Sensory Loss In One Side Of Body

Vibration

Apply tuning fork to surfaces with palpable subcutaneous bone (0-8/8)

Pallhypesthesia Pallanesthesia

Combined

Stereognosis

With eyes closed identify small objects placed in the hands

Astereognosis

Table 21.12. Additional pathologic signs/symptoms of sensory systems

Dysesthesia

Sensory perception is unpleasantly altered, e.g., touch is felt as pain

Paresthesia

Unpleasant sensations (itching, burning, formication) that are spontaneous, or elicited by gentle surface stimuli

Hyperpathia

Sensations are amplified and are felt as unpleasant, e.g., hyperalgesia

Dissociated sensory loss

Isolated sensory modalities lost within a body part, with other sensory modalities retained

Images Dissociated Sensory Loss

Fig. 21.7. Common patterns of sensory loss. a Unilateral loss of sensation with lesions of the contralateral cerebral hemisphere. b Loss of sensory perception in both legs with transverse damage to the spinal chord. c Glove-and-stocking pattern of sensory loss associated with a polyneuropathy

Deep tendon reflexes are variably elicitable under normal circumstances among patients in general. They can be quite weak in some patients, and lively in others. In order to identify correctly pathological weakening, care should be taken to compare one side to the other, to compare leg reflexes with those of the arm, or the arm and leg reflexes to those of the masseter. Pathological weakening of these reflexes should be diagnosed only when a clear and definite departure from normal can be detected.

Clinical Testing of Coordination - Ataxia Definition

Disturbances of coordination, i.e., of smoothly cooperative alternation of agonists and antagonists during the course of complex movements like walking, are in general referred to as ataxia.

Fig. 21.7. Common patterns of sensory loss. a Unilateral loss of sensation with lesions of the contralateral cerebral hemisphere. b Loss of sensory perception in both legs with transverse damage to the spinal chord. c Glove-and-stocking pattern of sensory loss associated with a polyneuropathy

Table 21.13. Types of reflexes

Type

Neurophysiology

Example

Peripheral disease

Central disease

Deep tendon reflexes (DTRs)

Stimulus site and responding body part are in the same muscle, monosynaptic reflex arc, no adaptation

Achilles reflex

Diminished or extinguished

Amplified

Superficial reflexes

Receptors mostly in the skin, responses in neighboring musculature, polysynaptic reflex arc spread over several adjacent spinal dermatomes, adaptation is typical

Physiologic:

abdominal reflexes

Weakened or extinguished (measured only by comparisons of symmetrical sites)

Weakened or extinguished (measured only by comparisons of symmetrical sites)

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