Dr Kane Sensation Definitions Somatosensory Sensory Integration Purposes 3 Feedback vs Feed forward Why do we test for Sensation Pattern Completeness CNS vs PNS Dermatomal glove and stocking PNS ID: 777228
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Slide1
PHT 1261C Tests and MeasurementsDr. Kane
Sensation
Slide2Definitions
Somatosensory
Sensory Integration
Purposes (3)
Feedback vs. Feed forward
Slide3Why do we test for Sensation?
Pattern
Completeness
CNS vs. PNS
Dermatomal
, glove and stocking = PNS
CVA, SCI = CNS
Slide4When do we test for Sensation?
Prior to motor function
Initial Evaluation
Progress
Discharge
Other
Slide5What is considered prior to sensation testing?
Arousal
Alert
Lethargic
Obtunded
Stuporous
Comatose
Attention Span
Orientation (x3)
Cognition
Fund of knowledge
Calculation ability
Proverb interpretation
Slide6Considerations prior to sensation testing?
Memory
Short term
Long term
Hearing
Visual Acuity
Peripheral vision
Depth perception
Slide7What are you testing with sensation testing?
Classification of Sensory System
By stimulus type/location of receptors
Mechanoreceptors
Thermoreceptors
Nocioreceptors
Chemoreceptors
Photic Receptors
By Spinal pathway mediating information to higher centers
Spinothalmic
tract
Dorsal Column Medial
Lemniscus
Pathway
Slide8Types of Sensory Receptors
Cutaneous Receptors
Free nerve endings
Hair follicle Endings
Merkel’s discs
Ruffini
Endings
Krause’s end-bulbs
Meissner’s
corpuscles
Pacinian
Corpuscles
Slide9Types of Sensory Receptors (cont.)
Deep Sensory Receptors
Muscle Receptors
Muscle Spindles
Golgi Tendon Organs
Free Nerve Endings
Pacinian
Corpuscles
Joint Receptors
Golgi Type endings
Free nerve endings
Ruffini
endings
Paciniform
Endings
Slide10Spinal Pathways for Sensory Signals
Spinothalmic
Pathway – nondiscriminatory;
Anterior
spinothalmic
tract
Lateral
spinothalmic
tract
Spinoreticular
tract
Dorsal Column Medial
Lemniscus
Pathway
Discriminitive
sensation from specialized mechanoreceptors
Stereognosis
Tactile pressure
Barognosis
Graphesthesia
Texture recognition
Kinesthesia
2 point discrimination
Proprioception
V
ibration
Slide11The Somatosensory Cortex
Post Central
Gyrus
Sensory
Homonculus
Slide12Treatment Approaches
Sensory Integration Approach
Compensatory Approach
Slide13Sensory Examination
Occlude vision (if possible)
Conduct a demonstration to familiarize your patient
Slide14Superficial Sensation Testing
Pain
Perception – paper clip; sharp/dull
Temperature
Awareness – test tubes; hot/cold
Touch
Awareness – cotton, tissue, brush; yes/now
Pressure
Perception – fingertip, cotton tip; yes/now
Slide15Deep Sensation Testing
Kinesthesia – describe movement;
Proprioception – describe position;
Vibration – Tuning Fork; yes/no
Slide16Combined Cortical Sensation Testing
Stereognosis
– object recognition
Tactile Localization – cotton swab or finger tip
2 Point Discrimination –
aesthesiometer
or paper clip
Double Simultaneous Stimulation
Opposite sides of body
Proximal and distal on opposite sides of body
Proximal and distal on same side of body
Slide17Combined Cortical Sensation (cont)
Graphesthesia
– tracing finger ID
Texture Recognition – cotton, silk, wool; rough/smooth
Barognosis
– weight recognition; heavier/lighter
Slide18Cranial Nerve Screening – see Table 5.3 pg. 151 & Box 5.5 pg. 152
I – Olfactory – non noxious odor
II – Optic –
Snellen
Chart; Peripheral Vision
III –
Oculomotor
– see below
IV – Trochlear – see below
V – Trigeminal – Sensory of face; Motor – jaw motions
VI –
Abducent
– see below
Note: III, IV, & VI are tested together – pupil equality & size; presence of strabismus; eye tracking; presence of ptosis of eyelid
Slide19Cranial Nerves - continued
VII Facial – facial expressions & symmetry
VIII Auditory – hearing; tuning fork
IX Glossopharyngeal – taste posterior 1/3 of tongue; gag reflex
X –
Vagus
– swallowing; uvula & soft palette symmetry
XI – Accessory – SCM and Trapezius
XII – Hypoglossal – tongue movements