Sensation Flashcards
what is the role of sensation on daily functioning
- with sensory loss e.g. in hand, fine motor coordination and manipulative ability is lost
- amount of force needed to maintain a grasp also depends on sensory feedback
- tactile sensation lets us know if an object is warm or too hot to carry and whether a shower is at the right temperature
what must be assessed
- vision
- hearing
- taste and smell
- vestibular
- proprioception
- tactile (cutaneous)
what is the purpose of a sensory evaluation?
assesses the type and extent of sensory loss
- evaluate and document sensory recovery
- assist in diagnosis
- determine impairment and functional limitations
- provide direction for OT
what does intervention entail?
- determine time to begin sensory reeducation
- determine the need for education to prevent injury
- determine need for desensitization
what are the common visual deficits in individuals with TBI
- reduced visual acuity
- visual field loss
- binocular dysfunction
- spatial perceptual deficit
how to assess the cutaneous sense
- ask client about nature of sensation
- select sensory assessment chart to be used and the skin areas to be tested based on client’s diagnosis
- explain reason for assessing sensation
stimulus from environment is divided into
- location (where)
- intensity ( how serious is the information)
- modality (type of sensation)
what are the principles of assessing sensation
- use quiet room with few extra stimuli
- first demonstrate test on yourself or an area of client’s skin that is unaffected or has intact sensation
- demonstrate test with vision then without vision
- auditory cues must be kept to minimum
- only apply stimuli you’re intending to assess
- apply a number of ‘non-touch’ stimuli
- multiple trails should be done for each sensory modality and area assessed
- make sure client knows how to respond to various stimuli
- record findings as being absent, diminished, impaired or intact
- re-assessment should be done at regular intervals on clients who have peripheral nerve repairs or are on a desensitization program
- contra-lateral uninvolved areas should be tested before involved ones
- start with lower threshold stimulus and move on to higher threshold stimuli
- be careful how you explain
- ask what you feel and where you feel it
- apply stimuli as consistently as possible and use recommended method of application
what should a sensory testing kit contain
- paint brush
- pair of divider
- two small glass bottles
- envelope/ container containing 2 identical cent pieces, keys, marbles, paper clips, matches
- dermatome chart
assessment of primary somatic system
pt. to indicate clearly:
- if they felt stimulus
- whether it felt normal or reduced and if reduced severely, moderately or mildly
- scoring according to trombly suggests a score can be determined by putting the number of correct responses over the number of times of the stimuli
TEMPERATURE AWARENESS assessment
• Temperature awareness is a test for protective sensation. Thermal
receptors detect warmth and cold
• Thermal receptors are also critical for a person to be able to determine
safe water temperature for bathing.
• A client who lacks temperature awareness must learn compensatory
strategies such as testing the water temperature with an unaffected body part
• Stimulus: Capped test tubes or bottles, one with cold water and the other with hot
water are applied in random order to the patient’s skin. To prevent interpretation of
the hot as painful it is recommended that the water should be between 40° - 45°C and
for the cold between 5° to 10°C
• Response: Client should either verbally respond by saying “hot” or “cold” or establish
other means of communication where verbal response is impossible or difficult.
• Scoring: The number of correct responses to the correct temperatures in relation to
the total number of stimuli.
PAIN SENSATION assessment
Pain is an unpleasant sensory and perceptual experience that is associated with either actual
or potential cellular damage.
• Using a sterilized safety pin, assess the amount of pressure required to elicit a pain response
on the uninvolved hand. This is the amount of pressure that the examiner will use on the
involved side.
• Stimulus: a combination of sharp and blunt stimuli using the sharp and blunt end of the
needle. Note – random pattern!
• Response: Client should either verbally respond by saying “sharp” or “blunt” or establish
other means where verbal response is impossible or difficult.
• Scoring: A correct response to both sharp and dull indicates intact protective sensation.
An incorrect response to both sharp and dull indicates absent protective sensation.
DEEP TOUCH / PRESSURE assessment
Stimulus: Where available a pressure aesthesiometer may be used (this applies
a known level of firm pressure to the patients skins). The Semmes-Weinstein
aesthesiometer is a fairy well known one.
Most common method is use of index finger or thumb to press down
reasonably firmly (i.e. so thumb or index finger print leaves a mark in skin)
Response: Client should indicate each time the pressure is applied if s/he feels
it. e.g. yes
Scoring: Simply express in writing whether or not there is a loss e.g 4/10
correct responses
LIGHT TOUCH assessment
Stimulus: touch lightly over the dermatomes or cutaneous area/distribution where
sensation is suspected to be absent or affected, using paint brush, cotton wool or
monofilaments
Response: Client should either verbally respond by saying “yes” or any other means
where verbal response is impossible or difficult.
TOUCH SENSATION-
2 POINT DISCRIMINATION assessment
• Two-point discrimination is a test for receptor density and is a good test
to use for mapping improvement following nerve repair.
• Moving two-point discrimination returns before static two-point
discrimination and is an indicator of recovery that is typically noticed
before static two-point discrimination improves.
• One criticism concerns potential variability in the force of application during testing
