05-04b: Sensation

Question 1

Role of Sensation - What does it do?

Answer 1

• Guides selection of motor response for effective environmental interactions
• Sensory input –> Motor output

Question 2

Dermatome

Answer 2

Skin segment innervated by one dorsal root

Question 3

Attention

Answer 3

Selective awareness of environment or responsiveness to a stimulus or task without being distracted by other stimuli

Question 4

Orientation

Answer 4

Awareness of person, place, time

Question 5

Cognition

Answer 5

• The “process of knowing”

- Includes both awareness and judgment

Question 6

Memory - Examining

Answer 6

• Short-Term: Difficulty following directions, Short list of words, recall list of 7 digits
• Long-Term: Recall date of wedding, where one went to school

Question 7

Sensory Receptors (3)

Answer 7

• Superficial sensation, Deep sensation, Combined cortical sensation
• Tactile sensation

Question 8

Superficial sensation (4)

Answer 8

• Pain, Temperature, Pressure, Light Touch
• Exteroceptors receive sensory stimuli from external environment from skin and subcutaneous tissue
• Dermatomes and peripheral nerve distribution

Question 9

Deep sensation (3)

Answer 9

• Vibration, Proprioception, Kinesthesia
• Proprioceptors provide sensory input
• Stimuli from muscles, joints, tendons, ligaments, fascia

Question 10

Proprioception

Answer 10

• Position sense and awareness of joints at rest; after movement
• Pt identifies static position of an extremity, trunk or body part - tests deep sensation at that joint, not whole body

Question 11

Kinesthesia

Answer 11

• Awareness of movement; tests during movement
• Pt identifies dynamic moving part of proprioception; identify direction and extent of movement of a joint or body part; small ROM

Question 12

Combined cortical sensation

Answer 12

• Stereognosis, Graphesthesia, 2-point discrimination, Barognosis
• Requires both exteroceptors and proprioceptors as well as cortical sensory association areas
• Combination of superficial and deep sensation to form 1 sensation
• Requires interpretation from cortex; processed in parietal lobe

Question 13

Stereognosis

Answer 13

Identify object by touch without looking at it

Question 14

Graphesthesia

Answer 14

Ability to recognize numbers, letters, shapes “written” on the skin with finger trace

Question 15

2-point discrimination

Answer 15

• Ability to perceive two points applied to the skin simultaneously
• Test with 2-point caliper

Question 16

Barognosis

Answer 16

Ability to recognize the difference in the weight (lighter or heavier) of objects by feeling, not looking

Question 17

Sensory impairment patterns

Answer 17

• Dermatome distribution: Nerve roots
• Peripheral nerve distribution: Includes entrapments
• “Glove and Stocking”: Starts with whole foot/feet and spreads to whole hand(s); Associated with peripheral neuropathy, DM
• MS: More scattered distribution because of CNS pathology
• SCI: Nerve root distribution below level of injury

Question 18

Sensation testing

Answer 18

• Superficial: Pain, Pressure, Light Touch, Temperature
• Deep: Vibration, Proprioception, Kinesthesia
• Cortical: Stereognosis, Barognosis, Graphesthesia, 2-point discrimination
• Also includes taste, smell, hearing, vision

Question 19

Sensory data results

Answer 19

Categories: Absent, impaired, delayed, intact

Question 20

Snellen Chart

Answer 20

• Tests vision

- Mounted on wall 20 feet away (the first “20”), then based in line they can correctly read comfortably

Question 21

Peripheral field test

Answer 21

Finger moves toward center until it reaches field of vision

Question 22

Light Touch Test

Answer 22

• Use light touch or stroke; do not indent skin

- Cotton ball or light pressure with finger

Question 23

Pressure test

Answer 23

• Press enough to indent skin for pressure receptors

- Dull side of safety pin or finger

Question 24

Pain test

Answer 24

• Sharp/dull discrimination

- Pin prick

Question 25

Vibration test

Answer 25

• Vibration perception using tuning fork (Random vibration/no vibration)
• Bony prominence - Not dermatome, but specific identification in that bone/area

Question 26

Age-related sensory changes

Answer 26

• Decline in tactile and vibratory sensation
• Decreased 2-point discrimination
• Decline in proprioception

Question 27

Sensory integration techniques

Answer 27

• Reorganize processing of sensory integration

- Treat using compensatory approach - compensate for the loss