Sensory Nerve Function Assessment

ASSESSMENT OF SENSORY NERVE FUNCTION(done with client's eyes closed)

Superficial pain
Prick with sterile needle
Have client identify whether sharp or dull
Temperature
Two test tubes: one filled with hot water, the other with cold water
Client identifies hot versus cold sensation and where it is felt
Light touch
Cotton ball; apply light wisp of cotton to different surface points;
Client identifies when touched
Vibration
Low pitched tuning fork
Apply to distal interphalangeal joint of finger then toe,
Client identifies when vibration stops
Position
Grasp client's finger or great toe, holding by its sides
Client identifies if moving up or down
Two-point discrimination
Two safety pins
Apply lightly and simultaneously to two different places on skin's surface.
Usually start with finger pads,
Find minimal distance at which client can discriminate one from two points, normally <5mm on finger pads;
Client identifies when can discriminate one from two points
Stereognosis
Use coin or paper clip or any familiar object with client's eyes closed
Client identifies object to identify by touch and manipulation
Graphesthesia (number identification)
Number is traced on the client's palm by a blunt object
Client identifies number
Extinction
Corresponding areas on both sides of body are simultaneously stimulated
Client identifies where touched