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| Root | Sensation | Index Muscle | Reflex | Comments |
|---|---|---|---|---|
| C3/4 | Pain or hypalgesia in shoulders | Paresis of diaphragm, occasionally rhomboids | None | C3 anterior diaphragm, C4 posterior diaphragm |
| C5 | Pain or hypalgesia laterally over upper arm and shoulders | Paresis of deltoid, supraspin-atus, infra- spinatus, rhomboids | Diminished biceps reflex | Common causes include brachial neuritis, upper plexus injury, cervical spondylosis |
| C6 | Pain or hypalgesia of radial forearm, thumb, and index finger | Paresis of biceps, brachialis, brachiorad-ialis, Extensor carpi radialis | Diminished biceps, brachiorad ialis reflex | Common causes include spondylosis, acute disc lesion (20%) |
| C7 | Pain or hypalgesia over triceps, mid- forearm and middle finger | Paresis of triceps, latissimus dorsi, pectoralis major, ext. carpi ulnaris , flex. carpi radialis | Diminished or absent triceps reflex | Common causes includes acute disc lesions (70%), spondylosis, DDX includes CTS (triceps reflex present) |
| C8 | Pain or hypalgesia over ulnar forearm, 4th/5th digits | Paresis of flex. dig. sup. & profundus, flex. poll. longus, flex. carpi ulnaris | Diminished finger jerk (Hoffmans or Tromner) | Caused rarely by spondylosis or acute disc lesion; DDX includes ulnar nerve palsy |
| T1 | Pain or hypalgesia from axilla to olecranon | Paresis of all small hand muscles and hypothenar wasting | None | Common causes include outlet syndrome, pancoast tumor, metastatic Ca of deep cervical nodes |
| L3 | Pain or hypalgesia across upper anterior thigh | Paresis of quadriceps femoris | Patellar reflex decreased or absent | DDX includes femoral nerve palsy |
| L4 | Pain or hypalgesia from lateral thigh, over patella to medial calf and inner foot | Paresis of quadriceps femoris, and tibialis anterior | Patellar reflex diminished | 5% lumbar discs, DDX includes femoral nerve palsy |
| L5 | Pain or hypalgesia from postero-lateral thigh to lateral calf to dorsum of foot | Paresis of EHL, occ EDB | Posterior tibial reflex decreased; useful only if elicitable on other side | 40% lumbar discs; DDX includes peroneal nerve palsy |
| S1 | Pain or hypalgesia from posterior thigh down to lateral aspect and sole of foot | Paresis of triceps surae, hamstrings, gluteus maximus | Achilles tendon reflex decreased | 45% lumbar discs |
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