deep pain and pressure sensation Flashcards
what are deep pain sensations mediated by in the spinal column?
dorsal columns of the spinal cord transfer deep pain sensations
deep pain sensations are more ______ and less well ___________ than superficial pain
deep pain sensations are more diffuse and less well localized than superficial pain
how are deep pain sensations generally tested?
pressing on deep structures that do not have much overlying tissue containing superficial pain receptors
what would indicate a positive finding during a deep pain sensation test?
loss of pain sensation in tissue
what is Abadie’s sign?
pinching the achilles tendon
what is Pitre’s sign?
pinching the testicles
how is Biernacki sign performed?
pinching or striking the ulnar nerve
how else can deep pain be tested?
putting pressure on the eyeball
when deep pain is diminished, what does it usually indicate?
Dorsal column disease with tabesdorsalis as the classic example
what are multimodal sensations?
a combination of both superficial and deep sensation
what do multimodal sensations integrate with?
higher cortical functions and memory
what is the procedure for sterognosis?
place a common object in the patients hand while their eyes are closed. the patient should be able to identify the object within a few seconds without switching hands. Check BOTH hands
what is the procedure for Barognosis?
Patient assesses the relative weights of similarly sized and shaped objects that have different weights
what is the procedure for topognosis?
touch the patient somewhere on the skin and have them point to the area touched
what is the procedure for Graphognosis?
test the patient by writing a letter or number on their chest, back or palm of the hand and have them identify it
what is the procedure for 2-point discrimination?
touch the patient in two points at the same time and move them closer together until they can only identify 1 point
what are the normal ranges of 2 point discrimination for fingertips, dorsum of fingers, palm, and the dorsum of the hand?
fingertips 2-4mm
dorsum of the fingers 4-6mm
palm 8-12mm
dorsum of the hand 20-30mm
what is Somatognosis?
the ability of the patient to know a body part is their own body part
what is the procedure for the somatognosis test?
place your arm next to the patient’s arm and ask them to “touch your own arm with your finger”
what is Nosognosis?
the ability for the patient to know that they are ill
how do you test Nosognosis?
even with overwhelming evidence of a neurological disease such as hemiplegia (some serious and obvious shit), they will deny that there is a problem… basically some serious denial issues!
