PHYSICAL EXAMINATION CHECKLIST – SENSORY SYSTEM

The student,

1. Greets the patient.

2. Introduces himself / herself.
3. Maintains appropriate distance.
4. Makes the patient feel comfortable.
5. Remains courteous and adopts positive body language.
6. Takes the patient in confidence, such as by briefly explaining the reason(s) to examine.
7. Approaches from the right side of the patient.
8. Takes permission to expose the areas to be examined (usually limbs).
9. The patient should be demonstrated the test before performing it.
10. Ask the patient to keep the eyes closed throughout the exam unless specified.
11. Always checks a single sensation modality throughout the body (preferably limbs) before
testing the other.
12. Always compares the sensation between corresponding right and left sides as well as
distal and proximal points.
Dorsal Column-Medial Lemniscus Sensation:
13. Asks the patient to say “YES” if he/she feels the light touch.
14. Tests by lightly touching the bare skin with a cotton-tip applicator over the points shown
in the dermatome diagram.
15. Checks the vibration sensation by touching a vibrating tuning fork at various bony
prominences over a limb.
16. Compares the sensation bilaterally as well as to himself.
17. Tells the patient to say “UP/DOWN” if he/she feels an upward/downward movement of
the digits.
18. Asks the patient to close eyes and checks position sense (proprioception) by holding the
most distal joint of the patient’s digit and moving it slightly up or down.
19. Checks two-point discrimination with calipers while alternatively touching with
single/double ends. The sensation is higher on distal parts of the limbs as compared to
proximal.
20. Checks double simultaneous stimulation on corresponding parts of the body.
21. Asks the patient to hold some common objects and tell their names/shape.
22. Elicits Romberg’s sign: asks the patient to open both eyes, stand with feet close together
and arms by side. After a few seconds, asks to close both eyes and records any sway or
fall with or without tapping.
Spinothalamic Sensation:
23. Ask the patient to say “YES” if he/she feels the sharp edge of a broken applicator.
24. Tests by lightly touching the bare skin with the sharp, broken edge of the applicator over
the points shown in the dermatome diagram.
25. Tests the temperature sensation by touching the bare skin with a metal object, such as a
tuning fork at various points over a limb.
Concludes:
26. Covers the exposed areas.
27. Thanks the patient.

Author: Dr. Nasir Ali Afsar, Senior Lecturer of Pharmacology, College of Medicine, Alfaisal University, Riyadh Page 1
 PHYSICAL EXAMINATION CHECKLIST – SENSORY SYSTEM

Video tutorials at http://library.med.utah.edu/neurologicexam/html/home_exam.html

Adult Dermatome Map

Reference: http://www.asia-spinalinjury.org/publications/Key_Sensory_Points.pdf

http://en.wikipedia.org/wiki/Dermatome_(anatomy)

Author: Dr. Nasir Ali Afsar, Senior Lecturer of Pharmacology, College of Medicine, Alfaisal University, Riyadh Page 2