EXAMINATION OF

SENSORY SYSTEM
DR AXELLE SAVERETTIAR
MBBS
PHYSIOLOGY DEPARTMENT
SSR MEDICAL COLLEGE
 EXAMINATION OF SENSORY SYSTEM
PRE-REQUISITES:
Introduce yourself
Explain nature of the test to be performed to the
subject to get his full cooperation
Ask for consent
 EXAMINATION OF SENSORY SYSTEM
PRINCIPLE:
Ask the subject to close his eyes and turn the face to
the other side
Test different forms of sensations
Always compare corresponding points on both sides
of the body
EXAMINATION OF SENSORY SYSTEM
 1. Tactile sensibility
TEST
Light touch
Pressure
Tactile localization
Tactile discrimination 

2. Pain

3. Temperature

4. Sense of position

5. Vibration sense

6. Recognition of size, shape and form of objects

7. Presence of abnormal sensations

EXAMINATION OF SENSORY SYSTEM
 EXAMINATION OF SENSORY SYSTEM
1. Tactile sensibility
A. Light touch
Use a wisp of cotton wool
Test different parts of the
body and compare both
sides of body
Ask subject to say ‘yes’
every time he feels a
touch
 EXAMINATION OF SENSORY SYSTEM
1. Tactile sensibility
A. Light touch
Anesthesia: Complete absence of touch sensibility
Hypoaesthesia: Partial loss of touch sensibility
Hyperaesthesia: Exaggerated touch sensibility
 EXAMINATION OF SENSORY SYSTEM
1. Tactile sensibility
B. Pressure sense
Pressure is sustained touch sensation
Use a blunt object
Test different parts of the body and compare both
sides of body
Ask subject to say ‘yes’ every time he feels a touch
 EXAMINATION OF SENSORY SYSTEM
1. Tactile sensibility
C. Tactile localization
It is the ability to tell exactly
the portion of body part
touched
Use a hair aesthesiometer
or cotton wisp
Test different parts of the
body; comparing both sides
Ask subject to localize it
 EXAMINATION OF SENSORY SYSTEM
1. Tactile sensibility
D. Tactile discrimination (Two
point discrimination)
It is the ability to distinguish
between two adjacent
touch stimuli to the skin
Tested by use of compass
aesthesiometer
 EXAMINATION OF SENSORY SYSTEM
1. Tactile sensibility
D. Tactile discrimination (Two point
discrimination)
 The two limbs of the instrument
are separated
 Ask whether he is being touched
with one or both the points
 Keep increasing the distance
between the two limbs till he feels
the two points on the skin
 Note the distance at which the
subject distinguish the two points
as two separate points
EXAMINATION OF SENSORY SYSTEM
 EXAMINATION OF SENSORY SYSTEM
2. Pain sensibility

Superficial
Prick of a pin
pain
Pain
sensibility Pressure on deeper
Deep pain structure such as
muscles or bone
 EXAMINATION OF SENSORY SYSTEM
2. Pain sensibility
A. Superficial pain
Use the point of a pin
Test different parts of the
body; comparing both
sides
Ask the subject to say
“yes” as he feels the prick
 EXAMINATION OF SENSORY SYSTEM
2. Pain sensibility
A. Deep pain
Squeezing the muscle or the
tendo-achilles
It is particularly disturbed in
tabes dorsalis
 EXAMINATION OF SENSORY SYSTEM
2. Pain sensibility
Analgesia: Absence of pain sensibility
Hypoalgesia: Partial loss of pain sensibility
Hyperalgesia: Exaggerated response to pain
 EXAMINATION OF SENSORY SYSTEM
3. Thermal sense
Tested using test tubes
containing warm and cold
water
Test different parts of body
with the test tubes of
warm and then cold water
Ask the subject to identify
which tubes feels hot or
cold
 EXAMINATION OF SENSORY SYSTEM
4. Sense of position
Move his finger or toe up
or down
Ask him to tell you in
which way it has been
moved
He should be able to
recognize movements of
only a few degree <10˚ at
all joints
 EXAMINATION OF SENSORY SYSTEM
4. Sense of position
Hold one of the subject’s limb and move it about in
various directions through air
Leave it in some definite position (semi flexed or
extended)
Ask him to put the corresponding limb in a similar
position
 EXAMINATION OF SENSORY SYSTEM
5. Vibration sense
If foot of a vibrating
tuning fork is placed on
the surface of the body,
the vibrations can be felt
The sensation is most
marked over bones
 EXAMINATION OF SENSORY SYSTEM
5. Vibration sense
A tuning fork of 128 Hz is made to
vibrate
The foot of the tuning fork is placed
on some subcutaneous bone in the
region to be tested
 shin of tibia
 malleoli
 olecranon process
 styloid process of radius
Ask the subject if he perceives the
vibrations
Compare on the other side
 EXAMINATION OF SENSORY SYSTEM
5. Vibration sense
Vibration sensibility is lost in:
Tabes dorsalis
Peripheral neuropathies - diabetes
Vitamin deficiency
Posterior column disorders
 
Vibration sensibility is lost partially in:
Feet and legs in old age
 EXAMINATION OF SENSORY SYSTEM
6. Recognition of size, shape and form of objects
The ability of recognize familiar objects such as coins, pen
or scissors etc. by handling them without looking at them
is called stereognosis.
Astereognosis: Loss of stereognosis
 EXAMINATION OF SENSORY SYSTEM
6. Recognition of size, shape and form of objects
A. Test the size of objects
Place in the subject’s palm objects of same shape but
different sizes.
The objects should be given consecutively.
Ask him to say which is larger or smaller.
 EXAMINATION OF SENSORY SYSTEM
6. Recognition of size,
shape and form of objects
B. Test the shape and form
of objects
Place familiar objects in
the hand of a subject
Ask the subject to identify
them and describe their
form
 EXAMINATION OF SENSORY SYSTEM
7. Presence of abnormal sensations
Paraesthesias: Presence of abnormal sensations over the
body
It consists of various sensations experienced by the person
without any outside stimulus.
Examples:
Feeling of pins and needles
Feeling of numbness
Feeling of itching
Feeling as if an insect is crawling over the body (formication)