Test 1: Sensory Screen and Evaluation Flashcards

(42 cards)

1
Q

describe how a sensory pathway works

A

sensory info enters SC through dorsal roots

carried to higher pathways via ascending pathways

interprets sensation within primary somatosensory cortex

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2
Q

2 main afferent sensory pathways

A

anterolateral spinothalamic pathway
-nondiscriminitive/crude touch/pain/temp
-more primitive

dorsal column medial lemniscus (DCML)
-precise location/discriminative touch

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3
Q

the anterolateral spinothalamic pathway recieves signals from what

A

mechanoreceptors
nociceptors
thermoreceptors

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4
Q

what fibers relay info from the anterolateral spinothalamic path

A

C fibers (peripheral n)

small unmyelinated

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5
Q

3 tracts for the anterolateral spinothalamic tract

A

anterior spinothalamic = crudely localized, light touch, pressure

lateral spinothalamic tract = pain and temp

spinoreticular = deep/diffuse/chronic pain

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6
Q

DCML is primary sensation for

A

discriminitive touch

combined cortical sensations (stereogenesis, tactile pressure, barogenesis, texture, kinesthesia, etc)

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7
Q

DCML receives signals from

A

specialized mechanoreceptors

fine graduations of intensity and precise location on a body surface

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8
Q

fibers involved with the DCML

A

A beta and A delta

large myelinated

rapid conduction

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9
Q

what type of info is perceived in the somatosensory cortex cortical areas

A

location
shape
texture
size

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10
Q

describe sensory receptors

A

nerve endings located at distal ends of afferent n fiber

specific/sensitive to type of stimulus they are designed for

tactile sensations recieved when specific receptors are stimulated

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11
Q

what are teh 3 divisions of sensory receptors

A

superficial
deep
combined (cortical) sensations

** also the 3 types of sensations**

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12
Q

what is superficial sensation/type of receptors

A

exteroreceptors recieve stimuli from environment via skin/subcutaneous tissue

responsible for perception of pain, temp, light touch, and pressure

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13
Q

what is deep sensation/type of receptors

A

proprioceptors recieve stimuli from muscles, tendons, ligaments, joints, and fascia

responsible for sense and awareness of joints at rest, movement awareness, and vibration

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14
Q

what is combined cortical sensation/type of receptors

A

combo of superficial and deep

require info from exteroceptive and proprioceptive receptors as well as intact function of cortical sensory association areas

2 point discrimination, barognosis, graphesthesia, tactile localization, etc

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15
Q

what is a mechanoreceptor

A

respond to mechanical deformation fo receptor/surrounding area

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16
Q

what are thermoreceptors

A

respond to change in temp

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17
Q

what are nociceptors

A

respond to noxious stimuli and result in perception of pain

18
Q

what are chemoreceptors

A

respond to chemical substances and are responsible for taste, smell, oxygen levels, etc

19
Q

what are photic receptors

A

respond to light within the visible spectrum

20
Q

what is a merkel’s disc

A

found abundantly in fingertips

responsible for 2 pt discrimination

21
Q

what is a free nerve ending

A

found throughout body

sense pain, temp, touch, and pressure

22
Q

what are the types of muscle receptors

A

muscle spindles
golgi tendon organs
free nerve ending
pacinian corpuscles

23
Q

what do muscle spindle fibers do

A

monitor changes in muscle length and velocity of these changes

vital role in position and movement and in motor learning

24
Q

types of joint receptors

A

golgi type endings

free nerve endings

ruffini endings

paciniform endings

25
what is a sensory screen and the 5 primary categories
screen that identifies need for further investigation of the neuro/MSK systems light touch pin prick temp joint position/awareness vibration
26
what is a gross sensation screening
part of neurologic evaluation which examines a patients somatosensation
27
what does somatosensory mean
sensation received from the skin and MSK system
28
what is sensory integrity
how clearly a sensation is being perceived determines pts ability to interpret and discriminate among incoming somatosensory information
29
what does a sensory exam/screen include
gross sensation screening part of systems review somatosensory exam tests sensory integrity includes assessing anterolateral spinothalamic and DCML pathways
30
testing order for sensory exam
superficial sensations (pain/light/crude touch/pressure/temp) deep/proprioceptive sensation (DCML path) combined cortical sensation logical because if there is a superficial impairment there will also be a deep one
31
performance considerations for sensory exam
apply stimuli randomly perform distal to proximal avoid desensitized surface areas block patients vision cater verbal cuing for accurate responses
32
common elements that need to be documented for sensory screening
type of sensation area of body being tested degree of involvement localization of the exact boundaries of sensory impairment patient position tools used
33
grading scale for sensation
2 = normal 1 = impaired/delayed 0 = absent NT = not testable (amputation, cast, etc) dermatome chart used to graphically display findings
34
how to test pain perception
sharp/dull discrimination indicates function of protective sensation apply uniform pressure and avoid summation of impulses
35
how to test temperature awareness
distinguish between warm and cool use 2 test tubes with different temps touch pt skin with side of test tube
36
how to test touch awareness
determines perception of tactile input use piece of cotton/monofilament device touch pts skin with instrument; can combine with tactile location (where do you feel touch)
37
how to test pressure perception
determines deeper perception of tactile input cotton swab/tongue depressor apply firm pressure on skin
38
how to test kinesthesia awareness
join tmoved passively through small ROM move in small increments have pt describe the direction of motion
39
how to test proprioceptive awareness
examines joint position sense and awareness joint moved pssively and repositioned statically held in static position patient asked to describe static position
40
what is pronator drift
pt holds arms out in front for 30 sec with eyes closed positive test is if the pts more affected side begins to droop or pronate back to neutral
41
how to test vibration perception
tuning fork (DCML) place on bony prominence while vibrating and still pt can distiguish between 2 conditions
42
what is steregnosis perception
ability to recognize the form of objects by touch