Physiology (sensory examination tests)

1. @OSAMA_Z96
Video :
(Click here)

3. * Components of sensory examination :
1- Primary sensations :
Touch, Pain, Temperature, Vibrations.
2- Cortical sensations :
Localization, 2 points discrimination, Stereognosis, Graphesthesia.
3- Hearing tests :
Weber’s test, Rinne’s test.
4- Vision :
Pupillary light reflexes, Ishihara chart.

4. * Touch test :
1- Instrument used : Cotton or piece of paper.
2- Sensations can be similar on both sides or not.
* Pain test :
1- Instrument used : Pin.
2- If there is feeling without differentiation, this means touch is intact but pain is
lost.
Temperature test :
1- Instrument used : Test tube with hot & cold water.
* Sense of vibration test :
1- Instrument used : 128 frequency Tuning fork.
2- This sense is lost in demyelinating neuropathies.

5. Touch testPain test Sense of vibration test

6. * Sense of localization test :
1- Touch a part of patient body with his eyes closed.
2- Ask him to open the eyes & place his finger of that part.
* 2 points discrimination test :
1- Instrument used : Special calibrated divider (2 points discrimination caliber).
2- Normal sense of 2 point on the pulp of fingers is 2mm, abnormal more than 5mm.
* Stereognosis test :
1- The ability to identify a suitable object after careful palpation.
2- This ability is lost in sensory cortex lesion (astereognosis).
* Graphesthesia test :
1- The ability to recognize a number or letter written in the palm with closed eyes.
2- This ability is lost in sensory cortex lesion (agraphesthesia).

7. Stereognosis test
2 Point Discrimination test Graphesthesia test

8. * Weber's test :
1- Instrument used : 512 frequency Tuning fork.
2- If the hearing is equal on both sides : indicates either normal hearing or equal deafness on
both sides.
3- In unilateral sensory neural deafness, hearing is lateralized to the normal side.
4- In unilateral conduction deafness, hearing is lateralized to the diseased ear.
* Rinne's test :
1- Instrument used : 512 frequency Tuning fork.
2- The fork on mastoid bone or 1cm away from the ear.

9. Rinne's test Weber’s test

10. * Pupillary light reflexes :
1- Instrument used : Light torch
2- Direct pupillary light reflex.
3- Relevant pupillary light reflex.
4- Indirect (consensual) pupillary light reflex.
* Color vision tests :
1- Instrument used : Ishihara chart book.
2- Test for color deficiencies.

11. Ishihara chart book

12. PicturesUsesInstruments
Assessment of
deep tendon reflex
Reflex hammer
Assessment of
touch sensation
Cotton or piece of paper
Assessment of
pain sensation
Pin

13. PicturesUsesInstruments
Assessment of
temperature sensation
Test tube
Assessment of
hearing & vibration sensation
128 frequency Tuning fork
512 frequency Tuning fork
Assessment of
2 point discrimination
Calibrated divider

14. PicturesUsesInstruments
Assessment of
pupillary light reflexes
Light torch
Assessment of
color deficiencies
Ishihara chart book