Important dermatomes and anatomical landmarks
The cutaneous innervation over the medial aspect of the elbow is represented by which dermatome?
| A |
C5 |
|
| B |
C6 |
|
| C |
C7 |
|
| D |
T1 |
The cutaneous innervation over the medial aspect of the elbow is represented by which dermatome?
| A |
C5 |
|
| B |
C6 |
|
| C |
C7 |
|
| D |
T1 |
The area of skin supplied by a single spinal (segmental) nerve is known as a dermatome. The medial surface of the upper arm is supplied by the T2 dermatome, and the medial aspect of the lower arm, elbow, and proximal forearm by the T1 dermatome. The T1 and T2 dermatomes frequently receive referred pain from the heart.
Little finger of the hand corresponds to which dermatome?
| A |
C6 dermatome |
|
| B |
C7 derma tome |
|
| C |
C8 dermatome |
|
| D |
T1 dermatome |
Little finger of the hand corresponds to which dermatome?
| A |
C6 dermatome |
|
| B |
C7 derma tome |
|
| C |
C8 dermatome |
|
| D |
T1 dermatome |
C i.e. C8 dermatome
According to International Standards for Classification of Spinal Cord Injury (ISCSCI) dorsal surface of proximal phalanx of thumb corresponds to C6, middle finger to C7 and little finger to C8.
A 45 year old male has multiple grouped vesicular lesions present on the T10 segment dermatome associated with pain. The most likely diagnosis is
| A |
Herpes zoster |
|
| B |
Dermatitis herpetiformis |
|
| C |
Herpes simplex |
|
| D |
Scabies |
A 45 year old male has multiple grouped vesicular lesions present on the T10 segment dermatome associated with pain. The most likely diagnosis is
| A |
Herpes zoster |
|
| B |
Dermatitis herpetiformis |
|
| C |
Herpes simplex |
|
| D |
Scabies |
A i.e. Herpes zoster
Nerve root for dermatome supplying thumb and index finger:
| A |
C6 C7 |
|
| B |
C6 C6 |
|
| C |
C7 C8 |
|
| D |
C5 C6 |
Nerve root for dermatome supplying thumb and index finger:
| A |
C6 C7 |
|
| B |
C6 C6 |
|
| C |
C7 C8 |
|
| D |
C5 C6 |
Ans. b. C6 C6
vesicles over erythematous plaques in T3 dermatome region of trunk. Which of fle following would be the most likely causative or:,tn?
| A |
Varicella zoster |
|
| B |
Herpes simplex |
|
| C |
Pox virus |
|
| D |
Papilloma virus |
vesicles over erythematous plaques in T3 dermatome region of trunk. Which of fle following would be the most likely causative or:,tn?
| A |
Varicella zoster |
|
| B |
Herpes simplex |
|
| C |
Pox virus |
|
| D |
Papilloma virus |
Ans. a. Varicella zoster
A 60-year-old male presents with painful, grouped vesicles over erythematous plaques in T dermatome region of trunk. Varicella zoster is the most likely causative organism.
A middle-aged male presents with multiple painful blisters on a erythematous base along the T3 dermatome on the trunk. Which of the following etiological agent is most likely to be implicated?
| A |
Varicella zoster |
|
| B |
Herpes simplex |
|
| C |
Human papilloma virus |
|
| D |
Pox virus |
A middle-aged male presents with multiple painful blisters on a erythematous base along the T3 dermatome on the trunk. Which of the following etiological agent is most likely to be implicated?
| A |
Varicella zoster |
|
| B |
Herpes simplex |
|
| C |
Human papilloma virus |
|
| D |
Pox virus |
Ans. a. Varicella zoster
Herpes Zoster
- Caused by Varicella Zoster (chicken pox) virusQ one attack gives life long immunity
- Thoracic nerves (intercoastal nerves)Q, ophthalmic division of trigeminal nerve and other spinal nerves are most commonly affectedQ
Pathology:
- Ballooning is characteristicQ
Clinical Features:
- Prodrome of segmental pain begins 1-4 days before the eruptionQ, erythema and edema is rapidly followed by appearance of grouped vesicles unilateral and in a segmental distribution (MC thoracic dermatome)Q, mucous membrane within the affected dermatome may be involved
- Unilateral vesicular eruption within a dermatome associated with severe pain
- The dermatome from T3 to L3 are most frequently involve
Complications:
- Post-herpetic neuralgia° (persistent neuralgic pain)
- Corneal ulcer and scarring (zoster of ophthalmic division of trigeminal nerve), eye involvement is indicated when vesicles are present on the side of nose- Hutchinson’s signQ
Herpes Zoster
Variants:
- Ramsay Hunt Syndrome: H. zoster involving sensory branch of facial nerveQ
- Zoster opthalmicus: H. zoster involving ophthalmic division of trigeminal nerve .Q
Herpes simplex:
- Painful, cluster of vesicles on face
- Recurrent
- Two types:
- Type I: Oral lesions seen in childhood
- Type II: Genital lesions (is STD and carcinogenic) in young adults usually after sexual contact.
