2. The sensory system evaluation is divided into the following
Superficial sensation :
Pain using pin prick
Touch using a piece of cotton
Temperature using hot and cold test tubes
1- compare both side to detect hemihypothesia
2- search to detect level in ( extra medullary) and search
To detect jack sensory loss in( intramedullary lesion )
3- search to detect stock and glove hypothesia in PN
4- compare different dermatomes ( for radicular sensory
Loss )
Head UL trunk LL
proximal and distal
3. Deep sensation
1- joint sense ( sense of position and movement ) Big toe
2- bone sense : vibration sense
Medial malleolus : represents PN
ASIS : represents Posterior column
Forehead : represents thalamus
3- muscle sense : squeeze calf muscle
4- nerve sense
Romberg sign ..!!
4. Cortical sensations
Tactile localization : localize the site of pin prick over body
Tactile discrimination “ 2-point discrimination “ : localize 2 stimulation pin
pricks , normally they can be felt distinct provided their minimal distance
between them ( 5 mm on finger and 5 cm over back )
Graphosthesia : recognition number or letter drawn on hands
Stereognosis : recognition familiar object in hand (key)
Sensory attention ( perceptual rivalry ) : 2 simultaneous pricks at 2
corresponding sites of body are felt on each side at same moment
