Exam 3- sensory and CN Flashcards
what are considered the 5 basic senses?
sight, smell, taste, touch, hearing
Name some senses
he said he will not test us on this, but this is just thought provoking
~Touch ~Sight ~Smell ~Taste ~Hearing ~Proprioception/ kinesthi ~Pain (visceral) ~Hunger/ satiety (visceral) ~Bowel/Bladder ~Temperature ~Tired/ malaise ~Vibration ~Thirst ~Need to breath ~Nausea ~Barognosis
what are the 2 main tracts that carry touch back?
~Dorsal column
~Anterolateral of spinothalamic tract
dorsal column- can also be called
medial lemniscus
sensory info traveling in dorsal column
~Proprioception
~Vibration
~light touch
~discriminatory touch
spinothalamic tract
anterolateral
sensory info traveling in Anterolateral of spinothalmic tract
~crude touch
~temperature
~pain
temperature can be easily tested by
asking the pts if your hand are cold/hot
Proprioception can be easily tested by
~move one arm to a position with eyes closed
~have him move the other arm to the same position (the joint know the position)
Vibration can be easily tested by
test with toning forks
Light touch can be easily tested by
~cotton (up and down so that hair does not get involved)
~monofilament possibly
Discrimination touch can be easily tested by
~2 pt discrimination
~2 sharp pts
~more in hands and face, less in back and thighs
Cortical sensory
~Traced figure (graphesthesia)- ~Stereognosis
~Double simultaneous
How to test for Graoheselsia?
draw an upper case figure somewhere on the back, etc
How to test for Sterognosis?
know if you are holding something, how much you are holding
How to test for Double simultaneous?
~different sides of the body at the same time (can be light touch, sharp, etc)
~Test bilateral, eyes closed, test randomly
Kinesthetic- meaning and how to test
~feeling the change of the length of tissue
~move the joint (lengthen or shorten the muscles) and pt should be able to tell us which direction we are moving them in
~Hold on sides of limb, so the pt cannot tell which direction you are moving it based just on pressure on limb.
~Could ask where in space the limb is
~Don’t have to have limb moving at that point
What is Proprioception?
feeling joint angle or position
Different types of sensations (or lack of)
~Anesthesia ~Hypoalgesia ~Hyperalgesia ~dysesthesia ~allodynia ~thigmesthesia ~thigmanestheia ~trichoesthesia ~pallesthesia ~pallanesthesia ~stereognosis ~asterognosis
Anesthesia
Loss of sense
Hypoalgesia
painful stimuli but mutes sensation (when you break your arm, you have a lessen pain then you should)
Hyperalgesia
heightened sensation to a painful stimuli (when you break your arm, you have an increase pain then you should)
dysesthesia
unpleasant or painful cutaneous sensory stimulus; pins and needles, etc
allodynia
~pain from non-noxious stimuli
~you sense pain from a non-noxious stimuli (when a person rests their hand on your shoulder, it is painful)
thigmesthesia
ability to feel light touch
thigmanestheia
inability to feel light touch
trichoesthesia
ability to feel the deflection of hair
pallesthesia
ability to feel vibration
pallanesthesia
inability to feel vibration
stereognosis
ability to know what is in out pocket without seeing it/ just feeling; ability to identify something by touch alone
asterognosis
inability to identify something by touch alone
How to label a reflex?
~0 ~1+ ~2+ ~3+ ~4+ ~**5+
Reflex Labeling- 0+
absent
Reflex Labeling- 1+
hyporeflexive
Reflex Labeling- 2+
normal
*can be normal with 1+ and 3+ if it is their normal
Reflex Labeling- 3+
hyperreflexive; brisk
Reflex Labeling- 4+
1-3 beats of clonus
Reflex Labeling- ***5+
sustained clonus
normal reflex spots
~Biceps ~Brachioradialis ~Triceps ~Patellar ~Ankle
what is the biceps reflex testing (spinal level)
C5/6
what is the brachioradialis reflex testing (spinal level)
C5/6
what is the triceps reflex testing (spinal level)
C7
what is the patellar reflex testing (spinal level)
L3/4
what is the ankle reflex testing (spinal level)
S1
other reflexes (the not as common, but good ones)
~Cremastric reflex ~Bulbocavernous ~Anal sphincter ~Abdominal reflex ~Plantar reflex/ Babinski
Cremastric reflex- what do you do?
Stroke the skin of proximal and medial aspects of thigh
Cremastric reflex- testing levels
Involves L1,2
Cremastric reflex- normal reflex
Normal response is elevation of testicles
Bulbocavernous reflex- what do you do?
Pinching of glans penis
Bulbocavernous reflex- testing levels
Involves S2-4
Bulbocavernous reflex- what is the reaction
Normal response is palpable contraction of bulbospongiosus meatus at base of penis
Anal sphincter- what do we do?
Scratching of perianal skin
Anal sphincter- testing levels
Involves S2-4
Anal sphincter- what is the reaction
Normal contraction of external anal sphincter
Abdominal reflex- what do we do
Scratching of skin of anterior abdominal wall with sharp object (lateral to medial scratch in a single dermatome)
Abdominal reflex- what is the testing level?
Evaluates integrity of T6-L1
Abdominal reflex- what is the reaction
Normal response is deviation of umbilicus toward stimulus
Plantar reflex/ Babinski- what do we do?
Stimulus of sole of foot in sweeping motion; calcaneus to distal over shat f 5th metatarsal to medial metatarsal heads
Plantar reflex/ Babinski- what is the testing level
Involves L5-S2
Plantar reflex/ Babinski- what is the reaction
Normal response is PF of toes
