Sensory Examination Procedures

Sensory examination procedures UNDERSTANDING a. Sensibility examination is a neurological examination that includes: b. Examination of tactile sensation (touch) c. Examination of superficial pain sensation d. Temperature sensation examination e. Examination of movement and position sensation f. Vibration sensation examination g. Test sensation of pressure. OBJECTIVE The sensibility examination aims to determine the sensory function of the nervous system POLICY Carrying out physical examinations and special actions as a result of collaboration PROCEDURE Preparation Examination of tactile sensation (touch) a. Soft brush b. Cloth c. Tissue d. Hair e. Touch the skin using your fingertips very gently Examination of superficial pain sensation a. Ordinary sewing needle b. A needle that has two blunt and sharp ends c. You can also use a needle in a reflex hammer Temperature sensation examination a. Metal tube containing cold water (5 - 10°C) b. Metal tube containing hot water (40 -50°C) Examination of movement and position sensation Does not require special equipment Vibration sensation examination a. Tunnel 128A or b. Tuning fork 256 Hz Test sensation of pressure. a. Any blunt object, you can also use your fingertips b. For quantitative examination use an aesthesiometer or piesimeter Procedure: PRE-INTERACTION STAGE 1) Assess patient needs according to related actions 2) Tools are fully prepared 3) The device is brought closer to the patient 4) Wash your hands properly ORIENTATION STAGE 1) Therapeutic greetings are delivered in a friendly manner 2) Correctly identify the patient* 3) The purpose of the action is conveyed correctly 4) Action procedures are conveyed correctly 5) Action steps are presented briefly 6) The required time is provided 7) Give clients the opportunity to ask questions 8) The patient's privacy environment is prepared WORK STAGE 1) Examination of tactile sensation (touch) 2) Encourage the patient to lie in a supine position 3) The area of skin induced by tactile stimulation must be free from hair because the 4) 5) 6) 7) 8) hair will move along with the stimulation, resulting in interpretation bias. Instruct the patient to close his eyes and relax Carry out left an examination a soft brush, bristle, cloth or tissue on the patient's right and skin (arm/leg)using alternately Ask the patient to answer "yes" or "no" if they feel or do not feel any stimulation Also patient intothe statelocation the location each between stimulus,the andtwo askpoints. the patient to stateask thethe difference of the ofstimuli Interpretation of tactile sensation examination results: Abnormality of Results Term Disturbance of sensation (confusion) anesthesia, hypoesthesia, Abnormalities for any tactile sensation in the hair trichoanesthesia Abnormalities when mentioning the location of the stimulus topoanesthesia Abnormalities in any light tactile sensation thigmanesthesia Mistakes in pronouncing letters scratched on the surface of the skingraphanesthesia Examination of superficial pain sensation a. Instruct the patient to close his eyes without pressing b. Try the tool on the examiner first c. Perform an examination on the right and left sides of the patient's body randomly d. Carry outwithout the examination using a sharp or blunt tip of the instrument which is used carefully causing bleeding or injury e. Ask the patient to answer whether the stimulus given is sharp or dull. f. Ask the patient to answer regarding the level of sharpness of the stimuli given. g. Ifrepeat an abnormality in the sensation of decreased intensity from the area where the sensation decreased to theis found, normalthe areaexaminer must h. Ifexaminer an abnormality in thefrom sensation of increased intensity ofsensation sensitivitybegan is found, the must repeat the area where the increased to the normal area. i. Interpretation of the results of examination of superficial pain sensations Results Term Not sensitive to stimuli Alganesthesia or Analgesia Decreased sensitivity to stimuli Hypalgesia Increased sensitivity to stimuli Hyperalgesia Temperature sensation examination a. Instruct the patient to close his eyes without pressing b. Try the tool on the examiner first c. Perform an examination on the right and left sides of the patient's body randomly d. Carry injuryout the examination using a metal tube carefully without causing injury or e. Normal results: can differentiate between hot and cold sensations Examination of movement and position sensation General principles: a. The sensation of motion is also referred to as “kinetic sensation” or “active/passive motion sensation”. b. The of movement describes awareness of the movement of each partterm of thesensation body relative to other parts of one's own body. c. The terms position posture sensation describe awareness of the body's movement towardssensation where it isorstanding. d. The term “arteresthesia” for theawareness perceptionof ofbody anyposture. joint movement and “statognosis” is a term thatis used describes e. Perception of body movement depends on joint movement and muscle tension. f. Normal are able to feel differences in interphalangeal joint movement betweenpeople 1-2 degrees. g. The purpose ofdirection the examination is to obtain the patient's response tothe his minimum perception ofangle movement, of movement, strength, range of movement, he can feel, and the patient's ability to name the location of his fingers. Procedure: a. This inspection does not require special equipment. b. The patient's eyes are closed, the patient is in a supine or sitting position. c. The patient's fingers free andpressing relaxedtheandfingers. can be moved passively by the examiner, touch themshould gentlybewithout d. The fingers being examined should not move, and be free from other fingers. e. The patient will be asked whether or not there is movement in the finger being examined. f. Ifthethere is an abnormality inanother, the sensation of movement, theforexaminer must repeat examination again on larger area of the body, example the leg or arm. g. Another way to examine is toeyes; placethen thethe finger being examined in a certain position while the patient closes his same finger on the other hand is asked to imitate the position determined by the examiner on the finger of the previous hand. Vibration sensation examination a. Vibrate the tuning fork by striking your fingers against a hard object. b. Place the spokes of the tuning fork as soon as possible on the area of the bone checked. c. Observe the intensity and duration of the vibration. d. Both the intensity and duration of thetime vibration depend on the strength of the vibration and “hitting” and sticking intervals.” e. e.patient Results: Normal if them the patient can vibrations feel maximum vibrations, especially if the can still feel when the have decreased, an abnormal condition is called palanesthesia, namely if the patient cannot feel any vibrations. Test sensation of pressure. General principles: a. This is also called piesthesia. b. The sensation of pressureofis pressure closely related the tactilearea. sensation, but is also related to the perception over theto subcutis c. The sensationcolumns of pressure is also the posterior of the spinalclosely cord.related to the sensation of position through d. Procedure: e. The patient is in a supine position, eyes closed. f. Press a blunt object against a muscle or tendon. g. Ask the patient if there is any pressure being felt and then ask the patient to state the location. TERMINATION STAGE a. Evaluate responses and actions carried out correctly b. The patient is well groomed c. Provide education related to follow-up after the action is taken d. Tools are neatly arranged e. The subsequent time contract was submitted correctly f. Therapeutic greetings are delivered in a friendly manner g. Wash your hands properly