Pin prick test

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PIN-PRICK TESTPROBLEM BASED LEARNING (PBL)

PREPARED BY: MUHAMMAD ARIFF B. MAHDZUB

BACHELOR MEDICINE AND SURGERY (MBBS)

UNIVERSITY COLLEGE SHAHPUTRA, KUANTAN

• DEF - a test of a person's ability to detect a cutaneous pain sensation and to differentiate such sensations from pressure stimuli. The test is performed with a pin or needle gently applied to a skin area where it cannot be observed by the subject/the eyes of patient are kept closed.

• Usually been done to test the numbness and pins and needles in a part of body

Pin prick test

Problems that can cause numbness and pins and needles

• The lack of vitamin B12 -causes pernicious anaemia and nerve damage.

• Pressure• Trapped nerve (A slipped disc or back problem)• Diabetes (damage small blood vessels that supply

nerves)• Injury (Damage to nerve endings)• Medicines• Alcohol• stroke, multiple sclerosis and brain tumours

Procedures of pin prick test

1) In examining the sensibility, it is important, not only whether the patient can feel, but whether he is able to recognize the place touched -- whether he can correctly localize the sensation. For this he must be asked not only whether he feels the touch, but to say or point out where he feels it. The patient’s eyes kept closed

2) A too fine point must not be used, not only because a sharp point may inflict a wound, but because, in the less sensitive parts of the skin, a fine point may be unfelt, although it penetrates the skin .Because of its sharpness and small area of stimulation it might miss pain spots, giving rise to misinterpretation of sensory deficiency. It might also draw blood. Hence a blunt point should be employed.

3) Use a sterile pin, comparing side with side, proximal with distal, segment with segmentin order for the patient to be able to compare the sensation.

4) The application of the pin is alternated with the pressing of a dull object against the skin.

5) Care is taken to prevent penetration of the dermis, and the sharp object used should be sterilized or discarded after the test.

• For our case, Christina have bilateral reduction in pin prick sensation that means both her feet has moderate loss of sensation because of vitamin B12 deficiency.

Vital Sign

Temperature• Temperature is an expression of heat or

coldness in term of a specific scale

• The main reason for checking body temperature is to examine any signs of systemic infection or inflammation in the presence of a fever (temp > 38.5°C/101.3°F )or elevated significantly above the individual's normal temperature.

• Temperature depression (hypothermia) also needs to be evaluated

• Body temperature is maintained through a balance of the heat produced by the body and the heat lost from the body.

• Blood pressure

• The blood pressure is recorded as two readings a high systolic pressure, which occurs during the maximal contraction of the heart, and the lower diastolic or resting pressure. A normal blood pressure would be 120 being the systolic over 80, the diastolic.

• Usually the blood pressure is read from the left arm unless there is some damage to the arm.

. The difference between the systolic and diastolic pressure is called the pulse pressure. The measurement of these pressures is now usually done with sphygmomanometer.

• Elevated blood pressure (hypertension) is variously defined when the systolic number is persistently over 140–160 mmHg.

• Low blood pressure is hypotension. Blood pressures are also taken at other portions of the extremities.

Pulse• The pulse is the physical expansion of the artery. • It is recorded as beats per minute. • The pulse commonly taken is from the radial

artery at the wrist. • Sometimes the pulse cannot be taken at the wrist

and is taken at the elbow (brachial artery), at the neck against the carotid artery (carotid pulse), behind the knee (popliteal artery), or in the foot dorsalis pedis or posterior tibial arteries.

Respiration rate•The respiration rate is the number of breaths a person takes per minute.

• The rate is usually measured when a person is at rest and simply involves counting the number of breaths for one minute by counting how many times the chest rises.

• Respiration rates may increase with fever, illness, and with other medical conditions

•When checking respiration, it is important to also note whether a person has any difficulty breathing.

•Normal respiration rates for an adult person at rest range from 15 to 20 breaths per minute.

•Respiration rates over 25 breaths per minute or under 12 breaths per minute (when at rest) may be considered abnormal