Neurorehabilitation- Sensory And Motor Function Flashcards
Spinal cord involvement
Bilateral typically
Below level of lesion with diffuse sensory involvement
Brain stem involvement
Ipsilateral facial impairments
Contra lateral trunk and limb impairments
Brain involvement
Cortical lesion- impairment is dependent on area of somatosesory cortex affect
Deeper lesions involving thalamus and adjacent structures can lead to diffuse unilateral dysfunction
Contra lateral side affected (crossing of tracts)
Feedback control
Sensory info is received during mvmt to adject motor output
Feedforward conril
Sensory info from past experience are used for anticipatory adjustments (postural control, mvmt)
Sensation testing
Vision should be occluded
Provide a normal
Test stimuli in a random and unpredictable manner
Order of testing sensory
Superficial (pain, tem, touch)
Deep (proprio)
Combine cortical sensations (stereognosis)
What do you record for sensory testing
Modality tested
Surface area affected
Degreee or severity of involvement
Subjective feelings about altered sensation
Potential impact of sensory impairment on function
Superficial sensations
Pain perception (sharp dull)
Temperature awareness (distinguish b/w hot and cold)
Touch awareness (tactile touch input)
Pressure perception (assess by pressing enough to leave an imprint)
Deep sensations testing
Proprioception awareness (up or down or mirroring) *hold sides to keep it controlled
Kinesthesia awareness (awareness of movement, going up or going down)
Vibration perception (assesses the ability to perceive vibratory stimuli with a tuning fork on a bony landmark)
Coritcal sensations
Stereognosis perception (assess tactile object recognition- objects they old know)
Tactile localizations (assess the ability to localize touch sensation- touch patient then patient point where they were touched)
Two-point discrimination (assesses the ability to perceive two separate points on the skin simultaneously and measure the minimal detectable distance between points)
Double simultaneous stimulation (assesses the ability to perceive simulaneous touch stimulus)
Graphesthesia (tracing number, letters, designs that are known)
Texture Recognition (assess the ability to differentiate among various textures)
Barognosis (assesses recognition of weight)
Allodynia
Non-noxious stimulus produces pain
Analgesia
Loss of pain sensitive
Causalgia
Burning painful sensation, often along nerve distribution
Dysesthesia
Touch sensation produces pain
Hyperalgesia
Heightened sensitivity to pain
Hyperasthesia
Heightened sensitivity to sensory stimulation
Hypoalgesia
Decreased sensitivity to pain
Paresthesia
Abnormal sensation with no apparent cause (numbness, tingling)
Interventions to impaired sensation- compensatory approach
How to accommodate with having sensory impairments
Developing alternate stratgies and environmental adaptions
Interventions to impaired sensation- sensory integration approach
Functional skills through guided practice with controllers sensory intake
Activates sensory receptors and higher brain centers
Stimuli are presented in the context of meaningful activities
Enhance sensory integrations is the goal- will have an effect on motor performance
Upper motor neurons
Originate in the brain, brainstorm,, or spinal cord
Before the anterior horn cells of the spinal cord
Lower motor neuron
Originate in the cranial nerve nuclei and motor neurons distal to the anterior horn cells of the spinal cord (receive info from the upper and carry to the muscles)
Weakness
UMN (spastic) and LMN (flaccid)
