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Neurology > Examination of the Sensory of Function > Flashcards

Examination of the Sensory of Function Flashcards

1
Q

Where do the sensory impulses travel through in the brain for sensory of function?

A

Spinothalamic tract
Posterior columns

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2
Q

explain the STT?

A

1st order neurons: pain, cold, or warm sensation (DORSAL ROOT GANGLION)

2nd order neurons: decussate via ventral commissure

3rd order neuron: Thalamic relay nuclei

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3
Q

what does the SST convey?

A

pain, temperature, crude & light touch

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4
Q

what parts of the brain is the SST clinically relevant to?

A

peripheral neuropathy
ridiculopathy
spinal cord
cerebral cortex - parietal lobe

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5
Q

explain the dorsal column-medial lemniscal pathway?

A

1st order neurons: DRG -> ipsilateral medulla
2nd order: medulla (decussate to CL side)
3rd order: Ventral Posterior lateral thalamus –> Primary somatosensory cortex

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6
Q

what does the DCLM convey?

A

2-point discirmunation
position (proprioception)
vibration
fine touch

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7
Q

where is the DCLM clinically relevant?

A

tabes dorsalis
posterior cord syndrome
subacute degeneration of the spinal cord
brown-squared syndrome

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8
Q

untreated syphilis can result to weakness or slow degeneration of dorsal columns & roots to?

A

Tabes dorsalis

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9
Q

What DCLM abnormality is caused by vit B12 def ?

A

subacute combined degeneration of the spinal cord

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10
Q

what peripheral nerve fiber type has touch & vibration sense? what are equipments used during test of these?

A

A & Beta

Touch = fingers, piece of cotton wool or soft brush
Vibration = tuning fork (128Hz)

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11
Q

What peripheral nerve fiber type has sensation of pinrpick, sharp pain, & cold?

A

A & Delta

Pinprick, sharp pain = Wooden cocktail sticks
Cold = cold object

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12
Q

What peripheral nerve fiber type has sensation of warmth? equipment used for this test?

A

C = warmth

Warmth = warm object (42)

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13
Q

what are the necessary body parts to evaluate for examination of sensory function?

A

dorsum of hands & feet
laeral aspect of upper thighs
inner aspect of upper arms

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14
Q

what are abnormal symptoms seen in assessing sensory function?

A

pain
numbness
tingling sensation

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15
Q

what are the important dermatomes from cervical to S1?

A

C3 = front of neck
T4 = nipples
T10 = umbilicus
C6= thumb
C7 = middle finger
C8 = little finger
T1 = posterior arm
L1 = inguinal
L3/L4 = knee
L5 = =big toe
S1 = pinky toe, posterior aspect of leg & thigh

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16
Q

what pattern of sensory loss has it lost throughout the opposite side of the face, arm, & legs?

A

Thalamic lesion - central from the thalamus up

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17
Q

What pattern of sensory loss has CL sensory loss below face & IL loss on the face?

A

Brainstem lesion

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18
Q

What pattern of sensory loss has asymmetrical & dissociation like pain, temp loss but light touch is intact?

A

Central cord lesion

19
Q

What pattern of sensory losss is a Brown-Sequard syndrome where there is CL pain & temp loss, IL weakness & DC loss below lesion, UMN?

A

Hemisection of cord or unilateral cord lesion

20
Q

What pattern of sensory loss has loss of modalities below lesion where spinal cord is transected?

A

transverse cord lesion

21
Q

What pattern of sensory lass has demyelination, loss of proprioception, vibration & light touch?

A

isolated dorsal column lesion

22
Q

what pattern of sensory loss has cervical root compression, shingles (T5), lumbar root compression (L4) peripherally?

A

Individual sensory root lesions

23
Q

what pattern of sensory loss has distal, symmetric polyneuropathy where multiple nerves are affected?

A

Typical glove & stocking distribution

24
Q

What are other sensory losses of Typical glove & stocking distribution?

A
  • Wullerian degeeneration = nerve gets damaged from tip of toes bilaterally to up and back to the root
  • peropheral nerve problem
  • metabolic & systemic problems
25
Q

what is the presentation of Brown Sequard syndrome?

A

ST & DCML on the same side but presents CL

26
Q

what type of nerve pattern loss has median nerve innervating the first 3 1/2 fingers on the palmar aspect but the dorsal aspect is only the giners?

A

Focal neuropathy

27
Q

what are other clin features of focal neuropathy?

A

ulnar nerve innervates the PINKy side
Radial nerve involves 3 1/2 aspects on the dorsal hand

28
Q

what is the order of asssessment for sensory loss?

A

Superficial (exteroceptive) sensation
Proprioceptive (deep) sensation
Combined cortical sensations

29
Q

what are the diff superficial sensations?

A

pain perception
temperature awareness
touch awareness
pressure perception

30
Q

what are the diff deep sensations?

A

Kinesthesia awareness (proprioception)
Vibration proprioception

31
Q

what are the diff combined cortical sensation?

A

stereogenesis perception
tactile localization
two-point distribution
double simultaneous stimulation
graphesthesia
recognition of texture
barognosis

32
Q

what are the 3 superficial sensations?

A

light touch sensation
temperature
pain

33
Q

in what conditions do you see abnormal findings of light touch sensation?

A

diabetes
folic acid def
alcoholism

34
Q

in what conditions do you see abnormal findings of pain sensation?

A

analgesia
hypoalgesia
hyperalgesia

35
Q

when do you test for temperature sensation?

A

when pain sensation is abnormal

36
Q

what are the 2 types of deep sensation?

A

vibration
position/kinesthesia

37
Q

what neuro pathway is observed in vibration?

A

Dorsal column pathway

38
Q

in px with length dependent polyneuropathies & glove & stocking distribution, what is the first site to be affected?

A

distal sites -> toes

39
Q

what if position sense is intact distally, what does it mean?

A

proximal position sense is also intact

40
Q

can px with severe dorsal column problems detect kinesthesia?

A

no

41
Q

what are the main features of gait of sensory ataxia?

A

“stamp & stick”
var degrees of difficult standing & walking
intact muscular power (motor strength)
no dizziness
+ Romberg sign
loss of position sense & vibratory sense of both lower extremities

42
Q

what are interprative sensory functions that require analysis of indiv sensory modalities by parietal lobes?

A

cortical sensation

43
Q

what are the diff cortical sensations tested?

A

Stereognosis - identify obejcts by feel
Graphesthesia = number identificaiton
2 point discrimination = paper clips
Sensory attention = perceive 2 simultaneous sensory stimuli

44
Q

what are the diff typical patterns in charting?

A

Thalamic lesion or higher = half of whole body
spinal cord lesion = half of upper/lower body
peripheral nervous system = peripheries (hands & legs)

Neurology (8 decks)

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