TEXT FOLLOWING LAST PHOTO
LEFT ARM
LEFT ARM
LEFT ARM
LEFT CERVICAL
LEFT SACRAL MALE
LEFT SACRAL MALE
LEFT SACRAL MALE
LEFT SACRAL MALE
LEFT THORACIC MALE
LEFT THORACIC MALE
LEFT THORACIC MALE
RIGHT THORACIC FEMALE
RIGHT THORACIC MALE
RIGHT THORACIC MALE
RIGHT THORACIC MALE
RIGHT THORACIC MALE
RIGHT THORACIC MALE
RIGHT CERVICAL
RIGHT CERVICAL
RIGHT CERVICAL
SENSORY DERMATOMES FREE DICTIONARY
| Instead of a diagnostic test this month, I decided to demonstrate the many images of HVZ. Please note the last group of images, "right cervical" group, which appears to be involvement of C3 (?and C4), and which, as the accompanying map of the sensory dermatomes demonstrates, illustrates the presence of C3 down onto the chest. This is a fact easy to forget for those of us who only visit the land of sensory dermatomes infrequently, unlike the neurologists and neurosurgeons who live there; in fact, I forgot it as recently as last week when I decided a woman who had complaints of arm paresthesias from a neck injury after a fall crossing the street had an "unanatomic" sensory loss because she had decreased sensation on her arms but a sensory level from her face caudad that I demarcated to her upper chest, a level which I mistakenly assumed was T2, which would have been below the level of C5-7 which her arm paresthesias would suggest. In fact she had a C1 fx and an evolving central cord syndrome! Fortunately, I was more thorough than I was smart and ordered the CT anyway. She was admitted to neurosurgery and will be the focus of a future image of the month. |
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