Sense of Touch - Practical by Dr. Roomi
Sense of Touch - Practical by Dr. Roomi
Sense of Touch - Practical by Dr. Roomi
Principle:
Sense of touch can be assessed by voluntary stimulation of tactile receptors in skin and noting the response.
Apparatus:
Fine touch aesthesiometer, crude touch aeshesiometer, cotton wool, webers compass, key , pencil and subject.
To test coarse or crude touch, coarse aesthesiometer is used to touch the same areas as we tested for fine touch.
Stereo$nosis& this is ability to recogni%e and identify objects by feeling them. !he absence of this ability is termed astereognosis. !his is tested by putting an object e.g. key in the hand of patient when his eyes are closed and he is asked to reply what it is.
Graphesthesia: this is ability to recogni%e symbols written on the skin. !he absence of this ability is termed graphanesthesia. !his is tested by making a circle or writing some digit on the palm of subject and asking him what has be drawn.
Two-point discrimination: this is ability to recogni%e simultaneous stimulation by two blunt points. 'easured by the distance between the points re"uired for recognition. !his is tested by using (ebers compass. !wo pointed ends of this compass are separated apart gradually and are touched to the skin of patient simultaneously. !he patient is asked whether he has felt two points or one. !he minimum distance at which he can appreciate two points as two is called as minimal separable distance. !his distance is very less on lips and finger tips )*+,mm- but much larger on the back )./+0/mmof our body. !his distance is inversely proportional to the number of receptors present in some area of skin and also inversely proportional to the representation of that area in sensory cortex of brain.
Part to (e touched)
4ips.
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Part to (e touched 4ips. 7alm. Fingertips. 8ack of hand. Forearm, hairy area. Forearm, non+hairy area.
&iscussion:
!he sensory system provides information that places the individual in relation to the environment. # sensation is any change in external or internal environment detected by receptors. 9eceptors may be located superficially in skin and mucous membranes or deeply in tendons, muscles, ligaments and joints. Sensations may be classified on the basis of location of receptors to exteroceptive and proprioceptive sensation. # third sensory modality re"uires cortical analysis to provide interpretation of sensory information. #ll three types of sensation should be evaluated in every patient examined.
Anesthesia: absence of touch appreciation Hypoesthesia: decrease of touch appreciation Hyperesthesia: exaggeration of touch sensation, which is often unpleasant
)!erms above are unfortunately used indiscriminately to apply to losses of all types of sensation. !hey are not specific for loss of tactile sensation.-
So!e i!portant clinical definition related to Pain sensation "al$esia#: Analgesia: absence of pain appreciation Hypoalgesia: decrease of pain appreciation Hyperalgesia: exaggeration of pain appreciation, which is often unpleasant So!e i!portant clinical definition related to Te!perature sensation- (oth hot and cold "ther!esthesia#: Thermanalgesia: absence of temperature appreciation Thermhypesthesia: decrease of temperature appreciation Thermhyperesthesia: exaggeration of temperature sensation, which is often unpleasant So!e Sensor. per,ersions: Paresthesia: abnormal sensations perceived without specific stimulation. !hey may be tactile, thermal or painful: episodic or constant. Dysesthesia: painful sensations elicited by a non+painful cutaneous stimulus such as a light touch or gentle stroking over affected areas of the body. Sometimes referred to as hyperpathia or hyperalgesia. ;ften perceived as an intense burning, dyesthesias may outlast the stimulus by several seconds.
*. mechanoreceptive sensations& !actile sensation )fine and crude touch, pressure, tickle, itch and vibration-. Sense of position )proprioception-.
.. !hermal sensation )heat and cold sensation-. ,. 7ain sensation )fast and slow pain-.
(#) &orsal colu!n !edial le!niscus path0a. 2conscious3 proprioception: =oint position )proprioception-, vibration, deep pressure, two point tactile discrimination, graphaesthesia and stereognosis. c#) &orsal and ,entral spinocere(ellar path0a. >unconscious? proprioception
Touch sensiti,it.:
Caries from part to part.
Depends on number of receptors. 'aximum sensitivity& at tip of tongue, lips, finger tips, then hands, forearm and arm. 'inimum sensitivity& on the back of body
Appendi
no 6: Spinothala!ic path0a.:
Pain perception 2 fibers& thin, unmyelinated # delta& thinly myelinated Te!perature # delta& thinly myelinated
Appendi
no 7:
Appendi
no ::
Appendi
no ;: Sensor. ho!unculus: