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Sensory Examination
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
A dermatome is defined as the area of skin innervated by a single nerve root or spinal segment. It determines the limb's sensory loss corresponding to that single spinal segment confirming the lesion to a particular nerve route (radiculopathy) or assigning a neurological level for a spinal cord lesion (Figure 5.4).
Spinal Injuries
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
The spinal cord is divided into 31 segments each with a pair of anterior (motor) and dorsal (sensory) spinal nerve roots. On each side, the anterior and dorsal nerve roots combine to form the spinal nerves as they exit from the vertebral column. Each segmental nerve root supplies motor innervation to specific muscle groups (myotomes) and sensory innervation to a specific area of skin (dermatome). By testing sensory modalities and motor functions, it is possible to localize any neurological abnormality to specific spinal levels. The neurological level of injury is the lowest (most caudal) segmental level with normal sensory and motor function. A patient with a C5 level exhibits, by definition, abnormal motor and sensory function from C6 down. It is important to remember that the spinal cord segments do not correspond to the vertebral levels.
Acute erythematous rash on the trunk and limbs
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
Then comes the rash – groups of small vesicles on a red background, followed by weeping and crusting. Healing takes 3–4 weeks. The rash is unilateral and confined to one or two adjacent dermatomes with a sharp cut off at or near the midline. This feature and the associated pain makes any other diagnosis unlikely. The pain may continue until healing occurs, but in the elderly may go on for months or even years.
Ethical questions arising from Otfrid Foerster’s use of the Sherrington method to map human dermatomes
Published in Journal of the History of the Neurosciences, 2022
Brian Freeman, John Carmody, Damian Grace
In 1933, the journal Brain published the Schorstein Memorial Lecture, “Dermatomes in Man,” which Professor Otfrid Foerster of Breslau had presented at the London Hospital Medical College on October 13, 1932 (Foerster 1933).1A dermatome is the area of skin that is innervated by the sensory nerves associated with a single spinal cord segment, as defined by the level at which the dorsal (sensory) roots join the spinal cord; the designations of the spinal cord segments include C, cervical; T, thoracic; L, lumbar; and S, sacral (see caption Figure 1). Foerster’s lecture was advertised in Medical News, BMJ (October 8, 1932, 697) and was presented in the Anatomical Theater of London Hospital; with a capacity of 120–150 people, it is now known as the Milton Lecture Theater in the Garrod Building. The scope of this presentation astonished the audience: “It was a sensation when Foerster … was first to show such a perfect scheme of human dermatomes” (Zülch 1967). The subsequent publication was described as “the best documented paper on the extent of the spinal dermatomes that has appeared” (Jefferson 1941) and an “extremely valuable incidental study, made as a result of his therapeutic division of posterior roots” (de Gutiérrez-Mahoney 1941).
Impairment of wound healing by reactive skin decontamination lotion (RSDL®) in a Göttingen minipig® model
Published in Cutaneous and Ocular Toxicology, 2020
Jessica M. Connolly, Robert S. Stevenson, Roy F. Railer, Offie E. Clark, Kimberly A. Whitten, Robyn B. Lee-Stubbs, Dana R. Anderson
The dermatome-inflicted injuries in this study were partial-thickness, non-life threatening, allowed to heal via secondary intention, and located in the same anatomical area. The creation of a full thickness wound with underlying subcutaneous or musculature exposure that was then treated with RSDL would provide representation of its wound-healing effects when severe injuries are encountered and numerous tissue types are exposed. Injuries sustained on the battlefield or during a mass casualty in the time surrounding a chemical attack will likely involve numerous anatomical locations and expand across varying tissue depths. Elucidating RSDL’s effect on various musculoskeletal structures, in addition to the skin, will aid in subsequent wound-management strategies. This could furthermore be coupled with non-sterile wounding that would more closely match a traumatic injury in which contamination is inevitable.
Challenging questions regarding the international standards
Published in The Journal of Spinal Cord Medicine, 2018
Ryan Solinsky, Steven C. Kirshblum
The development of the sensory points assigned to each dermatome has been accredited to guidance from the spinal surgical text by Austin.3 However, three different dermatomal maps are presented within this text. Through personal communication with Standards Committee previous Chairs, the original source relied upon within this text was felt to be Foerster’s 1933 article.28 While Foerster references several previous dermatomal maps detailing spinal innervation of both the dorsum and palmar surfaces of the hand, he also provides pictorial representations of pathologic dermatomal outlines. While not specifically advocating sensory testing on the dorsum of the hand for C6-C8, this report does demonstrate significant variable case presentations of the C8 dermatome involving the palmar aspect of the hand, perhaps presenting some evidence against using this surface.