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OTA week seven Flashcards

1
Q

steps of sensation

A
  1. sensory receptor
  2. sensory input
  3. integration
  4. brain and spinal cord
  5. CNS
  6. motor output in PNS
  7. effector
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2
Q

what is different sensory modes?

A
  • different receptors for different modalities - visual, auditory, gustatory, olfactory and tactile
  • if overstimulated - pain / discomfort
  • signals travel through spinal cord to thalamus and then to brain for processing
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3
Q

how can senroy and perception be distrupted?

A
  • UMN: tbi, stroke, cp, als
  • LMN: peripheral nerve leisons, ALS
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4
Q

what are possible sensory deficits for clients with neurological conditions?

A
  1. Impaired proprioception
  2. No kinesthesia
  3. Vestibular impairments
  4. Loss of superficial sensation
  5. Loss of sensation (severe)
  6. Hypersensitivity to affected area
  7. Poor stereognosis
  8. No graphesthesia
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5
Q

what is proprioception?

A

Knowing the position of your
body/limbs/joint in space when at rest

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6
Q

what is the assessment for proprioception?

A

With the client’s eyes closed, you
move their joint into flexion and extension and ask
them to identify if the upper extremity is flexed or
extended position after the movement has taken
place and the UE is at rest

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7
Q

what is the treatment for proprioception?

A

retraining - stimulate

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8
Q

what are the functional issues in proprioception?

A
  • balance –> mobility
  • appropriate use of objects
  • knowing where to place UE when not looking to shirt armhole
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9
Q

what is kinesthesia?

A

Awareness of the position and
movement of body parts by means of sensory organs (proprioceptors) in the muscles and joints.

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10
Q

what is the assessment for kinesthesia?

A
  1. ask client to close eyes
  2. hold distal side of pt arm
  3. while passively moving client arm in flex or ext, ask them to identify whether their arm is moving up or down
  4. document
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11
Q

what is the treatment for kinesthesia?

A

retraining (stimulate)

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12
Q

what is vestibular?

A

Sensory information about
motion, equilibrium, and spatial orientation is provided by the vestibular apparatus, which in
each ear includes the utricle, saccule, and three semicircular canals.

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13
Q

what is the assessment for vestibular?

A

thorough evaluation of inner ear may therefore require several different kinds of tests

pt/ot: gait and balance test, berg balance scale

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14
Q

what is loss of superficial sensation?

A

pain , temp and touch are aspects of superficial sensation

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15
Q

what is the assessment for loss of superficial sensation?

A

1) Test for temperature awareness: Apply test tubes filled with hot or cold fluid randomly to areas
of the involved limb
2) Test for pressure: Monofilaments
3) Test for localization of touch: 1-pointlocalization (tactile): Being able to determine area of
touch
4) Test for touch sensation: 2-point
discrimination: Ability to differentiate between 2 points of contact

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16
Q

what is the treatment of superficial sensation?

A
  • discriminative sensory retraining
  • localization retraining
  • graded discrimination retraining
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17
Q

what is the treatment for sensation for severe tbi?

A

sensory stimulation

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18
Q

what is hypersensitivity?

A
  • increased sensory pain

dysesthesia: unpleasant sensation that may be spontaneous or stimulated

allodynia: pain in response to stimulus that is not normally painful

19
Q

what is the assessment for hypersensitivity?

A
  • test for pain (protective response)
20
Q

what is the treatment for hypersensitivity?

A
  • desensitization
21
Q

what is stereognosis?

A
  • use of proprioceptive information and touch to identify items without visual input
22
Q

what is the assessment for stereognosis?

A

stereognosis test

23
Q

what is the treatment for stereognosis ?

A
  • retraining (stimulate), attempts at recognition with actual feedback
24
Q

what is graphesthsia?

A
  • to replicate drawing of letters, numbers, figure drawn on skin of hand/digits
25
what is the assessment of graphesthesis?
ask pt to close eyes and identify letters / numbers that are being drawn on their palm or tip of their finger
26
what is the treatment for graphesthsia?
- retraining (stimulate)
27
what are other symptoms in sensory deficits?
- peripheral neuropathy - neglect -extinction - hemianopia
28
what is damaged to the PNS?
- body's message system is impaired - axons can regenerate as long as nerve cell is not deaad - >100 types
29
what are other symptoms with peripheral neuropathy other than muscle weakness?
- painful cramps - fasciculation (uncontrolled muscle twitiching visible under skin - muscle shrinking
30
what does the treatment and management depends on?
- Proper foot care (i.e. with diabetes) * Diet and exercise, smoking cessation * Medication (ex. In case of immune disorder) * Surgery * Pain is usually managed with meds, depending on severity * Also TENS, hand and foot braces, acupuncture and massage, etc
31
what functional implications are people with peripheral neuropathy challenged with?
* Pressure and vibration threshold * 2-point discrimination * Fine touch * Sensing temperature changes * Feeling pain * Sensing itch
32
what is neglect?
Unilateral spatial neglect (USN) is one of the disabling features of a stroke and is defined as a failure to attend to the side opposite a brain lesion
33
what condition is neglect typically associated with?
stroke
34
what is extinction ?
* When stimuli are presented on both sides, only the one on the same side of the brain lesion is acknowledged * If only one stimulus was presented on the opposite side of the lesion, it would be acknowledged
35
how to retrain extinction?
similar to neglect: cueing, scanning, reading and copying tasks multi sensory approach for neglect and extinction varying input, combinations of input
36
what is hemianopia?
partial blindness or a loss of sight in half of your visual field. It’s caused by brain damage, rather than a problem with your eyes
37
can heminopia be permanent or temporary?
depends on cause
38
what are the two types of heminaopia
homonymous hemianopia: affects same side of each eye, you may only be able to see out of the right half of each eye heternymous hemianopia: affects different sides of each side, you may only be able to see out the left side of your right eye and the right side of the left eye
39
how to reduce sensory deficits?
neuroplasticity -reduced hand use can cause retrogressive modifications to receptors - facilitating hand use can result in stimulation of new receptors - similar changes are noted in the brain with increased acitivity and challenges
40
what can influence neuroplasticity?
- age - motivation - cognitive capacity - practice
41
what is the sensory retraining approach?
1.Stimulating 2.Desensitization 3.Discriminative retraining (localization, grading) * Provide sensory re-education * Short sessions – 10-15 minutes intervals (due to focus needed) a few times daily * No task or object used in the testing of sensation should ever be used in training
42
reinforce learning with mental rehearsal
- mirror therapy - feel different objects with both hands and make them feel the same - find quiet place and mentally practice and rehearse how things feel when they are being used in normal movements - 15 min/day
43
what are strategies to teach in protective sensory re - education
- use unaffected body part to compare sensation - visual input - avoid extreme temps and sharp objects - attempt to soften use of force - use build up handles to distrubute force - change tools and work tasks often - check skin for warmth , redness, edema, blisters, be carefule to treeat wounds and avoid infection - moisturize to maintian supple skin

OTA (8 decks)

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