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FINAL PREPARATIONS FOR RECOMPRESSION THERAPY

Physical Examination

Sensory Systems

Sensory function of the parietal cortex

The assessment of parietal cortical sensory function involves higher orders of processing and thus relates to the interpretation of more complex stimuli than to the detection or discrimination of simpler stimuli. For example, the abilities of the patient to identify a letter or number traced on the hand (i.e., graphesthesia) and recognize and identify objects by touch (stereognosia) reflect the functional integrity of the parietal lobe. Attentional mechanisms that also involve the parietal lobe are necessary for the accurate identification of double simultaneous stimulation. To explain, the clinician may apply simple tactile stimulation to a particular location bilaterally and coincidentally. However, the patient demonstrating dysfunction of a parietal lobe will not attend and thus not detect the stimulus delivered contralateral to the dysfunctional lobe. Importantly, the assessment may be confounded by rudimentary somatosensory deficits related to dysfunction of the postcentral gyrus (anterior parietal lobe), cerebral white matter, the thalamus, the medial and spinal lemnisci, the dorsal columns, the anterolateral system, the dorsal horn of the spinal cord, the dorsal root, or peripheral sensory fibers.