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Anatomy

Upper Limb

Question 22 of 180

A 32 year old motorcyclist has been brought in following a head on collision with a car. Following initial resuscitation, you are performing a full neurological examination. The C3 dermatome is best tested at which of the following landmarks:

Answer:

The C3 dermatome is best tested in the supraclavicular fossa, at the midclavicular line.

Dermatomal Supply of Upper Limb

Table: Dermatomal Supply of the Upper Limb

Dermatome Landmark
C2 Occipital Protuberance
C3 Supraclavicular Fossa
C4 Acromioclavicular Joint
C5 Lateral Antecubital Fossa
C6 Thumb
C7 Middle Finger
C8 Little Finger
T1 Medial Antecubital Fossa
T2 Apex of Axilla

By Grant, John Charles Boileau (An atlas of anatomy, / by regions 1962) [Public domain], via Wikimedia Commons

Dermatome Map. (Image by Grant, John Charles Boileau (An atlas of anatomy, / by regions 1962) [Public domain], via Wikimedia Commons)

The C2 dermatome is best tested at least one cm lateral to the occipital protuberance at the base of the skull. Alternately, it can be located at least 3 cm behind the ear.

The C3 dermatome is best tested in the supraclavicular fossa, at the midclavicular line.

The C4 dermatome is best tested over the acromioclavicular joint.

The C5 dermatome is best tested on the lateral (radial) side of the antecubital fossa just proximal to the elbow.

The C6 dermatome is best tested on the dorsal surface of the proximal phalanx of the thumb.

The C7 dermatome is best tested on the dorsal surface of the proximal phalanx of the middle finger.

The C8 dermatome is best tested on the dorsal surface of the proximal phalanx of the little finger.

The T1 dermatome is best tested on the medial (ulnar) side of the antecubital fossa, just proximal to the medial epicondyle of the humerus.

The T2 dermatome is best tested at the apex of the axilla.

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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