Method Of Exam

• Test light touch with a wisp of cotton.
• Test pain sense with a blunted, disposable safety pin or splintered cotton tip applicator.
  For light touch and pain:
  • Have patient close eyes and report each test stimulus.
  • Test over sides of each foot, leg, thigh, hand, forearm and arm.
  • Compare the right and left and distal with proximal.
  • Test the trunk where indicated.
• Test position sense by moving the toe or finger up and down, held by its sides, and have the patient report its position with eyes closed.
• Vibration sense is tested with a vibrating tuning fork placed over bony prominences of the feet (ankles) and hands (knuckles).
• Ask the patient to report when the vibration sense is lost.
• Sensation is tested by comparing the right and left sides
• In cases of suspected root or nerve lesions, sensation in a dermatomal or peripheral nerve distribution is carefully tested.
• If a spinal cord lesion is suspected, check for sensory loss over the trunk and sacral areas.

Normal:

• Light touch, pinprick, vibration and position sense are intact throughout.