Stereognosis is the integrative function of the parietal and occipital lobes. It is tested by having the patient attempt to identify an object placed in the hands. Have the patient
Figure 21-51 Technique for testing vibration sensation. A, Correct position for evaluating vibration sensation in the finger. B, Technique for the toe.
close his or her eyes. Place a key, pencil, paper clip, or coin in the palm of the patient's hand, and ask what it is. Test the other hand and compare the findings.
Graphesthesia is the ability to identify a number ''written'' in the palm of one's hand. Ask the patient to close his or her eyes and extend the hand. Use the blunt end of a pencil to ''write'' numbers from 0 to 9 in the palm. The numbers should be oriented facing the patient. This is demonstrated in Figure 21-55. Normally, the patient should be able to identify the numbers. Compare one hand with the other. The inability to identify the numbers is a sensitive sign of parietal lobe disease.
Point localization is the ability of a person to point to an area where he or she was touched. Have the patient close his or her eyes. Touch the patient. Ask the patient to open the eyes and point to the area touched. Abnormalities of the sensory cortex impair the ability to localize the area touched.
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