Lab 7 - Sensation and Deep Reflexes Flashcards
What are 4 types of sensation testing?
- 2-point discrimination
- Tactile extinction
- Stereognosis
- Graphesthesia
How do you administer the 2-point discrimination test
Measure on the back over the inferior angle of the scapula and over the palmar surface of the distal phalanx of the little finger
eyes closed
How do you administer a test for tactile extinction
Present two simultaneous sensations to a patient touching one or both sides of their body randomly and the patient should be able to identify if one side or both sides are touched at the same time (swipe hands on forearms)
eyes closed
What happens if a person fails tactile extinction
They are declared to have perceptual deficit (parietal lobe) of tactile extinction
How do you administer stereognosis testing
- Ensure patient has motor control to manipulate objects (eg. keys, coin, paper clip) in both hands
- Ask patient to close eyes
- Present small object to patient and ask them to identify the object by feeling with hands and fingers
- Make sure to test both sides
What does a stereognosis test determine
Ensures the client has contralateral cerebral sensory cortex intact -> if not they are diagnosed as absent stereognosis
How do you administer a test for graphesthesia and when?
Use when patient cannot manipulate objects in hand (eg. stroke-hemiparesis)
1. Ask patient to close eyes
2. Tell client whether using numbers or letters
2. Ask client to identify capital letter or single digit number drawn on palm of clients hand
What does a graphesthesia test determine?
Ensures client has contralateral cerebral sensory cortex intact -> if not they are diagnosed with absent graphesthesia
When measuring for superficial sensations of pain, temperature, light touch, discriminative touch and pressure what are 2 important things you should always do?
- Determine if patient can firstly acknowledge that a sensation is present
- Determine if the quality of sensation is important by comparing it bilaterally
Describe how to administer the pin prick and light touch assessment
- Demonstrate what client would expect to feel on presumed intact area (eg. on cheek, forehead or unaffected limb)
- Instruct client to tell you when they feel something during test
- Ask client to close eyes
- Perform testing using systematic approach (change pattern)
- When client feels something ask where they felt it and if it felt the same as the intact area (keep responses neutral never tell when correct or incorrect)
- Continue testing as needed
Why do we assess both light touch and pinprick sensation
To assess both spinothalamic and DCML sensory tracts
Why do we need to ask if sensation can be felt, where it is felt and if it felt the same as the other side?
To tell a difference between normal and possibly altered sensations
When a sensation is impaired how do we determine if it follows a peripheral nerve or dermatomal pattern?
Determine by testing other areas of the dermatome or up the nerve distribution
What are 3 ways that your handling of administering the test cause issues during sensation of the test?
- Moving hands too much during manipulation
- Working on top of a joint
- Not comparing lesioned sensation to normal sensation
What are the 7 deep tendon reflex assessments and identify location
- Jaw
- Biceps brachii
- Brachioradialis
- Triceps brachii
- Patellar Tendon
- Medial Hamstring
- Achilles Tendon
What is the scale to measure deep tendon reflexes
