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{{Short description|Type of area of skin}} |
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{{Other uses|Dermatome (disambiguation)}} |
{{Other uses|Dermatome (disambiguation)}} |
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{{Infobox anatomy |
{{Infobox anatomy |
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|Name=Dermatome |
|Name=Dermatome |
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|Image=Grant 1962 663.png |
|Image=Grant 1962 663.png |
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|Caption=Dermatomes of the |
|Caption=Dermatomes of the upper and lower limbs (modified, after Keegan, J. J., and Garrett, F. D.) |
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|Image2=Grant 1962 664.png |
|Image2=Grant 1962 664.png |
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|Caption2=Dermatomes of the |
|Caption2=Dermatomes of the upper parts of the body, displaying significant overlapping (modified, from Fender, after Foerster) |
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|Latin= |
|Latin= |
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}} |
}} |
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A '''dermatome''' is an area of [[skin]] that is mainly supplied by [[afferent nerve |
A '''dermatome''' is an area of [[skin]] that is mainly supplied by [[afferent nerve fibres]] from the [[dorsal root of spinal nerve|dorsal root]] of any given [[spinal nerve]].<ref>{{cite web |last=Kishner |first=Stephen |title=Dermatomes Anatomy |url=http://emedicine.medscape.com/article/1878388-overview |url-access=registration |access-date=2013-10-09 |website=eMedicine |publisher=Medscape}}</ref><ref> |
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{{cite web | title = dermatome | url = https://medical-dictionary.thefreedictionary.com/dermatome | publisher = The Free Dictionary by Farlex, Medical dictionary | |
{{cite web | title = dermatome | url = https://medical-dictionary.thefreedictionary.com/dermatome | publisher = The Free Dictionary by Farlex, Medical dictionary | archive-url = https://web.archive.org/web/20170916113828/http://medical-dictionary.thefreedictionary.com/dermatome | archive-date = 2017-09-16 }}</ref> |
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There are 8 [[cervical nerves]] (C1 being an exception with no dermatome), |
There are 8 [[cervical nerves]] (C1 being an exception with no dermatome), |
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12 [[thoracic nerves]], |
12 [[thoracic nerves]], |
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Each of these nerves relays sensation (including pain) from a particular region of skin to the [[brain]]. |
Each of these nerves relays sensation (including pain) from a particular region of skin to the [[brain]]. |
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The term is also used to refer to a part of an embryonic [[somite]]. |
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Along the [[thorax]] and [[abdomen]] the dermatomes are like a stack of discs forming a human, each supplied by a different spinal nerve. Along the arms and the legs, the pattern is different: the dermatomes run longitudinally along the limbs. Although the general pattern is similar in all people, the precise areas of innervation are as unique to an individual as fingerprints. |
Along the [[thorax]] and [[abdomen]], the dermatomes are like a stack of discs forming a human, each supplied by a different spinal nerve. Along the arms and the legs, the pattern is different: the dermatomes run longitudinally along the limbs. Although the general pattern is similar in all people, the precise areas of innervation are as unique to an individual as fingerprints. |
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An area of skin innervated by a single [[peripheral nervous system|nerve]] is called a [[peripheral nerve field]]. |
An area of skin innervated by a single [[peripheral nervous system|nerve]] is called a [[peripheral nerve field]]. |
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The word ''dermatome'' is formed from [[Ancient Greek]] {{Lang|grc-Grek|δέρμα|italic=no}} 'skin, hide' and {{Lang|grc-Grek|τέμνω|italic=no}} 'cut'. |
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== Clinical significance == |
== Clinical significance == |
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[[Referred pain]]: Conscious perception of visceral sensations is referred to specific regions of the body that are not sources of the sensations. Some referred pain due to visceral sensations refer to dermatomes that send fibers to the same level of spinal cord. |
[[Referred pain]]: Conscious perception of visceral sensations is referred to specific regions of the body that are not sources of the sensations. Some referred pain due to visceral sensations refer to dermatomes that send fibers to the same level of spinal cord. |
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]] |
]] |
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A dermatome is an area of skin supplied by sensory neurons that arise from a spinal nerve ganglion. Symptoms that follow a dermatome (e.g. like pain or a rash) may indicate a pathology that involves the related nerve root. Examples include somatic dysfunction of the spine or viral infection. Certain skin problems tend to orient the lesions in the dermatomal direction. |
A dermatome is an area of skin supplied by sensory neurons that arise from a spinal nerve ganglion. Symptoms that follow a dermatome (e.g. like pain or a rash) may indicate a pathology that involves the related [[nerve root]]. Examples include somatic dysfunction of the spine or viral infection. Certain skin problems tend to orient the lesions in the dermatomal direction. |
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In [[referred pain]], [[sensory nerve fibers]] such as that from dermatomes may come together at the |
In [[referred pain]], [[sensory nerve fibers]] such as that from dermatomes may come together at the same [[spinal cord]] level as the [[general visceral afferent fibers]] such as that from the [[heart]]. |
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When the general visceral sensory fiber is |
When the general visceral sensory fiber is stimulated, the [[central nervous system]] does not clearly discern whether the [[pain]] is coming from the body wall or from the [[viscera]], so it perceives the pain as coming from somewhere on the body wall, e.g. left arm/hand pain, jaw pain. |
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So the pain is "referred to" the related dermatomes of the same spinal segment.<ref>{{cite web | |
So the pain is "referred to" the related dermatomes of the same spinal segment.<ref>{{cite web |date=2019-02-02 |title=Referred Pain |url=https://www.physio-pedia.com/Referred_Pain |url-status=live |archive-url=https://web.archive.org/web/20190521092611/https://www.physio-pedia.com/Referred_Pain |archive-date=2019-05-21 |publisher=Physiopedia}} cited {{cite book |last=van Cranenburghauthors |first=B. |title=SCHEMA'S FYSIOLOGIE |publisher=Elsevier/De Tijdstroom |year=1997 |location=Maarssen |pages=53, 65, 70}}</ref> |
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Viruses that lie dormant in nerve ganglia (e.g. [[varicella zoster virus]], which causes both [[chickenpox]] and |
Viruses that lie dormant in nerve ganglia (e.g. [[varicella zoster virus]], which causes both [[chickenpox]] and [[shingles]]), often cause either pain, rash or both in a pattern defined by a dermatome (a zosteriform pattern). However, the symptoms may not appear across the entire dermatome. |
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== Important dermatomes and anatomical landmarks == |
== Important dermatomes and anatomical landmarks == |
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Following is a list of [[spinal nerve]]s and points that are characteristically belonging to the dermatome of each nerve:<ref>{{cite web|url=http://www.asia-spinalinjury.org/elearning/Key_Sensory_Points.pdf |
Following is a list of [[spinal nerve]]s and points that are characteristically belonging to the dermatome of each nerve:<ref>{{cite web |date=June 2008 |title=International Standards for the Classification of Spinal Cord Injury - Key Sensory Points |url=http://www.asia-spinalinjury.org/elearning/Key_Sensory_Points.pdf |url-status=dead |archive-url=https://web.archive.org/web/20160304084632/http://www.asia-spinalinjury.org/elearning/Key_Sensory_Points.pdf |archive-date=2016-03-04 |website=American Spinal Injury Association}}</ref> |
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[[File:Grant 1962 665.png|thumb|250px|right|Dermatomes of the lower limb (modified, from Fender, after Foerster)]] |
[[File:Grant 1962 665.png|thumb|250px|right|Dermatomes of the lower limb (modified, from Fender, after Foerster)]] |
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*[[Cervical spinal nerve 2|C2]] |
* [[Cervical spinal nerve 2|C2]] – At least one cm lateral to the [[External occipital protuberance|occipital protuberance]] at the [[base of the skull]]. Alternately, a point at least {{Convert|3|cm|in|abbr=on}} behind the ear. |
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* [[Cervical spinal nerve 3|C3]] |
* [[Cervical spinal nerve 3|C3]] – In the [[supraclavicular fossa]], at the [[midclavicular line]]. |
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* [[Cervical spinal nerve 4|C4]] |
* [[Cervical spinal nerve 4|C4]] – Over the [[acromioclavicular joint]]. |
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* [[Cervical spinal nerve 5|C5]] |
* [[Cervical spinal nerve 5|C5]] – On the lateral (radial) side of the [[antecubital fossa]], just proximally to the elbow. |
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* [[Cervical spinal nerve 6|C6]] |
* [[Cervical spinal nerve 6|C6]] – On the dorsal surface of the [[Proximal phalanges|proximal phalanx]] of the [[thumb]]. |
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* [[Cervical spinal nerve 7|C7]] |
* [[Cervical spinal nerve 7|C7]] – On the dorsal surface of the [[Proximal phalanges|proximal phalanx]] of the [[middle finger]]. |
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* [[Cervical spinal nerve 8|C8]] |
* [[Cervical spinal nerve 8|C8]] – On the dorsal surface of the proximal phalanx of the [[little finger]]. |
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* [[Thoracic spinal nerve 1|T1]] |
* [[Thoracic spinal nerve 1|T1]] – On the medial (ulnar) side of the [[antecubital fossa]], just distal to the [[medial epicondyle of the humerus]]. |
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* [[Thoracic spinal nerve 2|T2]] |
* [[Thoracic spinal nerve 2|T2]] – At the apex of the [[axilla]]. |
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* [[Thoracic spinal nerve 3|T3]] |
* [[Thoracic spinal nerve 3|T3]] – [[Line-line intersection|Intersection]] of the [[midclavicular line]] and the third [[intercostal space]] |
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* [[Thoracic spinal nerve 4|T4]] |
* [[Thoracic spinal nerve 4|T4]] – Intersection of the [[midclavicular line]] and the fourth intercostal space, located at the level of the nipples. |
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* [[Thoracic spinal nerve 5|T5]] |
* [[Thoracic spinal nerve 5|T5]] – Intersection of the midclavicular line and the fifth intercostal space, horizontally located midway between the level of the nipples and the level of the [[xiphoid process]]. |
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* [[Thoracic spinal nerve 6|T6]] |
* [[Thoracic spinal nerve 6|T6]] – Intersection of the midclavicular line and the horizontal level of the [[xiphoid process]]. |
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* [[Thoracic spinal nerve 7|T7]] |
* [[Thoracic spinal nerve 7|T7]] – Intersection of the midclavicular line and the horizontal level at one quarter the distance between the level of the xiphoid process and the level of the [[navel|umbilicus]]. |
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* [[Thoracic spinal nerve 8|T8]] |
* [[Thoracic spinal nerve 8|T8]] – Intersection of the midclavicular line and the horizontal level at one half the distance between the level of the xiphoid process and the level of the umbilicus. |
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* [[Thoracic spinal nerve 9|T9]] |
* [[Thoracic spinal nerve 9|T9]] – Intersection of the midclavicular line and the horizontal level at three quarters of the distance between the level of the xiphoid process and the level of the umbilicus. |
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* [[Thoracic spinal nerve 10|T10]] |
* [[Thoracic spinal nerve 10|T10]] – Intersection of the midclavicular line, at the horizontal level of the umbilicus. |
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* [[Thoracic spinal nerve 11|T11]] |
* [[Thoracic spinal nerve 11|T11]] – Intersection of the midclavicular line, at the horizontal level midway between the level of the umbilicus and the [[inguinal ligament]]. |
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* [[Thoracic spinal nerve 12|T12]] |
* [[Thoracic spinal nerve 12|T12]] – Intersection of the midclavicular line and the midpoint of the inguinal ligament. |
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* [[Lumbar spinal nerve 1|L1]] |
* [[Lumbar spinal nerve 1|L1]] – Midway between the key sensory points for T12 and L2.{{Clarify | date = May 2019 | reason = A little vague: what specifically are key sensory points? }} |
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* [[Lumbar spinal nerve 2|L2]] |
* [[Lumbar spinal nerve 2|L2]] – On the anterior medial thigh, at the midpoint of a line connecting the midpoint of the inguinal ligament and the [[medial epicondyle of the femur]]. |
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* [[Lumbar spinal nerve 3|L3]] |
* [[Lumbar spinal nerve 3|L3]] – At the [[medial epicondyle of the femur]]. |
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* [[Lumbar spinal nerve 4|L4]] |
* [[Lumbar spinal nerve 4|L4]] – Over the [[medial malleolus]]. |
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* [[Lumbar spinal nerve 5|L5]] |
* [[Lumbar spinal nerve 5|L5]] – On the [[foot dorsum|dorsum of the foot]] at the third [[metatarsophalangeal joint]]. |
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*[[Sacral spinal nerve 1|S1]] |
* [[Sacral spinal nerve 1|S1]] – On the lateral aspect of the [[calcaneus]]. |
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*[[Sacral spinal nerve 2|S2]] |
* [[Sacral spinal nerve 2|S2]] – At the midpoint of the [[popliteal fossa]]. |
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*[[Sacral spinal nerve 3|S3]] |
* [[Sacral spinal nerve 3|S3]] – Over the [[tuberosity of the ischium]] or [[intragluteal fold]] |
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*[[Sacral spinal nerve 4|S4]] and [[Sacral spinal nerve 5|S5]] |
* [[Sacral spinal nerve 4|S4]] and [[Sacral spinal nerve 5|S5]] – In the [[perianal]] area, less than one cm lateral to the [[mucocutaneous zone]] |
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Following is a list [[cranial nerves]] responsible for sensation from the face: |
Following is a list of [[cranial nerves]] responsible for sensation from the face: |
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* [[Ophthalmic nerve|V1 (1st division of the |
* [[Ophthalmic nerve|V1 (1st division of the trigeminal nerve)]] - associated with [[herpes zoster ophthalmicus]] |
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* [[Maxillary nerve|V2 (2nd division of the |
* [[Maxillary nerve|V2 (2nd division of the trigeminal nerve)]] |
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* [[Mandibular nerve|V3 (3rd division of the |
* [[Mandibular nerve|V3 (3rd division of the trigeminal nerve)]] |
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== Additional images == |
== Additional images == |
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<gallery> |
<gallery> |
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File:Gray812and814.svg|Diagram of segmental distribution of the cutaneous nerves of the right upper extremity |
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File:Gray826and831.svg|Lower limb |
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File:Gray834.svg|Foot |
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File:Dermatomes and cutaneous nerves - anterior. |
File:Dermatomes and cutaneous nerves - anterior.svg|Major dermatomes and [[cutaneous nerve]]s (anterior view) |
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File:Dermatomes and cutaneous nerves - posterior. |
File:Dermatomes and cutaneous nerves - posterior.svg|Major dermatomes and [[cutaneous nerve]]s (posterior view) |
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</gallery> |
</gallery> |
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== See also == |
== See also == |
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* [[Cutaneous innervation]] |
* [[Cutaneous innervation]] |
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* [[ |
* [[Dorsal root]] |
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* [[Peripheral nerve field]] |
* [[Peripheral nerve field]] |
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== External links == |
== External links == |
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{{Commons category|Dermatome (anatomy)}} |
{{Commons category|Dermatome (anatomy)}} |
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* [http://www.instamedic.co.uk/dermatomes/ 3D Dermatomes Web App], ''Instamedic'' |
* [https://web.archive.org/web/20140304080428/http://www.instamedic.co.uk/dermatomes/ 3D Dermatomes Web App], ''Instamedic'' |
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* {{KansasHandKinesiology|nerves/dermatome.htm}} |
* {{KansasHandKinesiology|nerves/dermatome.htm}} |
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* [https://www.nytimes.com/imagepages/2007/08/01/health/adam/18069Adultdermatome.html Diagram "Adult Dermatome"], ''The New York Times'' |
* [https://www.nytimes.com/imagepages/2007/08/01/health/adam/18069Adultdermatome.html Diagram of "Adult Dermatome"], ''The New York Times'' |
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{{DEFAULTSORT:Dermatome (Anatomy)}} |
{{DEFAULTSORT:Dermatome (Anatomy)}} |
Latest revision as of 15:37, 3 January 2024
Dermatome | |
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Anatomical terminology |
A dermatome is an area of skin that is mainly supplied by afferent nerve fibres from the dorsal root of any given spinal nerve.[1][2] There are 8 cervical nerves (C1 being an exception with no dermatome), 12 thoracic nerves, 5 lumbar nerves and 5 sacral nerves. Each of these nerves relays sensation (including pain) from a particular region of skin to the brain.
The term is also used to refer to a part of an embryonic somite.
Along the thorax and abdomen, the dermatomes are like a stack of discs forming a human, each supplied by a different spinal nerve. Along the arms and the legs, the pattern is different: the dermatomes run longitudinally along the limbs. Although the general pattern is similar in all people, the precise areas of innervation are as unique to an individual as fingerprints.
An area of skin innervated by a single nerve is called a peripheral nerve field.
The word dermatome is formed from Ancient Greek δέρμα 'skin, hide' and τέμνω 'cut'.
Clinical significance
A dermatome is an area of skin supplied by sensory neurons that arise from a spinal nerve ganglion. Symptoms that follow a dermatome (e.g. like pain or a rash) may indicate a pathology that involves the related nerve root. Examples include somatic dysfunction of the spine or viral infection. Certain skin problems tend to orient the lesions in the dermatomal direction.
In referred pain, sensory nerve fibers such as that from dermatomes may come together at the same spinal cord level as the general visceral afferent fibers such as that from the heart. When the general visceral sensory fiber is stimulated, the central nervous system does not clearly discern whether the pain is coming from the body wall or from the viscera, so it perceives the pain as coming from somewhere on the body wall, e.g. left arm/hand pain, jaw pain. So the pain is "referred to" the related dermatomes of the same spinal segment.[3]
Viruses that lie dormant in nerve ganglia (e.g. varicella zoster virus, which causes both chickenpox and shingles), often cause either pain, rash or both in a pattern defined by a dermatome (a zosteriform pattern). However, the symptoms may not appear across the entire dermatome.
Important dermatomes and anatomical landmarks
Following is a list of spinal nerves and points that are characteristically belonging to the dermatome of each nerve:[4]
- C2 – At least one cm lateral to the occipital protuberance at the base of the skull. Alternately, a point at least 3 cm (1.2 in) behind the ear.
- C3 – In the supraclavicular fossa, at the midclavicular line.
- C4 – Over the acromioclavicular joint.
- C5 – On the lateral (radial) side of the antecubital fossa, just proximally to the elbow.
- C6 – On the dorsal surface of the proximal phalanx of the thumb.
- C7 – On the dorsal surface of the proximal phalanx of the middle finger.
- C8 – On the dorsal surface of the proximal phalanx of the little finger.
- T1 – On the medial (ulnar) side of the antecubital fossa, just distal to the medial epicondyle of the humerus.
- T2 – At the apex of the axilla.
- T3 – Intersection of the midclavicular line and the third intercostal space
- T4 – Intersection of the midclavicular line and the fourth intercostal space, located at the level of the nipples.
- T5 – Intersection of the midclavicular line and the fifth intercostal space, horizontally located midway between the level of the nipples and the level of the xiphoid process.
- T6 – Intersection of the midclavicular line and the horizontal level of the xiphoid process.
- T7 – Intersection of the midclavicular line and the horizontal level at one quarter the distance between the level of the xiphoid process and the level of the umbilicus.
- T8 – Intersection of the midclavicular line and the horizontal level at one half the distance between the level of the xiphoid process and the level of the umbilicus.
- T9 – Intersection of the midclavicular line and the horizontal level at three quarters of the distance between the level of the xiphoid process and the level of the umbilicus.
- T10 – Intersection of the midclavicular line, at the horizontal level of the umbilicus.
- T11 – Intersection of the midclavicular line, at the horizontal level midway between the level of the umbilicus and the inguinal ligament.
- T12 – Intersection of the midclavicular line and the midpoint of the inguinal ligament.
- L1 – Midway between the key sensory points for T12 and L2.[clarification needed]
- L2 – On the anterior medial thigh, at the midpoint of a line connecting the midpoint of the inguinal ligament and the medial epicondyle of the femur.
- L3 – At the medial epicondyle of the femur.
- L4 – Over the medial malleolus.
- L5 – On the dorsum of the foot at the third metatarsophalangeal joint.
- S1 – On the lateral aspect of the calcaneus.
- S2 – At the midpoint of the popliteal fossa.
- S3 – Over the tuberosity of the ischium or intragluteal fold
- S4 and S5 – In the perianal area, less than one cm lateral to the mucocutaneous zone
Following is a list of cranial nerves responsible for sensation from the face:
- V1 (1st division of the trigeminal nerve) - associated with herpes zoster ophthalmicus
- V2 (2nd division of the trigeminal nerve)
- V3 (3rd division of the trigeminal nerve)
Additional images
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Diagram of segmental distribution of the cutaneous nerves of the right upper extremity
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Lower limb
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Foot
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Major dermatomes and cutaneous nerves (anterior view)
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Major dermatomes and cutaneous nerves (posterior view)
See also
References
- ^ Kishner, Stephen. "Dermatomes Anatomy". eMedicine. Medscape. Retrieved 2013-10-09.
- ^ "dermatome". The Free Dictionary by Farlex, Medical dictionary. Archived from the original on 2017-09-16.
- ^ "Referred Pain". Physiopedia. 2019-02-02. Archived from the original on 2019-05-21. cited van Cranenburghauthors, B. (1997). SCHEMA'S FYSIOLOGIE. Maarssen: Elsevier/De Tijdstroom. pp. 53, 65, 70.
- ^ "International Standards for the Classification of Spinal Cord Injury - Key Sensory Points" (PDF). American Spinal Injury Association. June 2008. Archived from the original (PDF) on 2016-03-04.
External links
- 3D Dermatomes Web App, Instamedic
- Hand kinesiology at the University of Kansas Medical Center
- Diagram of "Adult Dermatome", The New York Times