G . KIM BIGLEY Proprioceptive sensation (also termed deep sensation) : receptors located in muscles, tendons, ligaments and joints Joint position sense (arthresthesia) : Absence is described as such Vibratory sense (pallesthesia) : Absence is described as such Kinesthesia : perception of muscular motion . Usually not measured in routine clinical evaluation . Corticalsensory functions: interpretative sensory functions that require analysis of individual sensory modalities by the parietal lobes to provide discrimination . Individual sensory modalities must be intact to measure cortical sensation . Stereognosis : ability to recognize and identify objects by feeling them . The absence of this ability is termed astereognosis . Graphesthesia: ability to recognizesymbols written on the skin. The absence of this ability is termed graphanesthesia . Two-point discrimination : ability to recognize simultaneous
The sensory system provides information that places the individual in relation to the environment . Sensation may be classified into categories by various methods dependent on anatomic or functional criteria . An anatomic classification divides sensoryfunction into somatic and visceral components with general and special subgroups of each . Clinically, however, only somatic sensation is easily measured . One functional classification separates sensory modalities into simple affective sensations, termed protopathic, and sensations that provide discriminative analysis with regard to the environment, termed epicritic . A more practical scheme ofclassification was developed early in this century by Sherrington and remains the most useful for the clinician . This scheme utilizes both anatomic criteria including the types and locations of end organs and functional criteria such as the types of stimuli measured by each modality to separate exteroceptive and proprioceptive sensation . A third sensory modality requires cortical analysis toprovide more complex interpretation of primary sensory information . All three types of sensation should be evaluated in every patient examined . Exteroceptive sensation (also termed superficial sensation) : receptors in skin and mucous membranes Tactile or touch sensation (thigmesthesia) : Anesthesia : absence of touch appreciation Hypoesthesia : decrease of touch appreciation Hyperesthesia :exaggeration of touch sensation, which is often unpleasant (Terms above are unfortunately used indiscriminately to apply to losses of all types of sensation . They are not specific for loss of tactile sensation .) Pain sensation (algesia) : Analgesia : absence of pain appreciation Hypoalgesia: decrease of pain appreciation Hyperalgesia: exaggeration of pain appreciation, which is often unpleasantTemperature sensation, both hot and cold (thermesthesia) : Thermanalgesia: absence of temperature appreciation Thermhypesthesia : decrease of temperature appreciation Thermhyperesthesia : exaggeration of temperature sensation, which is often unpleasant Sensory perversions (see Chapter 52, Pain and Sensory Perversions) : Paresthesia : abnormal sensations perceived without specific stimulation . They maybe tactile, thermal or painful ; episodic or constant . Dysesthesia: painful sensations elicited by a nonpainful cutaneous stimulus such as a light touch or gentle stroking over affected areas of the body . Sometimes referred to as hyperpathia or hyperalgesia . Often perceived as an intense burning, dyesthesias may outlast the stimulus by several seconds. 343
stimulation by two blunt points .Measured by the distance between the points required for recognition . Absence is described as such . Touch localization (topognosis) : ability to localize stimuli to parts of the body . Topagnosia is the absence of this ability . Double simultaneous stimulation : ability to perceive a sensory stimulus when corresponding areas on the opposite side of the body are stimulated simultaneously . Loss...