Sensory testing

Question 1

What is sensory integration

Answer 1

• the ability of the brain to organize, interpret and use sensory information
• it informs and guides motor responses
• requires ability to interpret and discriminate among the senses

Question 2

Why screen sensation

Answer 2

• determine the need for more detailed screening
• determine if referral to another health care practitioner is needed
• focuses the search for symptom origin
• aids in identification of system related impairments that contribute to activity and participation limitations or disability

Question 3

Somatosensation

Answer 3

• sensation received from the skin and MSK system
• separate from the 5 senses

Question 4

Where along the system can deficits occur

Answer 4

• sensory receptors
• peripheral nerves
• spinal nerves
• nerve roots
• spinal cord
• brainstem
• thalamus
• sensory cortex also known as somatosensory cortex

Question 5

Cutaneous superficial sensory receptors

Answer 5

• mechanoreceptors
• thermoreceptors
• nociceptors

Question 6

Deep mechnoreceptros

Answer 6

• GTO
• Muscle spindles
• work with superficial to convey the sensory information

Question 7

Patterns of sensory distribution impairments

Answer 7

• dermatomal
• peripheral nerve
• spinal cord
• brain injury

Question 8

Dermatomal distribtion

Answer 8

• nerve root radicular neuropathy

Question 9

Peripheral nerve sensory distribution

Answer 9

• peripheral neuropathy
• sensory, motor, autonomic impairments

Question 10

spinal cord sensory distribution

Answer 10

• more diffuse, can be complete, or incomplete lesions

Question 11

brain injury sensory distribution

Answer 11

• diffuse patterns of sensory loss related to area and amount of damaged tissue

Question 12

Anterolateral spinothalamic pathway

Answer 12

• carry pain, temperature, non-discriminative touch
• activated primarily by mechanoreceptors, nociceptors, thermoreceptors
• crosses over when it enters the SC → medulla → thalamus → somatosensory cortex
• afferent fibers, small diameter, unmyleinated = slow conducting

Question 13

Dorsal column medial lemniscus DCML

Answer 13

• carry more discriminative sensation
• discriminative touch, kinethesia (movement), proprioception (static) and vibration
• activated by mechanoreceptors in skin, joints, muscles and tendons
• large myleinated fibers, conduct rapidly
• enter SC → cross in medulla→ thalamus → somatosensory cortex

Question 14

Sensory examinaiton

Answer 14

1. start distally on extremity; if intact there is no need to continue
2. superficial sensation - more primitive responses (choose one - pain or temperature with dull/sharp or cold/hot)
3. followed by deep sensation choose one = prorioception, kinesthesia, vibration

• if deficits are present then can test combined cortical response which use information from both systems as well as higher level thinking

Question 15

Stereognosis

Answer 15

ability to perceive and recognize the form of an object in the absence of visual and auditory information, by using tactile information to provide cues from texture, size, spatial properties, and temperature

Question 16

Tactile localization

Answer 16

• reflects internal organization of the hand even early in normal development
• the individual’s ability to perceive where on the skin he/she was touched with a light stimulus

Question 17

2 point discrimination

Answer 17

• the ability to discern that two nearby objects touching the skin are truly two distinct points, not one.

Question 18

Double simultaneous stimulation

Answer 18

• examines the ability to perceive a simultaneous touch stimulus on opposite sides of the body;
• proximally and distally on a single extremity; or
• proximally and distally on one side of the body.

Question 19

Graphesthesia

Answer 19

The ability to recognize letters, numbers, or designs traced on the skin

Question 20

Barognosis

Answer 20

ability to recognize weight