numbness Flashcards
Pins and needles, no pain, appears even with (-) stimulus
paresthesia
Cover all types of abnormal sensation including
painful ones, (+/-) stimulus.
dysesthesia
pain in response to touch
hyperesthesia
reduction of cutaneous sensation
hypesthesia
Reduced pain perception (usually seen in poorly
controlled diabetic patients)
hypalgesia
Encompasses all (Allodynia, Hyperesthesia,
Hyperalgesia)
o Delayed perception with increased threshold of
pain
Hyperpathia
patient sways markedly or topples when asked to stand with feet close together and eyes closed
+ romberg sign
pain and temperature
spinothalamic tracts/ anterolateral system
TOUCH, PROPRIOCEPTION and VIBRATION
POSTERIOR COLUMN-MEDIAL LEMNISCAL
posterior column
ipsilateral— proprioception, vibration
spinothalamic tract
contralateral — pain, light touch, temperature
motor supply
anterior and lateral corticospinal
small fobers
Pain, temperature, Heat and cold
PTHC
Large fibers
touch, vibration, position
an area of skin supplied by a single spinal nerve for the modalities of sensation.
dermatomes
dermatome plexus
lumbosacral plexus
dermatomes of the upper limbs
brachial plexus
dermatomes of the trunk
facial, cervical, thoracic
PROPRIOCEPTION: ORDER OF TESTING (upperlimb)
Distal interphalangeal joint, proximal interphalangeal joint, metacarpophalangeal joint,
wrist, elbow, shoulder
proprioception order of testinhg (lowerlimb)
Distal interphalangeal joint of the hallux, metatarsophalangeal joint, ankle knee and hip
quantitative sensory testing
2-point discrimination
touch localization
bilateral simultaneous stimulation tests
perception of figures on the skin,
writing a letter/number on the patient’s skin and
the patient will try to identify
graphesthesia
identifying objects
stereognosis
balance requires
o Vision
o Vestibular sense
o Proprioception
Falling with eyes open or closed
cerebellar lesion
falling only with eyes closed
posterior column or vestibular lesion
deep aching pain along the course of the related nerve trunk
nerve & root: radicular or root lesions
simultaneous malfunction of many peripheral nerves throughout the body
polyneuropathies
enhanced pain but other sensations are diminished
polyneuropathies
are not dermatomal and usually result in loss of sensation, not pain such as the Thalamic lain syndrome
central deficit
brown-sequard
hemisection of the cord
in hemisection of the cord, there is loss of
proprioception and vibration
The afferent sensory fibers are damaged and
theoretically cut so there will be lost of proprioception, vibration, temperature, pain, and light touch.
complete transection
harlequin pattern and lateral medullary syndrome
brainstem lesion
right face affected and left neck
downwards affected.
right lesion
left face affected and right neck downwards affected.
left lesion
Opposite side will be affected. There will be loss of
proprioception, vibration, temperature, pain, and light
touch.
The feeling is like the flesh is being torn off or being
bathed in acid. It is very painful.
thalamic lesion
