PERIPHERAL NERVOUS SYSTEM DERMATONUES CGN: (1) Begin with he diagram at let, depicting sensory innervation ofan area of skin {aermatome) anc the degree of over among contiguous spinal nerve cutaneous branches and the dermatomes they supply. Color aray he tree spiral nerves and the rectangular borcers ofthe telaled dermatomes. Note the overap. (2) Use very ight color forth fv groups of dermatomes. Use one color fora dermatomes with the lei V, another cole for he dermatomes marked wih 3 C. and g0 on with TL, and S, Suggestion: carefully eutine he collation of © dexmstomes withthe Celor used for C, then coer inthe enclosed area, focusing oa the skin areas eewvices by the felated spinal nerve: repeat wit TL, and cermatomes SPIMVAL MERVEs+ PSRMATOME' CUTANEOUS [NERVE OVERLAP ooStap poe (Cometare) DERMATOMES OF TRIGERIDAL MUSRBUEy Yiowey CERVICAL HERVES, GB°GBa TWORACIE WERVES: PAaeTAQs LUMBAR NERVES. b2°aS- Midate SAECRAL WERVES. Sa S5> Vinge ont kB | dermatome is an area of skin (cutaneous area) supplied by the sensory axons ‘ot a single spina! nerve or @ single division of the trigeminal (V cranial) nerve. The body surlace is globally covered by sensory receptors. The dermatomes constitule ‘a map of cutaneous innervation. Testing of general sensations (hot, cold, touch, pressure) and pain can help determine deficits in specitic dermatomes. The accu: racy o! dermatomal representation has been corroborated in cases of spinal sen. sory 1oot/nerve deficit (radiculopathy), trigeminal nerve initation (tigeminal neuralgia}, and spinal cord deticts (myelopathy) In the case of spinal nerves and the trigeminal nerve, there is overlap among ‘cutaneous branches of neighboring sensory axons. Thus, two branches of dilferent spinal nerves or divisions ofthe trigeminal nerve cover the border zone between pairs of contiguous dermatomes. In the case of pain, itis important io understand that dermatomes relect only cutaneous pain and pain referred to the skin (e.g. visceral pain, spinal or rigeminal sensory nerve root pain). Commonly, pain of visceral origin may be reterred to Cutaneous areas served by the same spinal sensory nerve(s) as those supplying the visceral structure. For example, the pain ofan inflamed lining ofthe lung (leu risy), which is innervated by C3~C5 spinal nerves (phrenic nerve), may be felt dur ing deep inspiration in the cervical dermatomes C3~C5 (usually long the supraclavicular nerve distibution), Finally, note that (1) C1 has no dermatome because It has no sensory root; (2) G4 and 12 dermatomes overlap the chest wall because the spinal nerves C5-T1 are largely committed to the upper limb; and (3) the same is true in the low back and perineum with respect to spinal nerves L4-S2, which are largely committed 10 the lower ib. ANTERIOR rea ot ingots igament| 90 i, . Posterior 3 VIEW Shovider ca > 2 —_ \ Prantar (ator Fostsor)