
- C8: Medial arm and forearm to long, ring, and little fingers
Thoracic Dermatomes (T1-T12)
- T1: Medial forearm to base of little finger
- T2: Medial upper arm to elbow, pectoral and midscapular areas
- T3-T6: Upper thorax
- T5-T7: Costal margin
- T8-T12: Abdomen and lumbar region
Lumbar Dermatomes (L1-L5)
- L1: Back, over trochanter and groin
- L2: Back, front of thigh to knee
- L3: Back, upper buttock, anterior thigh and knee, medial lower leg
- L4: Medial buttock, lateral thigh, medial leg, dorsum of foot, big toe
- L5: Buttock, posterior and lateral thigh, lateral leg, dorsum of foot, first three toes
Sacral Dermatomes (S1-S4)
- S1: Buttock, posterior thigh and leg
- S2: Similar to S1
- S3: Groin, medial thigh to knee
- S4: Perineum, genitals, lower sacrum
The coccygeal dermatome is located on the buttocks, surrounding the coccyx.
Challenges and Controversies in Dermatome Mapping
Despite their clinical importance, dermatome maps face several challenges and controversies:
- Variability between individuals: Dermatome patterns can differ significantly from person to person
- Inconsistencies between maps: Different dermatome maps may show varying patterns for the same spinal levels
- Outdated research: Some commonly used dermatome maps are based on older studies with potential methodological flaws
- Overlap between dermatomes: Adjacent dermatomes often have areas of sensory overlap, making precise delineation challenging
These factors highlight the need for ongoing research and refinement of dermatome maps to improve their accuracy and clinical utility.
The Clinical Significance of Dermatomes in Diagnosis and Treatment
Dermatome knowledge is invaluable in various clinical scenarios:
- Localizing spinal cord injuries: Dermatome patterns help determine the level of spinal cord damage
- Diagnosing radiculopathies: Sensory changes in specific dermatomes can indicate nerve root compression
- Evaluating peripheral neuropathies: Dermatome testing aids in differentiating between radicular and peripheral nerve lesions
- Guiding pain management: Understanding dermatomes assists in targeted interventions for chronic pain conditions
- Assessing recovery: Monitoring changes in dermatome sensation helps track neurological improvement after injury or surgery
Case Study: Herniated Disc Diagnosis
Consider a patient presenting with numbness and tingling along the lateral aspect of their right leg and the top of their foot. By referencing dermatome maps, a clinician can quickly identify that these symptoms correspond to the L5 dermatome. This information narrows down the potential causes, suggesting a possible L5 nerve root compression, which could be due to a herniated disc at the L4-L5 level.
Advanced Techniques in Dermatome Assessment
While traditional pin-prick and light touch tests remain standard, newer technologies are enhancing dermatome evaluations:
- Quantitative sensory testing (QST): Provides precise measurements of sensory thresholds across dermatomes
- Thermal testing: Assesses temperature sensation in different dermatomes
- Electrical stimulation: Measures sensory nerve conduction in specific dermatomes
- 3D body mapping: Uses computer technology to create detailed, patient-specific dermatome maps
These advanced techniques offer more objective and quantifiable data, potentially improving the accuracy of neurological diagnoses and treatment planning.
Integrating Dermatome Knowledge in Multidisciplinary Care
Understanding dermatomes is crucial for various healthcare specialties:
- Neurology: Dermatome assessments are fundamental in evaluating neurological disorders
- Orthopedics: Spine surgeons use dermatome patterns to localize nerve root compression
- Pain Management: Dermatome maps guide targeted interventions for chronic pain
- Physical Therapy: Therapists use dermatome knowledge to assess and treat sensory deficits
- Emergency Medicine: Quick dermatome checks help in rapid neurological screening
This multidisciplinary application underscores the importance of comprehensive dermatome education for healthcare professionals across various fields.
Dermatomes in Medical Education
How can medical curricula effectively teach dermatome concepts? Consider these strategies:
- Interactive 3D models: Visualize dermatome patterns on digital human anatomy models
- Case-based learning: Present clinical scenarios requiring dermatome knowledge for diagnosis
- Hands-on practice: Conduct supervised dermatome testing sessions with standardized patients
- Multimedia resources: Utilize videos and animations to illustrate dermatome distributions and testing techniques
By employing these diverse teaching methods, educators can ensure that future healthcare professionals have a solid foundation in dermatome concepts and their clinical applications.
Dermatomes – Physiopedia
Original Editor – Lucinda Hampton
Top Contributors –
Naomi O’Reilly,
Anas Mohamed,
Lucinda hampton,
Joao Costa,
Nikhil Benhur Abburi,
Rachael Lowe,
Kim Jackson and
Blessed Denzel Vhudzijena
Lead Editors
Contents
- 1 Dermatomes
- 2 History
- 3 Purpose
- 4 Technique
- 5 Controversies
- 6 Clinical Significance
- 7 References
The term “dermatome” is a combination of two Greek words; “derma” meaning “skin”, and “tome”, meaning “cutting” or “thin segment”. Dermatomes are areas of the skin whose sensory distribution is innervated by the afferent nerve fibres from the dorsal root of a specific single spinal nerve root, which is that portion of a peripheral nerve that “connects” the nerve to the spinal cord.
Nerve roots arise from each level of the spinal cord (e. g., C3, C4), and many, but not all, intermingle in a plexus (brachial, lumbar, or lumbosacral) to form different peripheral nerves as discussed above. This arrangement can result in a single nerve root supplying more than one peripheral nerve. For example, the median nerve is derived from the C6, C7, C8, and T1 Nerve Roots, whereas the ulnar nerve is derived from C7, C8, and T1.
In total there are 30 dermatomes that relay sensation from a particular region of the skin to the brain – 8 cervical nerves (note C1 has no corresponding dermatomal area), 12 thoracic nerves, 5 lumbar nerves and 5 sacral nerves. Each of these spinal nerves roots.[1] Dysfunction or damage to a spinal nerve root from infection, compression, or traumatic injury can trigger symptoms in the corresponding dermatome. [2]
[3]
Nerve Root | Dermatome | ||
---|---|---|---|
Cervical | C2 | Supply Skin of Neck | Temple, Forehead, Occiput |
C3 | Entire Neck, Posterior Cheek, Temporal Area, Prolongation forward under Mandible | ||
C4 | Shoulder Area, Clavicular Area, Upper Scapular Area | ||
C5 | Supply the Arms | Deltoid Area, Anterior aspect of entire arm to base of thumb | |
C6 | Anterior Arm, Radial side of hand to thumb and index finger | ||
C7 | Lateral Arm and Forearm to index, long, and ring fingers | ||
C8 | Medial Arm and forearm to long, ring, and little fingers | ||
Thoracic | T1 | Medial side of forearm to base of little finger | |
T2 | Supply the chest and abdomen | Medial side of upper arm to medial elbow, pectoral and midscapular areas | |
T3 – 6 | Upper Thorax | ||
T5 – 7 | Costal Margin | ||
T8 – 12 | Abdomen and Lumbar Region | ||
Lumbar | L1 | Back, over trochanter and groin | |
L2 | Back, front of thigh to knee | ||
L3 | Supply Skin of Legs | Back, upper buttock, anterior thigh and knee, medial lower leg | |
L4 | Medial buttock, latera thigh, medial leg, dorsum of foot, big toe | ||
L5 | Buttock, posterior and lateral thigh, lateral aspect of leg, dorsum of foot, medial half of sole, first, second, and third toes | ||
Sacral | S1 | Buttock, Thigh, and Leg Posterior | |
S2 | Supply Groin | Same as S1 | |
S3 | Groin, medial thigh to knee | ||
S4 | Perineum, genitals, lower sacrum | ||
Coccygeal | The dermatome corresponding with the coccygeal nerves is located on the buttocks, in the area directly around the coccyx.![]() |
The idea of dermatomes originated from initial efforts to associate anatomy with the physiology of sensation. Multiple definitions of dermatomes exist, and several maps are commonly employed. Although they are valuable, dermatomes vary significantly between maps and even among individuals,[6] with some evidence suggesting that current dermatome maps are inaccurate and based on flawed studies.[7][8]
The medical profession typically recognised two primary maps of dermatomes. Firstly, the Keegan and Garret Map (Fig.1) from 1948, which illustrates dermatomes in alignment with the developmental progression of the limb segments. Secondly, the Foerster Map from 1933, which portrays the medial area of the upper limb as being innervated by T1-T3, depicting the pain distribution from angina or myocardial infarction. This latter map is the most frequently used in healthcare and accounts for the dermatomes used in the American Spinal Cord Injury Association Impairment Scale (ASIA Scale). In recent years there have been few attempts at verifying these original dermatome maps. Lee et al conducted an in-depth review that examined the discrepancies among dermatome maps. They put forth an “evidence-based” dermatome map that combined elements of previous maps (Fig.3). Though the application of the term “evidence-based” may be somewhat questionable, their proposed map represents a systematic attempt to synthesise the most credible evidence available.[6][7]
Testing of dermatomes is part of the neurological examination. They are primarily used to determine whether the sensory loss on a limb corresponds to a single spinal segment, implying the lesion is of that nerve root (i.e., radiculopathy), and to assign the neurologic “level” to a spinal cord lesion[9].
Dermatome Testing is done ideally with a pin and cotton wool. Ask the patient to close their eyes and give the therapist feedback regarding the various stimuli. Testing should be done on specific dermatomes and should be compared to bilaterally.
- Light Touch Test – Light Touch Sensation – Dab a piece of cotton wool on an area of skin [10]
- Pinprick Test – Pain Sensation – Gently touches the skin with the pin ask the patient whether it feels sharp or blunt
During the review of systems, asking the patient to carefully describe the pattern or distribution of sensory symptoms (e.g., tingling, numbness, diminished, or absent sensation) provides the therapist with preliminary information to help guide the examination and to assist in identifying the dermatome(s) and nerve(s) involved.[11]
Light touch dermatomes are larger than pain dermatomes. When only one or two segments are affected, testing for pain sensibility is a more sensitive method of examination than testing for light touch.[9]
Dermatomes have a segmented distribution throughout your body. The exact dermatome pattern can actually vary from person to person. Some overlap between neighboring dermatomes may also occur. There exist some discrepancies among published dermatome maps based on the methodologies used to identify skin segment innervation.
In a clinical commentary, Downs and Laporte discuss the history of dermatome mapping, including the variations in methodologies employed, and the inconsistencies in the dermatome maps used in education and practice.[11] [[Laporte C. Conflicting dermatome maps: educational and clinical implications. journal of orthopaedic & sports physical therapy. 2011 Jun;41(6):42[12]7-34.]]
Dermatomes are important because they can help to assess and diagnose a variety of conditions. Neurological screening of dermatomes helps to assess patterns of sensory loss that can suggest specific spinal nerve involvement. For instance, symptoms that occur along a specific dermatome may indicate disruption or damage to a specific nerve root in the spine.
- Nerve Entrapment
- Radiculopathy
- Spinal Cord Injury
- Herpes Zoster [2]
- ↑ Wikipedia Dermatome. Available from: https://en.wikipedia.org/wiki/Dermatome_(anatomy) (last accessed 23.4.2019)
- ↑ 2.02.1 Medical news today What and where are dermatomes? Available:https://www.medicalnewstoday.com/articles/what-are-dermatomes (accessed 25.5.2022)
- ↑ M Roehrs. Dermatomes. Available from: https://www.youtube.com/watch?v=CYZBH6NX8wg&feature=youtu.be (last accessed 23.4.2019)
- ↑ Medical news today What and where are dermatomes? Available:https://www.medicalnewstoday.com/articles/what-are-dermatomes (accessed 25.5.2022)
- ↑ David J. Magee. Orthopedic Physical Assessment. 6th edition. Elsevier. 2014.
- ↑ 6.06.1 Apok V, Gurusinghe NT, Mitchell JD, Emsley HC. Dermatomes and dogma. Practical neurology. 2011 Apr 1;11(2):100-5.
- ↑ 7.07.
1 Lee MW, McPhee RW, Stringer MD. An evidence-based approach to human dermatomes. Australasian Musculoskeletal Medicine. 2013 Jun;18(1):14-22.
- ↑ Downs MB, Laporte C. Conflicting dermatome maps: educational and clinical implications. journal of orthopaedic & sports physical therapy. 2011 Jun;41(6):427-34.
- ↑ 9.09.1 Liebenson C, editor. Rehabilitation of the spine: a practitioner’s manual. Lippincott Williams & Wilkins; 2007.Available: https://www.sciencedirect.com/topics/medicine-and-dentistry/dermatome (accessed 25.5.2022)
- ↑ Slide share. Dermatomes and myotomes. Available from: https://www.slideshare.net/TafzzSailo/special-test-for-dermatomes-and-myotomes (last accessed 23.4.2019)
- ↑ 11.011.1 Susan B.O’Sullivan, Thomas J. Schmitz, George D. Fulk. Physical Rehabilitation. 6th edition. F. A. Davis Company. 2014.
- ↑ Downs MB, Laporte C. Conflicting dermatome maps: educational and clinical implications.
journal of orthopaedic & sports physical therapy. 2011 Jun;41(6):427-34.
Dermatomes – Physiopedia
Original Editor – Lucinda Hampton
Top Contributors –
Naomi O’Reilly,
Anas Mohamed,
Lucinda hampton,
Joao Costa,
Nikhil Benhur Abburi,
Rachael Lowe,
Kim Jackson and
Blessed Denzel Vhudzijena
Lead Editors
Contents
- 1 Dermatomes
- 2 History
- 3 Purpose
- 4 Technique
- 5 Controversies
- 6 Clinical Significance
- 7 References
The term “dermatome” is a combination of two Greek words; “derma” meaning “skin”, and “tome”, meaning “cutting” or “thin segment”. Dermatomes are areas of the skin whose sensory distribution is innervated by the afferent nerve fibres from the dorsal root of a specific single spinal nerve root, which is that portion of a peripheral nerve that “connects” the nerve to the spinal cord.
Nerve roots arise from each level of the spinal cord (e.g., C3, C4), and many, but not all, intermingle in a plexus (brachial, lumbar, or lumbosacral) to form different peripheral nerves as discussed above. This arrangement can result in a single nerve root supplying more than one peripheral nerve. For example, the median nerve is derived from the C6, C7, C8, and T1 Nerve Roots, whereas the ulnar nerve is derived from C7, C8, and T1.
In total there are 30 dermatomes that relay sensation from a particular region of the skin to the brain – 8 cervical nerves (note C1 has no corresponding dermatomal area), 12 thoracic nerves, 5 lumbar nerves and 5 sacral nerves. Each of these spinal nerves roots.[1] Dysfunction or damage to a spinal nerve root from infection, compression, or traumatic injury can trigger symptoms in the corresponding dermatome. [2]
[3]
Nerve Root | Dermatome | ||
---|---|---|---|
Cervical | C2 | Supply Skin of Neck | Temple, Forehead, Occiput |
C3 | Entire Neck, Posterior Cheek, Temporal Area, Prolongation forward under Mandible | ||
C4 | Shoulder Area, Clavicular Area, Upper Scapular Area | ||
C5 | Supply the Arms | Deltoid Area, Anterior aspect of entire arm to base of thumb | |
C6 | Anterior Arm, Radial side of hand to thumb and index finger | ||
C7 | Lateral Arm and Forearm to index, long, and ring fingers | ||
C8 | Medial Arm and forearm to long, ring, and little fingers | ||
Thoracic | T1 | Medial side of forearm to base of little finger | |
T2 | Supply the chest and abdomen | Medial side of upper arm to medial elbow, pectoral and midscapular areas | |
T3 – 6 | Upper Thorax | ||
T5 – 7 | Costal Margin | ||
T8 – 12 | Abdomen and Lumbar Region | ||
Lumbar | L1 | Back, over trochanter and groin | |
L2 | Back, front of thigh to knee | ||
L3 | Supply Skin of Legs | Back, upper buttock, anterior thigh and knee, medial lower leg | |
L4 | Medial buttock, latera thigh, medial leg, dorsum of foot, big toe | ||
L5 | Buttock, posterior and lateral thigh, lateral aspect of leg, dorsum of foot, medial half of sole, first, second, and third toes | ||
Sacral | S1 | Buttock, Thigh, and Leg Posterior | |
S2 | Supply Groin | Same as S1 | |
S3 | Groin, medial thigh to knee | ||
S4 | Perineum, genitals, lower sacrum | ||
Coccygeal | The dermatome corresponding with the coccygeal nerves is located on the buttocks, in the area directly around the coccyx.![]() |
The idea of dermatomes originated from initial efforts to associate anatomy with the physiology of sensation. Multiple definitions of dermatomes exist, and several maps are commonly employed. Although they are valuable, dermatomes vary significantly between maps and even among individuals,[6] with some evidence suggesting that current dermatome maps are inaccurate and based on flawed studies.[7][8]
The medical profession typically recognised two primary maps of dermatomes. Firstly, the Keegan and Garret Map (Fig.1) from 1948, which illustrates dermatomes in alignment with the developmental progression of the limb segments. Secondly, the Foerster Map from 1933, which portrays the medial area of the upper limb as being innervated by T1-T3, depicting the pain distribution from angina or myocardial infarction. This latter map is the most frequently used in healthcare and accounts for the dermatomes used in the American Spinal Cord Injury Association Impairment Scale (ASIA Scale). In recent years there have been few attempts at verifying these original dermatome maps. Lee et al conducted an in-depth review that examined the discrepancies among dermatome maps. They put forth an “evidence-based” dermatome map that combined elements of previous maps (Fig.3). Though the application of the term “evidence-based” may be somewhat questionable, their proposed map represents a systematic attempt to synthesise the most credible evidence available.[6][7]
Testing of dermatomes is part of the neurological examination. They are primarily used to determine whether the sensory loss on a limb corresponds to a single spinal segment, implying the lesion is of that nerve root (i.e., radiculopathy), and to assign the neurologic “level” to a spinal cord lesion[9].
Dermatome Testing is done ideally with a pin and cotton wool. Ask the patient to close their eyes and give the therapist feedback regarding the various stimuli. Testing should be done on specific dermatomes and should be compared to bilaterally.
- Light Touch Test – Light Touch Sensation – Dab a piece of cotton wool on an area of skin [10]
- Pinprick Test – Pain Sensation – Gently touches the skin with the pin ask the patient whether it feels sharp or blunt
During the review of systems, asking the patient to carefully describe the pattern or distribution of sensory symptoms (e.g., tingling, numbness, diminished, or absent sensation) provides the therapist with preliminary information to help guide the examination and to assist in identifying the dermatome(s) and nerve(s) involved.[11]
Light touch dermatomes are larger than pain dermatomes. When only one or two segments are affected, testing for pain sensibility is a more sensitive method of examination than testing for light touch.[9]
Dermatomes have a segmented distribution throughout your body. The exact dermatome pattern can actually vary from person to person. Some overlap between neighboring dermatomes may also occur. There exist some discrepancies among published dermatome maps based on the methodologies used to identify skin segment innervation.
In a clinical commentary, Downs and Laporte discuss the history of dermatome mapping, including the variations in methodologies employed, and the inconsistencies in the dermatome maps used in education and practice.[11] [[Laporte C. Conflicting dermatome maps: educational and clinical implications. journal of orthopaedic & sports physical therapy. 2011 Jun;41(6):42[12]7-34.]]
Dermatomes are important because they can help to assess and diagnose a variety of conditions. Neurological screening of dermatomes helps to assess patterns of sensory loss that can suggest specific spinal nerve involvement. For instance, symptoms that occur along a specific dermatome may indicate disruption or damage to a specific nerve root in the spine.
- Nerve Entrapment
- Radiculopathy
- Spinal Cord Injury
- Herpes Zoster [2]
- ↑ Wikipedia Dermatome. Available from: https://en.wikipedia.org/wiki/Dermatome_(anatomy) (last accessed 23.4.2019)
- ↑ 2.02.1 Medical news today What and where are dermatomes? Available:https://www.medicalnewstoday.com/articles/what-are-dermatomes (accessed 25.5.2022)
- ↑ M Roehrs. Dermatomes. Available from: https://www.youtube.com/watch?v=CYZBH6NX8wg&feature=youtu.be (last accessed 23.4.2019)
- ↑ Medical news today What and where are dermatomes? Available:https://www.medicalnewstoday.com/articles/what-are-dermatomes (accessed 25.5.2022)
- ↑ David J. Magee. Orthopedic Physical Assessment. 6th edition. Elsevier. 2014.
- ↑ 6.06.1 Apok V, Gurusinghe NT, Mitchell JD, Emsley HC. Dermatomes and dogma. Practical neurology. 2011 Apr 1;11(2):100-5.
- ↑ 7.07.
1 Lee MW, McPhee RW, Stringer MD. An evidence-based approach to human dermatomes. Australasian Musculoskeletal Medicine. 2013 Jun;18(1):14-22.
- ↑ Downs MB, Laporte C. Conflicting dermatome maps: educational and clinical implications. journal of orthopaedic & sports physical therapy. 2011 Jun;41(6):427-34.
- ↑ 9.09.1 Liebenson C, editor. Rehabilitation of the spine: a practitioner’s manual. Lippincott Williams & Wilkins; 2007.Available: https://www.sciencedirect.com/topics/medicine-and-dentistry/dermatome (accessed 25.5.2022)
- ↑ Slide share. Dermatomes and myotomes. Available from: https://www.slideshare.net/TafzzSailo/special-test-for-dermatomes-and-myotomes (last accessed 23.4.2019)
- ↑ 11.011.1 Susan B.O’Sullivan, Thomas J. Schmitz, George D. Fulk. Physical Rehabilitation. 6th edition. F. A. Davis Company. 2014.
- ↑ Downs MB, Laporte C. Conflicting dermatome maps: educational and clinical implications.
journal of orthopaedic & sports physical therapy. 2011 Jun;41(6):427-34.
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Dermatoma What is it, types and clinical significance / Anatomy and Physiology | Thpanorama
dermatoma is a skin area innervated by a single spinal nerve. In particular, they are controlled by sensory neurons that arise from the ganglion of the spinal nerve.
There are eight cervical nerves, twelve thoracic nerves, five lumbar nerves and five sacral nerves. Each of these nerves allows us to feel temperature, touch, pressure, and even pain.
Information moves from a certain area of the skin to the brain. The dermatomes are organized as a stack of discs in parts of the thorax and abdomen, with each disc supplied with a different spinal nerve. Thus, dermatomes run along the arms and legs in a longitudinal direction. Thus, each half of each limb has its own dermatome.
Although all people usually have the same general pattern in the organization of dermatomes, specific areas of innervation can differ in each person, as if they were fingerprints.
The spinal column has over 30 different vertebrae, which are divided according to their location, from the neck to the coccyx. They are classified as cervical, thoracic, lumbar and sacral. Each vertebra contains a specific spinal nerve that will innervate specific areas of the skin.
All nerves except the first cervical nerve (C1) are associated with the dermatome. Dermatomes make it possible to map the spinal cord, which is very useful for medical professionals and researchers. And also for the diagnosis and treatment of pathologies.
There are currently two main cards accepted in the medical profession. The first is Keegan and Garrett’s 1948 map and the second is Förster’s 1933 map, the latter being the most widely used..
What is a dermatome?
Have you ever wondered why back pain leads to tingling in the legs? Or why do neck cramps make you feel numb in your fingers?
Apparently, this is due to the fact that there is a connection between sensations and disturbances on the surface of the skin with specific nerve roots that originate in the spine. Therefore, each region that is innervated by each of these nerve roots is called a dermatome..
Dermatoma is subdivided into dermat, meaning skin, and oma, meaning mass. We have 29 dermatomes in the human body. These nerves are connected to each other since they originated from the same somite groups during embryonic development. Somites are structures formed on the sides of the neural tube during the fourth week of human development.0085
Dermatomes should not be confused with myotomes. On the other hand, myotomes are those that innervate the skeletal muscles of the same group of somites. Each dermatome is classified according to the spinal nerve that innervates it. That is, the seventh cervical nerve innervates the C7 dermatome.
This dermatome sensitizes the skin of the shoulder, some parts of the arm, and the index and ring fingers..
Cervical dermatomes
They nourish the skin of the neck, neck, back, arms and hands.
Thoracic dermatomes
They cover the skin of the inner arm, chest, abdomen and mid back.
Lumbar dermatomes
Innervate the skin that is located in the lower back, in the frontal area of the legs, outer thighs and in the upper and lower parts of the legs.
Sacral dermatomes
They cover the skin of the genital and anal regions, the back of the legs, the back of the thighs and calves, in addition to the outer edge of the legs.
However, it is important to note that dermatomes have been discovered in recent years by clinical observations and are only a guideline. Each person can present small changes within the dermatomes.
Clinical significance
It is important to know how dermatomes work clinically to localize nerve or spinal cord lesions. , it could be something to do with the nerve root. For example, a herniated disc that compresses the L5 nerve root results in pain and tingling in the lower leg and foot.
Dermatomes are useful in the diagnosis and treatment of various conditions. The main ones are viral diseases, radiculopathy and spinal cord injuries. This virus is hidden in the spinal cord, and when it manifests itself, it moves through the spinal cord, causing a painful rash on the skin that is associated with this nerve..
Herpes zoster is usually limited to a specific dermatome, such as the chest, leg, or arm. Usually appears years and even decades after recovery from chickenpox.
radiculopathy
This condition consists of pain caused by damage to the root of any nerve. It can also lead to loss or decrease in sensory function. The most common regions affected are L5 and S1, and less commonly C6 and C7.
Pain is aggravated when we put ourselves in a position that stretches the roots of the nerves. It can be cervical or lumbar depending on where the pain is.
Spinal Cord Injury
When there is spinal cord injury, the healthcare professional will look for the affected dermatitis.