Enviar búsqueda
Cargar
Sensory Examination
•
182 recomendaciones
•
67,021 vistas
M
meducationdotnet
Seguir
Denunciar
Compartir
Denunciar
Compartir
1 de 23
Descargar ahora
Descargar para leer sin conexión
Recomendados
Examination of motor system
Examination of motor system
8224080546
Cerebellar examination
Cerebellar examination
rzgar hamed
Muscle Power and Tone Examination
Muscle Power and Tone Examination
meducationdotnet
Superficial and deep reflexes!
Superficial and deep reflexes!
Muhammadasif909
Differences UMN lesion vs LMN lesion
Differences UMN lesion vs LMN lesion
Dr Nilesh Kate
Spinal cord syndromes
Spinal cord syndromes
Dr. Mohammed Sadiq Azam M.D.
Upper and lower motor neuron
Upper and lower motor neuron
Muhammad Saim
Part 5 examination of reflex
Part 5 examination of reflex
Atul Saswat
Más contenido relacionado
La actualidad más candente
Cranial nerve examination
Cranial nerve examination
Gagan Gupta
Clinical examination of cranial nerves
Clinical examination of cranial nerves
Oriba Dan Langoya
Tests for shoulder joint
Tests for shoulder joint
Aarti Sareen
Peripheral nerve injuries
Peripheral nerve injuries
Binod Chaudhary
Reflexes - Superficial and Deep tendon reflexes
Reflexes - Superficial and Deep tendon reflexes
Chetan Ganteppanavar
Differences SPASTICITY VS RIGIDITY
Differences SPASTICITY VS RIGIDITY
Dr Nilesh Kate
Examination of sensory system
Examination of sensory system
Dr.Shalu Jain
HIGHER MENTAL FUNCTIONS ASSESSMENT
HIGHER MENTAL FUNCTIONS ASSESSMENT
shuchij10
Cortical sensations
Cortical sensations
Yasser Alzainy
Gait normal & abnormal
Gait normal & abnormal
Ratan Khuman
Sensory Assessment
Sensory Assessment
shuchij10
Superficial reflexes
Superficial reflexes
Kurian Joseph
Part 4 examination of motor and sensory system
Part 4 examination of motor and sensory system
Atul Saswat
DERMATOMES AND MYOTOMES
DERMATOMES AND MYOTOMES
Dr.Monica Dhanani
Neuro Proforma
Neuro Proforma
Dr. Nithin Nair (PT)
Claw Hand,Definition,Causes,Types,Symptoms and Management
Claw Hand,Definition,Causes,Types,Symptoms and Management
Dr.Md.Monsur Rahman
Plantar reflex
Plantar reflex
TONY SCARIA
Special test for dermatomes and myotomes
Special test for dermatomes and myotomes
Tafzz Sailo
Gait abnormalities presentation
Gait abnormalities presentation
Nosheen Almas
Radial nerve palsy
Radial nerve palsy
manoj das
La actualidad más candente
(20)
Cranial nerve examination
Cranial nerve examination
Clinical examination of cranial nerves
Clinical examination of cranial nerves
Tests for shoulder joint
Tests for shoulder joint
Peripheral nerve injuries
Peripheral nerve injuries
Reflexes - Superficial and Deep tendon reflexes
Reflexes - Superficial and Deep tendon reflexes
Differences SPASTICITY VS RIGIDITY
Differences SPASTICITY VS RIGIDITY
Examination of sensory system
Examination of sensory system
HIGHER MENTAL FUNCTIONS ASSESSMENT
HIGHER MENTAL FUNCTIONS ASSESSMENT
Cortical sensations
Cortical sensations
Gait normal & abnormal
Gait normal & abnormal
Sensory Assessment
Sensory Assessment
Superficial reflexes
Superficial reflexes
Part 4 examination of motor and sensory system
Part 4 examination of motor and sensory system
DERMATOMES AND MYOTOMES
DERMATOMES AND MYOTOMES
Neuro Proforma
Neuro Proforma
Claw Hand,Definition,Causes,Types,Symptoms and Management
Claw Hand,Definition,Causes,Types,Symptoms and Management
Plantar reflex
Plantar reflex
Special test for dermatomes and myotomes
Special test for dermatomes and myotomes
Gait abnormalities presentation
Gait abnormalities presentation
Radial nerve palsy
Radial nerve palsy
Destacado
Sensation neurology
Sensation neurology
Hasan Sultan
Motor and sensory examination, Examination of reflexes
Motor and sensory examination, Examination of reflexes
Nahry Omer
Motor System Examination
Motor System Examination
Vib Kaul
Neurological assessment ppt by heena mehta
Neurological assessment ppt by heena mehta
goverment nursing college.
Neurological Examination
Neurological Examination
Richard Brown
,motor examination
,motor examination
Pramod Mahender
Muscle tone munish G B PANT DELHI
Muscle tone munish G B PANT DELHI
Dr. Munish Kumar
Stroke in children
Stroke in children
Lm Huq
NurseReview.Org - The Sensory System
NurseReview.Org - The Sensory System
Nurse ReviewDotOrg
Sensory system
Sensory system
Benz Almasco
Spinal cord& its lesions,compressive myelopathy
Spinal cord& its lesions,compressive myelopathy
govt. medical college, kozhikode
Muscle tone
Muscle tone
PS Deb
Neurological examination
Neurological examination
Nursing Path
Test De Marcha En Adultos Mayores
Test De Marcha En Adultos Mayores
Universidad de Chile
Coordination test
Coordination test
Zakiah'pasha Unes
Sensory revision
Sensory revision
Afnan Elsolia
Neurological assessment sp07 webversion
Neurological assessment sp07 webversion
coolboy101pk
NEUROLOGICAL EXAMINATIONS
NEUROLOGICAL EXAMINATIONS
Ma Wady
Dorsal column
Dorsal column
Haji Khan Khoharo
Scan exam
Scan exam
Physical Therapy Central
Destacado
(20)
Sensation neurology
Sensation neurology
Motor and sensory examination, Examination of reflexes
Motor and sensory examination, Examination of reflexes
Motor System Examination
Motor System Examination
Neurological assessment ppt by heena mehta
Neurological assessment ppt by heena mehta
Neurological Examination
Neurological Examination
,motor examination
,motor examination
Muscle tone munish G B PANT DELHI
Muscle tone munish G B PANT DELHI
Stroke in children
Stroke in children
NurseReview.Org - The Sensory System
NurseReview.Org - The Sensory System
Sensory system
Sensory system
Spinal cord& its lesions,compressive myelopathy
Spinal cord& its lesions,compressive myelopathy
Muscle tone
Muscle tone
Neurological examination
Neurological examination
Test De Marcha En Adultos Mayores
Test De Marcha En Adultos Mayores
Coordination test
Coordination test
Sensory revision
Sensory revision
Neurological assessment sp07 webversion
Neurological assessment sp07 webversion
NEUROLOGICAL EXAMINATIONS
NEUROLOGICAL EXAMINATIONS
Dorsal column
Dorsal column
Scan exam
Scan exam
Similar a Sensory Examination
Examination of Lower Limbs
Examination of Lower Limbs
meducationdotnet
Musculoskeletal Exam
Musculoskeletal Exam
meducationdotnet
Continuation of Cranial Nerve Exam
Continuation of Cranial Nerve Exam
meducationdotnet
Basics of a Clinical Exam
Basics of a Clinical Exam
meducationdotnet
Male Genital Exam
Male Genital Exam
meducationdotnet
Respiratory Exam
Respiratory Exam
meducationdotnet
Rectal Examination
Rectal Examination
meducationdotnet
Abdominal Exam
Abdominal Exam
meducationdotnet
Breast Exam
Breast Exam
meducationdotnet
3. RADIAL NEUROPATHY.pdf
3. RADIAL NEUROPATHY.pdf
DR NIYATI PATEL
Diabetes, Peripheral Neuropathy & How to Conduct
Diabetes, Peripheral Neuropathy & How to Conduct
Trevor Perkes
Otoscopy
Otoscopy
meducationdotnet
Male Ap + Tg Sprague Dawley
Male Ap + Tg Sprague Dawley
Victoria Leon
Examination of a Swelling
Examination of a Swelling
meducationdotnet
Opthalmoscopy
Opthalmoscopy
meducationdotnet
Median nerve injury
Median nerve injury
Dr Chinmoy Mazumder
1. MEDIAN NEUROPATHY.pdf
1. MEDIAN NEUROPATHY.pdf
DR NIYATI PATEL
Carpal tunnel syndrome- short case
Carpal tunnel syndrome- short case
Yapa
Coordination Exam
Coordination Exam
meducationdotnet
Hand 2009 (2) Questions Included Not To Post
Hand 2009 (2) Questions Included Not To Post
Pam Kasyan
Similar a Sensory Examination
(20)
Examination of Lower Limbs
Examination of Lower Limbs
Musculoskeletal Exam
Musculoskeletal Exam
Continuation of Cranial Nerve Exam
Continuation of Cranial Nerve Exam
Basics of a Clinical Exam
Basics of a Clinical Exam
Male Genital Exam
Male Genital Exam
Respiratory Exam
Respiratory Exam
Rectal Examination
Rectal Examination
Abdominal Exam
Abdominal Exam
Breast Exam
Breast Exam
3. RADIAL NEUROPATHY.pdf
3. RADIAL NEUROPATHY.pdf
Diabetes, Peripheral Neuropathy & How to Conduct
Diabetes, Peripheral Neuropathy & How to Conduct
Otoscopy
Otoscopy
Male Ap + Tg Sprague Dawley
Male Ap + Tg Sprague Dawley
Examination of a Swelling
Examination of a Swelling
Opthalmoscopy
Opthalmoscopy
Median nerve injury
Median nerve injury
1. MEDIAN NEUROPATHY.pdf
1. MEDIAN NEUROPATHY.pdf
Carpal tunnel syndrome- short case
Carpal tunnel syndrome- short case
Coordination Exam
Coordination Exam
Hand 2009 (2) Questions Included Not To Post
Hand 2009 (2) Questions Included Not To Post
Más de meducationdotnet
No Title
No Title
meducationdotnet
Spondylarthropathy
Spondylarthropathy
meducationdotnet
Diagnosing Lung cancer
Diagnosing Lung cancer
meducationdotnet
Eczema Herpeticum
Eczema Herpeticum
meducationdotnet
The Vagus Nerve
The Vagus Nerve
meducationdotnet
Water and sanitation and their impact on health
Water and sanitation and their impact on health
meducationdotnet
The ethics of electives
The ethics of electives
meducationdotnet
Intro to Global Health
Intro to Global Health
meducationdotnet
WTO and Health
WTO and Health
meducationdotnet
Globalisation and Health
Globalisation and Health
meducationdotnet
Health Care Worker Migration
Health Care Worker Migration
meducationdotnet
International Institutions
International Institutions
meducationdotnet
Haemochromotosis brief overview
Haemochromotosis brief overview
meducationdotnet
Ascities overview
Ascities overview
meducationdotnet
Overview of the Liver
Overview of the Liver
meducationdotnet
Overview of Antidepressants
Overview of Antidepressants
meducationdotnet
Gout Presentation
Gout Presentation
meducationdotnet
Review of orthopaedic services: Prepared for the Auditor General for Scotland...
Review of orthopaedic services: Prepared for the Auditor General for Scotland...
meducationdotnet
Sugammadex - a revolution in anaesthesia?
Sugammadex - a revolution in anaesthesia?
meducationdotnet
Ophthamology Revision
Ophthamology Revision
meducationdotnet
Más de meducationdotnet
(20)
No Title
No Title
Spondylarthropathy
Spondylarthropathy
Diagnosing Lung cancer
Diagnosing Lung cancer
Eczema Herpeticum
Eczema Herpeticum
The Vagus Nerve
The Vagus Nerve
Water and sanitation and their impact on health
Water and sanitation and their impact on health
The ethics of electives
The ethics of electives
Intro to Global Health
Intro to Global Health
WTO and Health
WTO and Health
Globalisation and Health
Globalisation and Health
Health Care Worker Migration
Health Care Worker Migration
International Institutions
International Institutions
Haemochromotosis brief overview
Haemochromotosis brief overview
Ascities overview
Ascities overview
Overview of the Liver
Overview of the Liver
Overview of Antidepressants
Overview of Antidepressants
Gout Presentation
Gout Presentation
Review of orthopaedic services: Prepared for the Auditor General for Scotland...
Review of orthopaedic services: Prepared for the Auditor General for Scotland...
Sugammadex - a revolution in anaesthesia?
Sugammadex - a revolution in anaesthesia?
Ophthamology Revision
Ophthamology Revision
Sensory Examination
1.
Examination of the Sensory
System In association with Dr David Smith Consultant Neurologist Walton Centre for Neurology and Neurosurgery 10/13/2011 © Clinical Skills Resource Centre, University of Liverpool, UK 110/13/2011 © Clinical Skills Resource Centre, University of Liverpool, UK
2.
The sensory system
1 Sensory information, detected at peripheral receptors, travels via peripheral nerves, nerve roots, spinal cord, brainstem and thalamus to sensory cortex Pain and Temperature sensation carried by small unmyelinated fibres Vibration and Proprioception (joint position) carried by large myelinated fibres 10/13/2011 © Clinical Skills Resource Centre, University of Liverpool, UK 2
3.
The sensory system
2 Pain and Temperature sensation carried in the spinothalamic tract decussates (crosses over) immediately in the spinal cord Vibration and Proprioception (joint position) are carried in the dorsal columns Ascend on the same side of spinal cord cross over in the brain stem 10/13/2011 © Clinical Skills Resource Centre, University of Liverpool, UK 3
4.
10/13/2011 © Clinical
Skills Resource Centre, University of Liverpool, UK 4 Spinal cord section Posterior column ipsilateral (crosses at medulla) proprioception vibration Spinothalamic tract contralateral (crosses at spinal level) pain light touch temperature • Motor supply Anterior corticospinal Lateral corticospinal
5.
Normal sensory examination
Normal sensation allows a patient to detect pain (pinprick) and temperature in whichever area is tested, vibration at tips of fingers and toes joint position (i.e. small amplitude movements ) at distal joints In order to identify abnormality, it is important to know what normal means In someone with no sensory symptoms, it is not essential to examine the sensory system 10/13/2011 5© Clinical Skills Resource Centre, University of Liverpool, UK
6.
sensory pathway Peripheral receptor peripheral
nerves nerve roots spinal cord thalamus sensory cortex Localisation of problems can be determined by knowledge of area of skin supplied by peripheral nerves, sensory dermatomes, decussation of spinothalamic tract and dorsal columns 10/13/2011 6© Clinical Skills Resource Centre, University of Liverpool, UK
7.
10/13/2011 © Clinical
Skills Resource Centre, University of Liverpool, UK 7 Dermatomes of the upper limb C7 C3 C4 C5 C6 C8 T1 T2 C5 C6
8.
10/13/2011 © Clinical
Skills Resource Centre, University of Liverpool, UK 8 Dermatomes of the lower limb S4 S5L1 L2 L3 L4 L5 S1 S2 S3 A dermatome is an area of skin supplied by a single spinal nerve for the modalities of sensation.A knowledge of the dermatomes can help to localise problems involving the spinal cord or nerves
9.
10/13/2011 © Clinical
Skills Resource Centre, University of Liverpool, UK 9 Dermatomes of the trunk C2 C3 C4 T2 T5 T10 V1 V2 V3
10.
10/13/2011 © Clinical
Skills Resource Centre, University of Liverpool, UK 10 Testing light touch Use a wisp of Cotton wool or a fine paint brush Ask the patient to respond when stimulus is detected Dab the skin and then withdraw the stimulus - do not drag the cotton wool across the skin Compare one side with the other
11.
Pain (superficial) Use
a disposable neurotip, pin or unfolded paper clip Do NOT use a hypodermic needle Always dispose of “sharp” safely Explain and show the touching with “sharp” and “blunt” on an unaffected area Test by randomly using sharp and blunt (negative stimulus) noting patient‟s response in each dermatome (always try to apply same pressure) Start distally and move proximally 10/13/2011 © Clinical Skills Resource Centre, University of Liverpool, UK 11
12.
In Clinical Practice
Allow the patient to describe the distribution of altered sensation Demonstrate the nature of test sensation in an area of skin the patient perceives to be normal Test sensation within the area reported to be abnormal Map the extent of altered sensation Decide if this area makes anatomical sense (relates to or associated with a spinal, dermatomal or peripheral /cutaneous nerve pattern of altered sensation. 10/13/2011 12© Clinical Skills Resource Centre, University of Liverpool, UK
13.
Testing Proprioception1 Hold
distal interphalangeal joint of patient‟s great toe/thumb or finger between thumb and index finger of your left hand Make a small amplitude movement of the joint using your right hand to demonstrate „up‟ and „down‟ Repeat with patient‟s eyes closed 10/13/2011 13© Clinical Skills Resource Centre, University of Liverpool, UK
14.
Proprioception 2 If
patient cannot detect small amplitude movements, or makes errors, increase the amplitude of movement If patient cannot detect larger amplitude movements, test proprioception at a more proximal joint (see next slide) 10/13/2011 14© Clinical Skills Resource Centre, University of Liverpool, UK
15.
Proprioception - order
of testing Upper limb distal interphalangeal joint proximal interphalangeal joint, metocarpophalangeal joint Wrist Elbow shoulder Lower limb – interphalangeal joint of the hallux, metatarsophalangeal joint, ankle knee hip 10/13/2011 © Clinical Skills Resource Centre, University of Liverpool, UK 15 Proprioceptive sense tends to decline with age
16.
Testing proprioception 3 (also
see coordination) ask patient to close eyes and stretch arms, then to touch tip of their nose with their index finger. If proprioception is normal this will be done accurately With patient standing, feet approx.20cm apart, and eyes closed, gently push them on chest. If proprioception is intact balance is maintained. This is a negative Romberg's test 10/13/2011 16© Clinical Skills Resource Centre, University of Liverpool, UK
17.
Testing vibration sense
1 With a 128 Hz tuning fork create vibration by either taping it gently against your hand or by pushing the prongs towards one another To avoid reducing the vibration hold at the round thumb rest just under the fork, the flat rest at the base is held against the patient. 10/13/2011 17© Clinical Skills Resource Centre, University of Liverpool, UK Demonstrate on a boney prominence away from the affected area (forehead or sternum for example)
18.
Testing vibration sense
2 Place base of 128 Hz tuning fork on tip of a finger or toe Ask patient „Can you feel that buzzing?‟ If they can not, move proximally, testing vibration sense at bony prominences (hallux, medial malleolus … clavicle) until the vibration is detected 10/13/2011 © Clinical Skills Resource Centre, University of Liverpool, UK 18
19.
Patterns of sensory
loss As with motor examination, the pattern of sensory loss helps to localise a lesion to specific parts of the nervous system The initial distinction is whether the lesion is in the central or peripheral nervous system A good way of achieving this is to recognise patterns of sensory loss caused by spinal cord lesions (central) peripheral neuropathy (peripheral) 10/13/2011 19© Clinical Skills Resource Centre, University of Liverpool, UK
20.
Spinal Cord Lesion
Sensation is lost or altered below the level of the lesion this is called a sensory level The extent of the lesion determines whether the loss of sensation is uni- or bi-lateral Familiarity with cross-sections of the cord and sites of where the main tracts decussate (cross over) will enable you to understand the detail of the pattern of sensory loss. 10/13/2011 © Clinical Skills Resource Centre, University of Liverpool, UK 20
21.
10/13/2011 © Clinical
Skills Resource Centre, University of Liverpool, UK 21 Spinal cord section Posterior (dorsal) column ipsilateral (crosses at medulla) proprioception vibration Spinothalamic tract contralateral (crosses at spinal level) pain light touch temperature • Motor supply Anterior corticospinal Lateral corticospinal
22.
10/13/2011 © Clinical
Skills Resource Centre, University of Liverpool, UK 22 Patterns of sensory loss Complete transverse lesion of the cord Right Loss of proprioception Loss of vibration Loss of temperature Loss of pain Loss of light touch Left Loss of proprioception Loss of vibration Loss of temperature Loss of pain Loss of light touch
23.
Peripheral Neuropathy Loss,
or altered, sensation starts at the end of the longest nerves; i.e. in the toes and spreads proximally The fingers are affected after the toes/feet This produces a “glove and stocking” pattern of sensory loss The type of nerve fibre affected (myelinated, unmyelinated or both) determines which modalities are lost. 10/13/2011 © Clinical Skills Resource Centre, University of Liverpool, UK 23
Descargar ahora