Sensory system of the upper limbs examination

Question 1

What do you do before starting the examination of the sensory system of the upper limbs?

Answer 1

Introduce yourself to the patient
Confirm name and date of birth
Wash/sanitise hands
Explain examination and obtain consent
Position the patient so that they are comfortably seated.
Ask them to expose their arms, positioning them so that the palms are facing towards you
Ask if they are currently experiencing any pain

Question 2

What do you have to examine when looking at the sensory system?

Answer 2

Inspect the patient
Test light touch
Test 'pain' sensation
Test proprioception
Test vibration sense
Test temperature sense

Question 3

What is a dermatome?

Answer 3

A dermatome is an area of skin supplied by a single spinal nerve for the modalities of sensation

Question 4

How would a syringomyelia effect an examination of the sensory system of the upper limbs?

Answer 4

It would cause a loss of pain and temperature sensation but not of other sensory modalities

Question 5

How would Brown-Śequard syndrome affect an examination of the sensory system of the upper limbs?

Answer 5

It would cause a numbness to touch and vibration and loss of proprioception (and weakness) on same side of the lesion, and loss of pain and temperature sensation on the opposite side

Caused by lateral hemisection or injury of the spinal cord

Question 6

How would radiculopathy affect an examination of the sensory system of the upper limbs?

Answer 6

Lesion would affect sensation of a single root nerve e.g. C6

Question 7

How would a polyneuropathy effect an examination of the sensory system of the upper limbs?

Answer 7

Lesion affecting multiple nerves in a glove and stocking distribution, such ha in diabetic neuropathy

Question 8

What is glove and stocking distribution?

Answer 8

Peripheral neuropathy is often described as having a “glove and stocking” distribution of symptoms, because the symptoms are often present in the areas covered by gloves or stockings

Question 9

How would a mononeuropathy effect an examination of the sensory system of the upper limbs?

Answer 9

Lesion affecting a single nerve e.g. ulnar, median, or radial nerve

Question 10

What size tuning fork do you use for testing vibration sensation?

Answer 10

128 Hz tuning fork