![]() With the patient's eyes closed, test his ability to determine the direction of movement as you move the great toe upward or downward. To test warm sensation, use a glass tube or other container filled with warm water. Tuning fork test foot skin#To test cold sensation, apply the cool tines of your tuning fork to the skin in the areas outlined above. Usually, if pain sensation has been tested and is normal, there is no need to test temperature sensation. Using your fingertips or a wisp of cotton, lightly stroke the skin and determine if the patient feels this symmetrically in all areas tested. In any area where the patient complains of sensory loss or hypersensitivity, more detailed testing may be required. At minimum, test the shoulders, arms and legs, comparing side to side and proximal to distal areas. Using the sharp point, apply light pressure to the skin. Take care not to puncture the skin, and remember that universal precautions require you to discard the instrument after examination. Objects frequently used include the point of a safety pin or a wooden tongue depressor broken to create a sharp edge. Compare symmetrical areas on both sides of the body and compare proximal to distal areas. Therefore, your exam should not be rushed, but must proceed efficiently. This portion of the exam is very subjective, and may become unreliable if repeated in quick succession. The sensory exam involves evaluation of pain (or temperature), light touch, position sense, vibration, and discriminative sensations. ![]()
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