Sensory Assessment

Question 1

What is the importance of somatosensory function in the clinical setting?

Answer 1

It is crucial for assessing and diagnosing sensory impairments.

Question 2

What are the common tests of the somatosensory system used in the clinical setting?

Answer 2

Tests include…

• touch awareness,
• sharp/dull discrimination,
• temperature sensation,
• vibration sense,
• proprioception,
• combined cortical sensations

Question 3

What functions does the anterolateral (spinothalamic) pathway serve?

Answer 3

• Pain
• Temperature
• Crude touch sensations

Question 4

What functions does the dorsal column-medial lemniscus (DCML) pathway serve?

Answer 4

It is responsible for light touch, two-point discrimination, pressure, vibration, proprioception, barognosis, graphesthesia, texture recognition, and stereognosis.

Question 5

What are the types of superficial sensations?

Answer 5

• Pain (sharp/dull)
• Touch awareness
• Temperature
• Pressure

Question 6

What are the types of deep sensations?

Answer 6

Kinesthetic awareness, proprioception, and vibration.

Question 7

What are the types of combined cortical sensations?

Answer 7

Stereognosis, tactile localization, two-point discrimination, double simultaneous stimulation, graphesthesia, and barognosis.

Question 8

What are the key considerations before starting a sensory exam?

Answer 8

Assess patient’s ability to participate, check arousal and orientation, request patient not to guess, and ensure the patient is in a comfortable position.

Question 9

Why is it important to eliminate vision during sensory tests?

Answer 9

To ensure that the patient’s responses are based on sensory perception rather than visual cues.

Question 10

How can you prevent a patient from anticipating stimuli during a sensory test?

Answer 10

By presenting the stimuli in a randomly variable sequence.

Question 11

What is the procedure for testing touch awareness and tactile localization?

Answer 11

Apply light touch to the skin and ask the patient to respond when they feel the touch and to identify the location of the touch.

Question 12

What is the procedure for the sharp/dull test and its interpretation?

Answer 12

Use a sharp and a dull object to apply to the skin, ask the patient to identify each stimulus, and interpret responses based on accuracy and consistency.

Question 13

What is the procedure for the temperature test and its interpretation?

Answer 13

Use test tubes filled with warm and cool water, apply to the skin, ask the patient to identify the temperature, and interpret based on accuracy of identification.

Question 14

What is the procedure for testing tactile threshold (pressure) and its interpretation?

Answer 14

Use a monofilament aesthesiometer, apply to the skin, ask the patient to respond to the touch, and interpret based on the filament force required for perception.

Question 15

What is the procedure for testing joint movement sense?

Answer 15

Move the patient’s joint and ask them to identify the direction of movement.

Question 16

What is the procedure for testing joint position sense?

Answer 16

Move the patient’s joint to a position and ask them to match the position with the opposite limb or describe the position.

Question 17

What is the procedure for testing vibration sense and its interpretation?

Answer 17

Apply a vibrating tuning fork to bony prominences, ask the patient to identify if it is vibrating, and interpret based on accuracy of responses.

Question 18

What is the procedure for the two-point discrimination test and its interpretation?

Answer 18

Use calipers to apply two points to the skin, ask the patient to distinguish between one and two points, and interpret based on the minimum distance at which two points are perceived as separate.

Question 19

What is the procedure for the bilateral simultaneous touch test and its interpretation?

Answer 19

Touch one or both sides of the body, ask the patient to identify the side touched, and interpret based on accuracy of identifying unilateral and bilateral stimuli.

Question 20

What is the procedure for the graphesthesia test and its interpretation?

Answer 20

Draw a letter or number on the patient’s palm, ask them to identify it, and interpret based on accuracy.

Question 21

What is the procedure for the stereognosis test and its interpretation?

Answer 21

Place an object in the patient’s hand, ask them to identify it by touch, and interpret based on accuracy.

Question 22

How does sensory testing aid in differential diagnosis?

Answer 22

It helps localize the extent and site of lesions, supporting or rejecting differential diagnoses.

Question 23

What are the grading scales used in sensory examination forms?

Answer 23

0 = absent, 1 = impaired, 2 = normal, NT = not testable.

Question 24

How do you document normal, impaired, and absent sensation?

Answer 24

Normal: 5/5 correct; Impaired: 3-4/5 correct or different intensity; Absent: 0-2/5 correct or no sensation.

Question 25

Why is it important to vary timing during superficial sensory testing?

Answer 25

To minimize patient guessing and ensure accurate responses.

Question 26

What is the importance of combining sensory tests with other neurological exams?

Answer 26

To gather comprehensive data supporting accurate diagnosis and treatment planning.

Question 27

What is the normal monofilament interpretation for pressure?

Answer 27

2.83

Question 28

What is the pressure the filament for pressure that is considered loss of protective sensation?

Answer 28

5.07

Question 29

What is the filament for pressure that is considered marked sensory loss?

Answer 29

6.10

Question 30

For interpretation of vibration examination what is it primarily testing?

Answer 30

A(beta) peripheral nerve fibers and the DCML