PREPARED BY: MUHAMMAD ARIFF B. MAHDZUB BACHELOR MEDICINE AND SURGERY (MBBS) UNIVERSITY COLLEGE SHAHPUTRA, KUANTAN

1. 1
PIN-PRICK TESTPROBLEM BASED LEARNING (PBL)
PREPARED BY: MUHAMMAD ARIFF B. MAHDZUB
BACHELOR MEDICINE AND SURGERY (MBBS)
UNIVERSITY COLLEGE SHAHPUTRA, KUANTAN

2. • 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

3. Pin prick test

4. 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

5. 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.

6. 3) Use a sterile pin, comparing side with side,
proximal with distal, segment with segment
in 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.

7. • 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.

8. Vital Sign

9. 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.

10. • 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.

11. • 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.

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

13. • 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.

14. 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.

17. 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

18. •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