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Pain referral
Trigger points
Cranial nerve
Spinal nerve
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To afford you with a working model we are providing a
dermatome link
and
basic trigger point chart link
in the Pain Referral. Other means of assessing
nerve supply focus on body temperature and will be discussed independently.
Home
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Pain referral
Trigger points
Cranial nerve
Spinal nerve
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Continuing Education © Copyright
Pinwheel Evaluation
Pinwheel evaluation is an excellent way of determining sensory depravation (hypoesthesia)
or elevation (hyperesthesia). It can be performed by rolling the pinwheel across
a region of the trunk, up and down the extremities or more specifically attempting
to trace segmental nerve supply known as dermatomal patterns. Care should be used
when rolling the pinwheel not to apply so much pressure that the test is significantly
uncomfortable or that the skin becomes damaged. If the practitioner is attempting to
trace dermatome patterns, they should be aware that segmental nerve supply could vary
as to site of innervation or supply from the dermatome chart that they are referencing.
Therefore, they should view segmental innervation as a close approximation, but not an absolute.
Dermatome, myotome, viscerotome and sclerotome
patterns have been developed from an author’s pool of individuals studied. Not
only can the segmental supply be off by one or two segments, but also the
patterns overlap, thus, making objective specificity difficult to interpret.
Additionally, multiple trigger point patterns and their subsequent satellite
referral can skew the subjective input of the individual. Therefore, the
pinwheel offers the practitioner a quick and simple means of assessing
sensation, as well as basic insight to segmental nerve involvement, but lacks
the clinical specificity of electromyography or nerve conduction.
Temperature Gradient Evaluation
As in the pinwheel evaluation, flawless technique as well as regulation of skin temperature,
is required to obtain accurate values. The skin requires a sufficient time to equalize temperature
so that the values will not be skewed by clothing, or extremes in external temperature.
The temperature probe is placed at equal points bilaterally along dermatome patterns,
which may be accessed in the pain reference area of this site. However, the quality
of these findings is regarded as quite controversial and therefore individuals
performing this evaluation should recognize it as a crude indicator rather
than the specificity that can be obtained through a nerve study.