Practical Exam Steps Flashcards
Differentiating dermatomes from peripheral nerves locations UE
AC Joint
Lateral antecubital fossa
Dorsal thumb
palmar surface of middle finger
palmar surface of 5th finger
medial antecubital fossa
AC Joint
C4, supraclavicular N
Lateral antecubital fossa
C5, lateral cutaneous
Dorsal thumb
C6, radial
Palmar surface of middle finger
C7, median
Palmar surface of 5th finger
C8, ulnar
Medial antecubital fossa
T1, medial cutaneous
Differentiating dermatomes from peripheral nerves locations LE
Lateral upper thigh
medial knee
medial malleolus
dorusm of 3rd MTP
web space btwn 1st and 2nd MTP
Lateral heel
Medial posterior knee/thigh
Lateral upper thigh
L2, lateral femoral cutaneous
Medial knee
L3, anterior femoral cutaneous
medial malleolus
L4, saphenous
Dorsum of 3rd MTP
L5-S1, superficial peroneal
Web space btwn 1st and 2nd MTP
L5, deep peroneal
Lateral heel
S1, sural N
Medial posterior knee/thigh
S2, posterior femoral cutaneous
Documentation of Differentiating dermatomes from peripheral nerves locations
Describe the area of impaired sensation using intact, impaired, absent
Describe the pattern of loss
Differentiating dermatomes from peripheral nerves locations steps
Demonstration with eyes open, pt answers with “yes”
testing with eyes closed
apply light touch to each of key areas, alternate between sides
vary the rhythm
once area of impairment is found, apply 5+ stimulus to determine a pattern
Pin Prick Testing
Testing ability between sharp and dull stimuli, done after dermatome/peripheral nerve
Do demonstration with eye open, answer should be sharp or dull
apply sharp and dull stimulus 5 times
once an area of impaired sensation is found, apply only sharp from center of impaired to outwards.
ask patient to say when the stimulus changes
Documentation of pin prick test
describe the area of impaired sensation using intact, impaired, or absent
describe the pattern of loss, figure out if its a peripheral nerve, nerve root, neither
Vibration testing steps
explain that you’ll be testing pt ability to sense vibration
pt should be focusing on vibration not tuning fork
demonstrate with eyes open
testing with eyes closed
hold tuning fork by base and hit firmly against hand
place base of tuning fork against pt’s skin
squeeze the prongs to stop vibration, vary length of stimulus
Documentation of vibration testing
Describe the area of impaired sensation using intact, impaired, or absent
indicate the location and side of deficit
Proprioception test steps
Explain to the pt that you will be testing their ability to sense relative position of their joints in space
ask pt to respond up or down in response to passive movements
practice trial with eyes open
testing with eyes closed
hold digit or limb by lateral aspects, soft tissue that is crossing the joint you are testing
perform at least 5 movements in a random order
for a peripheral lesion, if distal is intact, you can assume its intact proximally
Proprioception documentation
testing the DCML
identify limb tested
note the # of correct responses out of 5
position sense may be described as intact, impaired, absent
Sensory Extinction Test
Explain that you will be testing their ability to identify simultaneous light touch on different parts of body
ask pt to respond to right, left, both
practice trial with eyes open
closed eyes testing
alternate randomly between unilateral and bilateral simultaneous light touch
equal in force
5 simultaenous stimuli at least
light touch sensation and language production should be tested beforehand
Documentation of sensory extinction
testing DCML, contralateral post parietal cortex
document whether sensation of simultaneous touch is either intact, impaired, absent
Stereognosis Test steps
explain to pt that you will be testing their ability to identify objects placed in hand with manipulation
perform practice trial on area w/known intact area
Light touch sensation should be completed prior
Eyes should be closed
place a common household object in pts hand, identify it
assess bilaterally
3 trials per side, different objects
Stereognosis documentation
testing DCML, somatosensory cortex, contralateral posterior parietal cortex
identify limb tested
note the # of correct responses out of 3 (total 6) and list objects used/identified
intact, impaired, absent
Graphesthesia testing steps
Explain that you will be testing their ability to identify letters and #s drawn on palm of hand
practice test with eyes open
Light touch sensation and language need to be intact
test with eyes closed
inform pt that you’ll be drawing letters or numbers with finger or pen
assess bilaterally
perform at least 5 trials per side
Documentation of Graphesthesia
testing DCML, S2, contralateral posterior parietal cortex
identify limb tested
note the number of correct responses out of 5 (total of 10)
describe as intact, impaired, absent
