 Now to check for the spinothalamic tract there are a couple of different things we can do and that would be either Check the patient's sensation to touch to pain or to temperature and typically we only check for temperature If the sensation to pain is abnormal and that doesn't mean that we induce any pain in the patient But that's again that sharp and dull assessment that we're doing with most likely our cotton-tipped applicator So first I'd like for you to close your eyes and tell me where I'm touching you Which side? Okay, how about now? And here And here Okay, good, so that would be the touch sensation and next we'll do the sharp and dull So I have this cute tip here again I'll be touching you in the upper and lower extremities. Tell me if you feel sharp or dull as a reminder Here is what dough feels like And here is what sharp feels like Okay, they felt the same. Let's try a different part of your hand sharp and dull okay, okay So sharp or dull? sharp Sharp or dull? sharp sharp or dull? dull Sharp or dull? dull Sharp or dull? sharp Sharp or dull? sharp Okay, now on the legs? sharp Okay, very good. So that is the sensation to sharp or dull. Now if that was abnormal we would check The temperature since and so what we could do is Use the handle of either the reflex hammer or the stethoscope Which is you typically cold and then hopefully the palm of your hand which is warm and we'll see if he can tell the difference here Is this cold? Does this feel cold to you? Yes, and does this feel different warm? Okay, so and we'll do the same thing but touching different body parts and asking him to identify whether it's warm or cold Okay, close your eyes, please and tell me if you feel warm or cold warm Okay, excellent. So this is the peripheral sensory neurologic exam