Sensation And Coordination

Question 1

Somatosensory senses

Answer 1

Tactile
Proprioception/ joint position sense
Stereognosis/ haptic perception

Question 2

Somatosensory senses: tactile

Answer 2

Touch - light, deep, 2-point discrimination
Temperature
Pain
Vibration

Question 3

Somatosensory senses: Proprioception/ joint position sense

Answer 3

Muscle and joints

Question 4

Somatosensory senses: stereognosis/ haptic perception

Answer 4

Ability to recognise objects by touch

Question 5

Ascending tracts: ipsilateral

Answer 5

Dorsal column-medial lemniscus pathway - fine touch, 2-point discrimination, vibration and Proprioception

Question 6

Ascending tracts: contralateral

Answer 6

Lateral spinothalamic tract - pain and temperature
Medial/ anterior spinothalamic tract - crude touch and firm pressure

Question 7

Thalamus

Answer 7

Ascending tracts travel via medulla, then from medial lemniscus to thalamus
Receives and modulates input from all ascending somatosensory tracts
Receives information from other areas e.g. basal ganglia and cerebellum
Processing centre of the brain

Question 8

Somatosensory cortex

Answer 8

Processing centre for all somatosensory modalities and marks beginning of conscious awareness of somatosensation
Post-central gurus of parietal lobe, within internal capsule
Information from all sources are integrated to give information about movement in a given body segment

Question 9

Dermatomes

Answer 9

Bilateral region of skin innervated by a pair of spinal nerve roots
Peripheral nerves
Sensory

Question 10

Stroke

Answer 10

Somatosensory deficits are common following stroke - 60%
Impaired tactile sensation in 7-53%
Impaired stereognosis in 31-89%
Impaired Proprioception in 34-64%

Question 11

Multiple sclerosis

Answer 11

Altered sensation occurs at some stage in almost all people with MS
Numbness, tinging or burning
Sensory symptoms are often patchy - affecting one limb, one side of the body or all four limbs

Question 12

Spinal cord injury: complete

Answer 12

Total loss of motor and sensory function below the level of injury

Question 13

Spinal cord injury: incomplete

Answer 13

Some function preserved

Question 14

Spinal cord injury: brown-sequard syndrome

Answer 14

Ipsilateral paralysis and loss of Proprioception
Contralateral loss of pain and temperature

Question 15

Spinal cord injury: anterior cord syndrome

Answer 15

Loss of motor function, pain and temperature sensation
Intact tactile and Proprioception

Question 16

Spinal cord injury: posterior cord syndrome

Answer 16

Loss of Proprioception below the level of injury

Question 17

Spinal cord injury: central cord syndrome

Answer 17

Loss of pain, temperature, light touch, and pressure
Upper limb weakness but lower limb mostly motor intact

Question 18

Why do we need to assess sensation

Answer 18

Diagnostic clues
Safety implications
Predictor of recovery
Implications for rehabilitation
Altered sensation can impact on all aspects of daily life

Question 19

Coordination: cerebellum

Answer 19

Role in movement control
Timing, coordination and integration of movement
Motor learning

Question 20

Ataxia

Answer 20

Cerebellar dysfunction
Postural unsteadiness
Jerky or clumsy movements of trunk and limbs
Low tone, especially proximally
Increased tone distally to gain some stability
Tremor
Gait abnormalities - wide based, staggering, high stepping
Dysarthria
Visual changes

Question 21

Dysmetria

Answer 21

Inaccurate amplitude of movement of intended limb at end-position

Question 22

Dyssynergia

Answer 22

Decomposition of movement
Loss of smooth performance of multi-joint movements
Lack of coordination between agonist and antagonist

Question 23

Dysdiadochokinesis

Answer 23

Inability to perform rapidly alternating movements of force or rhythm

Question 24

Tremor

Answer 24

Movement oscillations due to lack of coordination between agonist and antagonist
Intentional tremor - exaggerated with movements e.g. MS
Resting tremor - seen at rest, reduces with movement e.g. Parkinson’s disease