Flashcards in Sensation Deck (91)
Why would you do sensory testing?
-Identify a problem interfering with occuapation
--impairments hinder movement
--impairments increase the risk of injury
-Assist with diagnosis (assess type and extent of sensory
-Provide information about return of neurological function
--Evaluate and document sensory recovery
-Determine a treatment plan and approach
--Sensory re-education (remediation)
T/F: Sensation is particularly important for hand function
True. E.g., Fine motor coordination, manipulation, judging force for grasp...
Clients with which diagnosis would most likely NOT need a sensory assessment?
a. C5-6 tetraplegia
b. Multiple sclerosis
c. Myocardial infarction
d. Carpal tunnel syndrome
C. Myocardial infarction: need to evaluate sensory for all others
What clients are appropriate for Sensory Assessments?
-Any client with potential neurological involvement
-Diagnosis determines expected sensory picture
--Other neurological diagnoses
T/F: Any client with potential neurological involvement would be appropriate for sensory assessment
T/F: Diagnosis determines sensory deficits in a patient
False. Diagnosis determines what is expected in a sensory picture, but not always true
This condition results in a total absence in dermatomes below the level of lesion
A complete spinal cord injury. May have paresthesia (tingling or pins and needles) at level of lesion
This condition relates to damage within specific spinal tracts.
Incomplete spinal cord injury.
Anterior=pain and temperature (usually coms back before light touch and proprioception
Posterior=light touch, vibration, proprioception
T/F: Peripheral nerve injuries relate to dermatomes of the body while Spinal cord injury pattern varies with nerves involved and extent of damage
False. Spinal Cord Injuries relate to consistent dermatomes while peripheral nerve injury patterns vary with nerves involved and extend of damage
Damage to this area in a PNI affects a dermatome on one side of the body
Damage to a single nerve root affects a single dermatome on one side of the body.
Damage to this region in a PNI affects sensation within peripheral nerve distribution
Damage to a peripheral nerve affects sensation within peripheral nerve distribution
T/F: Sensory loss severity can very widely in a peripheral nerve injury
-Mild compression: increased sensitivity for light touch or vibration (slightly elevated threshold)
-Complete transection: total loss of tactile sensation within the region
-peripheral neuropathies: (diabetes, alcoholism) "glove and stocking distribution"...distal to proximal with possibly paresthesia/pain
Complete vs incomplete SCI
-Complete: total absence in dermatomes below level of lesion. Might have paresthesia (tingling or pins and needles) at level of lesion
-Incomplete: relates to damage within specific spinal tracts.
--Anterior=pain and temperature (usually come back before light touch and proprioception)
--Posterior=Light touch, vibration, proprioception, etc
Types of PNIs that affect sensation
1. Single nerve root
--affects dermatome on one side of body
2. Damage to peripheral nerve
--affects sensation within peripheral nerve distribution
Expectations for sensation in CVA and Brain injury (cortical lesion)
-Contralateral sensory loss
-perception of light touch and proprioception are most affected
-generalized inattention/lack of awareness
-breakdown in sensory processing-sensorimotor problem
T/F: In CVA and brain injuries, pain is the most affected, temperature is less affected, and fine touch/proprioception is least affected
False. Fine touch/proprioception is most affected, temperature is less affected, and pain is the least affected
T/F: Loss of proprioception and pain are more common following right CVA than left
What are expectations for sensory recovery in a CVA/TBI?
Decreased edema, increased vascular flow, plasticity and relearning
What are expectations for sensory recovery in a LMN injury?
decreased ischemia and edema with first 6 months (any recovery usually within first year)
What are the expectations for sensory recovery in a PNI?
Very likely to fully recover if compression was brief and mild:
-mild compression: full
-prolonged compression: full but not usually normal
-total transection: only with surgical intervention and adequate regrowth (pain and temp usually return first, then touch; moving before light touch and accurate localization recovers last)
-chronic conditions (peripheral neuropathy): usually not
T/F: with PNI sensory recovery, touch usually returns before pain and temperature
False. Pain and temperature usually returns before touch. Moving touch returns before light touch and accurate localization recovers last
T/F: with PNI sensory recovery, moving touch returns before light touch
True. Pain and temperature usually returns before touch, moving touch returns before light touch, and accurate localization recovers last
T/F: Normally, you would be Sensory testing before ROM/MMT/Cognition/Vision
False! Normally, you would do sensory testing after ROM/MMT/Cognition/Vision testing. You may need to alter the sequence based on abilities, limitations, impairments, etc
Sensory Assessment is done when in the sequencing of assessing a pt?
Sensory Assessment follows:
-Interview, Observation of occupational performance, and ROM/MMT/Cognition/Vision
What might you have already observed that would provide you with information regarding a client's sensory status?
Awkwardness with movement
How do you determine which sensory tests to do and the sequence to do them in?
-Look at diagnosis first...steers you toward certain tests
-General before discriminating: e.g., light touch/localization before sharp/dull. Most likely if they can't feel anything, won't be able to discriminate
-Don't do all the tests with all clients
-For the most part the way we sequence them/present them is a rough order of general to discriminating
T/F: When performing sensory testing, it is typical to perform general before discriminating tests
True. E.g., light touch/localization before sharp/dull. Most likely if they can't feel anything, won't be able to discriminate.
T/F: With sensory testing, test the more involved side first
False. Test less involved side first
T/F: In sensory testing, you should test proximal to distal
True. Higher to lower dermatomes.