Sensory Problems

 

• Neuroanatomy of sensory tracts

  Sensory information from the lower body is carried in two tracts:

  • The dorsal column, which decussates in the midbrain, and carries proprioception and fine touch.
  • The spinothalamic (aka anterolateral) tract, which decussates where it enters the spinal cord, and carries crude touch, pain, and temperature sensation.

• Dermatome landmarks

  Cervical

  • C2: occiput.
  • C3: mastoid.
  • C4: acromion.
  • C5: lateral ACF.
  • C6: dorsal 1st phalanx of thumb.
  • C7: just proximal to the nail of the middle finger.
  • C8: 4th or 5th finger.

  Thoracic

  Upper limb:

  • T1: medial ACF.
  • T2: medial axilla.

  Feel the following at the mid-clavicular line:

  • T4: nipple level.
  • T6: xiphisternum level.
  • T8: costal margin level.
  • T10: umbilicus level.
  • T12: ASIS.

  Lumbar

  • L1: groin crease.
  • L2: hands in pocket area.
  • L3: medial femur condyle.
  • L4: medial malleolus.
  • L5: just proximal to 1st web space.

  Sacral

  • S1: lateral border of heel and sole.
  • S2: popliteal fossa.
  • S3: ischial tuberosity.
  • S4-5: anal skin. Use neurotip to test for anal wink.