The sensory system examination is divided into evaluating superficial sensation, deep sensation, and cortical sensations. Superficial sensation tests pain, touch, and temperature using pin pricks, cotton, and hot/cold test tubes to detect hemihypothesia, level of lesion, stocking glove patterns, and radicular loss. Deep sensation evaluates joint position, vibration, and muscle strength. Cortical sensations include tactile localization, two-point discrimination, graphosthesia, stereognosis, and sensory attention.

1. neurology
Sensory system Examination
Dr mohamed rizk khodair
lecturer of neurology
October 6 university
Mohamedrizk.med@edu.edu.eg
‫والجراحة‬ ‫الطب‬ ‫كلية‬

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