KOLEHIYO NG LUNGSOD NG DASMARIÑAS

Laboratory Manual
Neural Pathways and Tracts - Sensory

Prepared by:

Inst. Earl Cyril G. Rosaldo

 Institute of Applied Sciences
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EXPERIMENT 5.1 – Neural Pathway and Tracts (Sensory)

OBJECTIVES
▪ Assesses the functionality of the somatosensory, visual, and auditory neural
pathways and tracts of the patient using various tests.
▪ Correlate the integrity of the somatosensory, visual, and auditory neural pathways
and tracts of the patient based on the inconsistencies or errors of the responses.
DISCUSSION
Sensory pathways — namely, somatosensory, visual, and auditory — are the
foundation of our perception, connecting us to the world in unique ways. The
somatosensory system interprets touch and proprioception, enabling interaction with
the environment. Meanwhile, the visual pathway decodes the intricate language of
light, color, and motion, while the auditory pathway captures the symphony of sounds
that shape our surroundings.

In this exploration, we delve into the neural intricacies of these sensory pathways,
unraveling the anatomy and function that underlie our ability to perceive and respond
to diverse stimuli. Join us in understanding the remarkable mechanisms that make
touch, sight, and sound integral components of the human experience.
MATERIALS

Quantity
Specs Item
(per group)
1 N/A Cotton ball
1 N/A Paper clip
1 N/A Tuning fork (256Hz, 512Hz)
1 N/A Snellen chart
1 N/A Ishihara plates
1 N/A Coin
2 N/A Yellow paper
1 N/A Ballpoint pen

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SAFETY
PRECAUTIONS
Gently apply the tools for each tests.
Do not play with the heat and keep lighter away when not in use.
Adhere to all laboratory rules and guidelines.
PROCEDURE
A. Mental Status Examination (MSE)
1. Examine your partner’s level of consciousness, orientation, speech, language,
memory, fund of information, abstract thought, and calculation ability by using
Folstein mini-mental status examination (MMSE).
2. Ask your partner to name the year, month, day, date, and time. Every correct
answer corresponds to one point (1).
3. Ask your partner to name the school, room number, city, province, and country.
Every correct answer corresponds to one point (1).
4. State three (3) random objects and ask your partner to repeat them. Every
correct answer corresponds to one point (1).
5. Ask your partner to subtract 7 from 100 for three (3) consecutive times. Every
correct answer corresponds to one point (1).
6. State one (1) simple word and ask your partner to spell it backwards. Then
repeat it again. Every correct answer corresponds to one point (1).
7. Ask your partner to recall the three (3) random objects you mentioned earlier.
Every correct answer corresponds to one point (1).
8. Place two (2) random objects in front of you and ask your partner to name and
describe those objects. Every correct answer corresponds to one point (1).
9. State the phrase “No ifs, ands, or buts” and ask your partner to repeat the
phrase. Every correct answer corresponds to one point (1).
10. State one (1) 3-step command “Take this paper, fold it in half, and place it on
the table” and ask your partner to follow the commands. Every correct action
corresponds to one point (1).
11. Write one (1) 1-step command “Close your eyes” and ask your partner to follow
the command. Every correct action corresponds to one point (1).
12. Ask your partner to write one (1) command. Every correct action corresponds
to one point (1).
13. Draw a simple clock and ask your partner to copy the design. Every correct
action corresponds to one point (1).
14. Total the number of points and analyze the results.

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B. Double Simultaneous Stimulation (DSS)

1. Choose two (2) stimuli from the following: tactile (e.g., cotton ball),
thermoception (e.g., cold metal), or nociception (e.g., sharp pin).
2. Ask your partner to avert their gaze to limit the influence of visual
information.
3. Apply the first stimulus to any region of the right forearm while the other to
any region of the left forearm.
4. Observe the response of your partner whether they can perceive and
distinguish the two (2) stimuli.
5. Document the response and analyze the results.

C. Two-point Discrimination
1. Prepare one (1) paper clip and reconfigure it into a U-shape.
2. Ask your partner to avert their gaze to limit the influence of visual
information.
3. Gently apply the two points of the U-shaped paper clip to any region of the
right forearm of the patient then ask the number of points your partner felt.
4. Repeat the previous step using varying proximity between the two points of
the U-shaped paper clip in any region of the right forearm.
5. Repeat the previous step in any region of the left forearm.
6. Document the response and analyze the results.

D. Graphesthesia
1. Prepare one (1) paper clip and reconfigure it into a line.
2. Ask your partner to avert their gaze to limit the influence of visual
information.
3. Gently write one (1) number on right palm of your partner then ask the
number your partner felt.
4. Repeat the previous step using varying single numbers or letters on right
palm.
5. Repeat the previous step using the left palm.
6. Document the response and analyze the results.

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E. Stereognosis
1. Prepare three (3) small objects.
2. Ask your partner to avert their gaze to limit the influence of visual
information.
3. Gently place the first small object on the right palm of your partner and allow
them to explore it then ask your partner to identify it.
4. Repeat the previous step using the second and third object.
5. Repeat the previous step using the left palm.
6. Document the response and analyze the results.

F. Visual Acuity using Snellen Chart

1. Setup the Snellen chart at the eye level of your partner.
2. Place your partner in the sitting position and 6 meters (20 feet) away from the
Snellen chart.
3. Ask your partner to cover one eye then ask your partner to read the from top
row and proceed downward.
4. If your partner reads a line correctly, record the visual acuity of that line. Note
the line with the smallest letter that the patient can read accurately and
document the Snellen fraction.
5. Repeat the previous step using the other eye.
6. Repeat the previous step using both eyes.
7. Document the Snellen fractions and analyze the results.

G. Color Vision Test using Ishihara Plate

1. Place the Ishihara plates at the eye level of your partner.
2. Place your partner in the sitting position and 0.3 meters (1 feet) away from
the Ishihara plates.
3. Ask your partner to read the numbers in the Ishihara plates.
4. Document the responses and analyze the results.

H. Sound Localization
1. Ask your partner to close both eyes then activate the 256Hz tuning fork
around the right ear the patient.
2. Ask your partner to locate the source of the sound then repeat the previous
step twice but with varying position and distance around the right ear of your
partner.
3. Repeat the previous step thrice around the left ear of your partner.
4. Document the responses and analyze the results.

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I. Frequency Discrimination
1. Ask your partner to close both eyes and respond if the sound is inaudible.
2. Activate the 256Hz tuning fork and place it near the right ear your partner
then activate the 512Hz tuning fork and pace it near the right ear.
3. Ask your partner for the number of frequencies they perceive.
4. Repeat the previous steps in the left ear.
5. Document the responses and analyze the results.

DISPOSAL AND
CLEAN-UP
All equipment and materials must be clean and dry properly.
Working table must be cleaned.
Dispose waste materials properly according to your lab's disposal protocols.

REFERENCES

Mental Status Examination and Bare Minimum Test. Hauser, S. L., Josephson,
S. A., & Ryan, S. J. (Eds.). (2010). Harrison’s Neurology in Clinical Medicine (2 nd ed.).
McGraw-Hill.

Naqvi, Usker, and Andrew l Sherman. “Muscle Strength Grading.” PubMed,

StatPearls Publishing, 29 Aug. 2022, www.ncbi.nlm.nih.gov/books/NBK436008/.

Harb, Andrew, and Stephen Kishner. “Modified Ashworth Scale.” PubMed,

StatPearls Publishing, 2020, www.ncbi.nlm.nih.gov/books/NBK554572/.

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NAME: ________________________________________________ RATING: _________________

PRELAB ACTIVITY
FOR EXPERIMENT GROUP: _________

5.1
DATE SUBMITTED: __________________

Neural Pathway and Tracts – Sensory

1. In the somatosensory neural pathways, what are the cranial nerves and regions of spinal nerves
involved?

2. In the visual neural pathways, what are the cranial nerves and regions of spinal nerves involved?

3. In the auditory neural pathways, what are the cranial nerves and regions of spinal nerves
involved?

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NAME: ____________________________ RATING: ____________

LAB REPORT FOR
EXPERIMENT 5.1 GROUP: _________

DATE SUBMITTED: ___________________

Results and Observations

TABLE 1. MENTAL STATUS EXAMINATION
Orientation Points 24-30 points:
year, month, day, date, time __ / 5 Typically considered
school, room number, city, province, country __ / 5 normal cognitive function
Registration Points
repeat the three (3) objects stated __ / 3 18-23 points:
Calculation Points Mild cognitive impairment
subtract 7 from 100 for three (3) consecutive times __ / 3
Attention Points 0-17 points:
spell two (2) simple words backwards __ / 2 Suggestive of more severe
Recollection Points cognitive impairment
recall the three (3) objects stated __ / 3
Communication Points
identify the two (2) objects in front. __ / 2
repeat the phrase: “no ifs, ands, or buts” __ / 1
follow a 3-step verbal command __ / 3
follow a 1-step written command __ / 1
create a 1-step written command __ / 1
copy your drawing or design __ / 1
Total __ / 30

TABLE 2. DOUBLE SIMULTANEOUS STIMULATION

Left Forearm Right Forearm
Stimulus #1 Stimulus #2 Stimulus #1 Stimulus #2
Trial 1: Trial 1: Trial 1: Trial 1:
Trial 2: Trial 2: Trial 2: Trial 2:
Trial 3: Trial 3: Trial 3: Trial 3:

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TABLE 3. TWO-POINT DISCRIMINATION

Left Forearm Right Forearm
Variety #1 Variety #2 Variety #1 Variety #2
Trial 1: Trial 1: Trial 1: Trial 1:
Trial 2: Trial 2: Trial 2: Trial 2:
Trial 3: Trial 3: Trial 3: Trial 3:

TABLE 4. GRAPHESTHESIA AND STEREOGNOSIS

Graphesthesia Stereognosis
Left Arm Right Arm Left Arm Right Arm
Trial 1: Trial 1: Trial 1: Trial 1:
Trial 2: Trial 2: Trial 2: Trial 2:
Trial 3: Trial 3: Trial 3: Trial 3:

TABLE 5. VISUAL ACUITY USING SNELLEN CHART

Left Eye Right Eye Binocular
Snellen Fraction: Snellen Fraction: Snellen Fraction:

TABLE 6. COLOR VISION TEST USING ISHIHARA PLATE

Plate 1 Plate 2 Plate 3 Plate 4 Plate 5 Plate 6

Plate 7 Plate 8 Plate 9 Plate 10 Plate 11 Plate 12

TABLE 7. SOUND LOCALIZATION

Left Ear Right Ear
Trial 1: Trial 1: Trial 1: Trial 1:
Trial 2: Trial 2: Trial 2: Trial 2:
Trial 3: Trial 3: Trial 3: Trial 3:

TABLE 8. FREQUENCY DISCRIMINATION

Left Ear Right Ear
256Hz 512Hz 256Hz 512Hz

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Post-Lab Questions
1. What is the total score of your patient in MMSE? Explain its implication to your patient’s overall
sensory neural pathway.

2. If your patient experiences inconsistencies or errors in perceiving and distinguishing simultaneous

stimuli, what does it imply?

3. If your patient experiences inconsistencies or errors in perceiving and distinguishing two point with
varying distance, what does it imply?

4. If you patient experiences inconsistencies or errors in perceiving and distinguishing the number
written on their skin, what does it imply?

5. If your patient experiences inconsistencies or errors in perceiving and distinguishing the object
using tactile exploration, what does it imply?

6. In the Snellen fraction representing binocular vision as 20/40, what do 20 and 40 mean?

7. In the Ishihara Color Vision Test, what type of color blindness does it detect?

8. If your patient experiences inconsistencies or errors in localizing the source of sound, what does it
imply?

9. If your patient experiences inconsistencies or errors in discriminating the frequencies, what does it
imply?

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Summary and Conclusions

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