Chapter·AnatomyDermatomes and myotomes

Lumbar dermatomes and myotomesDownloads

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1

A 49-year-old man comes to the physician because of severe, shooting pain in his lower back for the past 2 weeks. The pain radiates down the back of both legs and started after he lifted a concrete manhole cover from the ground. Physical examination shows decreased sensation to light touch bilaterally over the lateral thigh area and lateral calf bilaterally. Patellar reflex is decreased on both sides. The passive raising of either the right or left leg beyond 30 degrees triggers a shooting pain down the leg past the knee. Which of the following is the most likely underlying cause of this patient's current condition?

AInflammatory reaction in the epidural space

BInvoluntary contraction of the paraspinal muscles

CCompromised integrity of the vertebral body

DInflammatory degeneration of the spine

EHerniation of nucleus pulposus into vertebral canal

2

A 38-year-old man is brought to the emergency department after suffering a motor vehicle accident as the passenger. He had no obvious injuries, but he complains of excruciating right hip pain. His right leg is externally rotated, abducted, and extended at the hip and the femoral head can be palpated anterior to the pelvis. Plain radiographs of the pelvis reveal a right anterior hip dislocation and femoral head fracture. Which sensory and motor deficits are most likely in this patient's right lower extremity?

ALoss of sensation laterally below the knee, weak thigh extension and knee flexion

BNumbness of the ipsilateral scrotum and upper medial thigh

CSensory loss to the dorsal surface of the foot and part of the anterior lower and lateral leg and foot drop

DParesis and numbness of the medial thigh and medial side of the calf, weak hip flexion and knee extension

ENumbness of the medial side of the thigh and inability to adduct the thigh

3

A 68-year-old man presents to his primary care physician complaining of a bulge in his scrotum that has enlarged over the past several months. He is found to have a right-sided inguinal hernia and undergoes elective hernia repair. At his first follow-up visit, he complains of a tingling sensation on his scrotum. Which of the following nerve roots communicates with the injured tissues?

AS1-S3

BL1-L2

CS2-S4

DL4-L5

EL2-L3

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