UL
Sensation
- Testing light touch, pin prick, vibration, and joint position sense, or proprioception.
Light Touch
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Ask the patient to place their arms by their sides with their palms facing forwards. Lightly touch the patient’s sternum with a piece of cotton wool so that they know how it feels.
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Then, with the patient’s eyes shut, lightly touch their arm with the cotton wool. The places to touch them should test each of the dermatomes – make sure you know these! Tell the patient to say “yes” every time they feel the cotton wool as it
UL Proprioception/tuning fork test)
Vibration
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To assess vibration you should use a sounding tuning fork. Place the fork on the patient’s sternum to show them how it should feel.
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Now place it on the bony prominence at the base of their thumb and ask them if it feels the same. If it does, there is no need to check any higher. If it feels different you should move to the radial stylus and then to the olecranon until it feels
UL Proprioception joint position
Proprioception
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Assess proprioception Hold the distal phalanx of the thumb on either side so that you can flex the interphalangeal joint.
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Show the patient that when you hold the joint extended, that represents Up whereas when you hold it flexed that represents Down. Ask the patient to close their eyes and, having moved the joint a few times hold it in one position – up or down. Ask the patient which position the joint is in.
