Sensory Examination

Question 1

Dermatomal testing from C2- T10

Light Touch or Pin prick

Answer 1

Pin Prick

• Eyes open and prick skin gently with neuro tip an get paitent to see if they can feel and describe
• Close eyes
• Prick over dermatomal pathway and map for decrease sensitivity and pain

C2: Jaw line both angles

C3:Sternal Notch

C4: Shoulder Tips

C5: Outer Arms

C6: forearm and thumb

C7: Middle fingers

C8: Little finger both dies

T1: Inner forearm

T2: Inner arm

T3-T12: Chest Abdomen both sides

Question 2

Dermatomal testing from L1 – S3

Answer 2

Pin Prick

Eyes open and prick skin gently with neuro tip an get paitent to see if they can feel and describe

Close eyes

Prick over dermatomal pathway and map for decrease sensitivity and pain

L1: ASIS both sides

L2: Front of Thigh both sides

L3: knee

L4: mid anterior calf

L5: anterior of leg

S1: little toe both sides

S2: Back of thigh both sides

S3: Buttocks both sides

Question 3

Sensory cortical tests

Answer 3

Stereognosis - place a familer object in the pt’s hand and get them to identify

Graphaesthesia - outline a number on the pt’s palm and get them to identify

Two point discrimination - two point random touch and get them to say one or two

Question 4

Joint position sense and passive movement tests

Answer 4

Joint position sense

• close eyes
• place a limb in a position
• return to neutral
• get pt to mimic
• do both sides

Place fingers in different positions and get them to touch with eyes closed

Get pt to place finger on nose - eyes closed

Passive Movement

Tell the patient to close her eyes, and hold the thumb or finger on the medial and lateral side. Move the phalanx up and down and ask her if it is moving, and in which direction. If an error is made, repeat the test until 6 successive correct answers are given, or until the defect is firmly established. Move from distal to more proximal joints

Question 5

Vibration Sense

Answer 5

A 128Hz or 256Hz tuning fork is set to vibrate and placed on the clavicle of the patient (eyes open). He is asked if he feels it, what he is feeling and when it stops

The patient then closes the eyes. The vibration is applied at the shoulder tip, elbow, radial bone near the base of the thumb and on the pulp of the index finger. In the lower limb, it is applied to the ASIS, medial knee, medial maleolus of the ankle and the pulp of the big toe. The two sides are compared.

Question 6

Beevors Sign

Sensory: light touch and pain

Answer 6

Movement of the umbilicus upwards or superiorly when the neck is flexed or the patient is asked to sit up. This indicates weakness in the lower abdominal muscles.