measurement of sensation

• spinothalamic tract: sharp pain/ temperature/ crude touch/ pressure

  lateral: chemical sensation(pain/ temperature)/ anterior: physical sensation

  first order neuron: signal travel from receptor to spinal cord ipsilaterally

  second order neuron: signal cross at spinal cord to thalams

  third order neuron: signal from thalamas to PSA
• spinocerebellar tract: subconscious proprioception

  posterior: carry propreioceptive info ipsilateral via inferior cerebellar peduncle with first and second neuron

  anterior: first neuron cross over at medulla, second neuron cross back before reaching cerebellum wih superior cerebellar peduncle
• dorsal column: conscious proprioception, light touch

  carry info from skin, joint, muscle receptor to cortex

  cuneatus: upper limb chest

  gracilis: lower limb and trunk

  first order neurone: signal travel ipisilaterally to medulla

  second order neurone: signal cross over at medulla to thalamus

  third order neuron: from medulla to PSA
• lateral corticospinal tract: control limbs

  anterior corticospinal tract: control axial skeleton

  A) dorsal column

  B) spinocerebellar tract

  C) spinothalamic tract

  
• nottingham sensory assessment scoring

  0: fail to identify test all 3 time

  1: identify test but not all 3 time

  2: identify test all 3 time

  9: unable to test due to limitation
• light touch sensation: cotton wool ball

  pain sensation: neurotip (pinprick)

  sharp/ blunt discrimination: neurotip, stimulate skin 6 time at each location in random order 3 sharp 3 blunt

  hot/ cold discrimination: 2 test tube

  tactile localisation: index finger with talcum powder mark spot

  bilateral simultaneous touch: touch one or both side of patient, ask patient to indicate

  kinaesthetic proprioceptive awareness: ask patient mirror change of movement (1 joint only/ distal to proximal)

  stereognosis: 2p/10p/ ballpoint pen/ pencil/comb/ scissors/sponge/flannel/cup/glass
• scoring of kinaesthetic proprioceptive awareness:

  0: no movement

  1: patient indicate movement has occured

  2: patient can mirror direction of movement

  3:patient can mirror test within 10 degree