Method Of Exam
Author: A. Chandrasekhar, MD
Consultant: M. Kelly, MD and M. Merchut, MD
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.
Light touch, pinprick, vibration and position sense are intact throughout.