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Questions Answered: 26

Final Score 46%

12
14

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Anatomy

Lower Limb

Question 15 of 180

The L5 dermatome is best tested at which of the following landmarks:

Answer:

The L5 dermatome is best tested on the dorsum of the foot at the third metatarsophalangeal joint.

Dermatomal Supply of Lower Limb

Table: Dermatomal Supply of the Lower Limb

Dermatome Landmark
L1 Upper Anterior Thigh
L2 Mid Anterior Thigh
L3 Medial Femoral Condyle
L4 Medial Malleolus
L5 Dorsum 3rd MTP Joint
S1 Lateral Heel
S2 Popliteal Fossa
S3 Ischial Tuberosity
S5 Perianal Area

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 T12 dermatome is best tested at the midclavicular line, over the midpoint of the inguinal ligament.

The L1 dermatome is best tested  on the upper anterior thigh, at a point midway between the key sensory points for T12 and L2.

The L2 dermatome is best tested on the  anteromedial thigh, at the midpoint drawn on an imaginary line connecting the midpoint of the inguinal ligament and the medial femoral condyle.

The L3 dermatome is best tested at the medial femoral condyle above the knee.

The L4 dermatome is best tested over the medial malleolus.

The L5 dermatome is best tested on the dorsum of the foot at the third metatarsophalangeal joint.

The S1 dermatome is best tested on the lateral aspect of the calcaneus.

The S2 dermatome is best tested at the midpoint of the popliteal fossa.

The S3 dermatome is best tested over the ischial tuberosity or infragluteal fold (depending on the patient their skin can move up, down or laterally over the ischii).

The S4/S5 dermatome is best tested in the perianal area, less than one cm lateral to the mucocutaneous junction.

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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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