Sensation and visual testing

Question 1

How do you conduct visual field testing

Answer 1

test quadrants with other eye closed, patient looking at you: superior (60 degree), inferior (75 degree), lateral (100 degree), medial (60 degree)

Question 2

How do you conduct papillary light reflex testing

Answer 2

in on 2 and out on three, should see constriction of both pupils, direct and indirect (or consensual) reflex, test both eyes

Question 3

How do you conduct accommodation testing

Answer 3

Bring finger slowly towards patient’s nose and look for convergence and papillary constriction, tests optic, oculomotor, trochlear, and abducens nerves

Question 4

How do you test for Ptosis

Answer 4

look for drooping of eye lids - oculomotor, ask patient to gaze upwards without moving head

Question 5

How do you test eye movements

Answer 5

Tests oculomotor, trochlear, and abducens *make sure you ax superior oblique and inferior oblique close to medial aspect of eye, and superior and inferior rectus at midline

Question 6

How do you test smooth pursuit

Answer 6

range of 30 degrees side to side and up and down - look for nystagmus

Question 7

How do you test saccades

Answer 7

have finger 15 degrees to one side of nose, have patient look rapidly from your nose to your finger, do side to side and up and down; look for overshooting

Question 8

How do you test for Nystagmus

Answer 8

record direction, ax through eye movement, smooth pursuit * is normally elicited in extreme ranges of eye movement (ie looking to the side)

Question 9

What spinal pathway does light touch

Answer 9

Dorsal column medial lemniscus pathway

Question 10

What pathway does sharp and ull

Answer 10

lateral spinothalamic

Question 11

What pathway does thermal sensation?

How many time should you do thermal testing on a specific area?

Answer 11

Lateral spinothalamic

3-5 times

Question 12

If light touch is intact should you test sharp and ull?

Answer 12

no

Question 13

What spinal pathway is vibratory sense

Answer 13

Dorsal column medial lemniscus pathway

Question 14

How do you test vibratory sense

Answer 14

have 128 Hz tuning fork, start distally and move proximally, hit tuning fork against hand (each time, can quiet it if you aren’t wanting it to vibrate), hold to specific areas of skin for 2 minutes  intact, absent, or impaired

Question 15

Which spinal pathway does joint position sense

How do you test it?

Answer 15

Dorsal column medial lemniscus

• start distal work proximal until you get normal, up/down

Question 16

Which pathway does Two point discrimination

How do you test it?

Answer 16

Dorsal column medial lemniscus

• start with points 5 mm apart (normal: finger tips 2-5 mm, palm 8-12 mm, extremity and trunk 20-30 mm,

Question 17

How do you test stereogenesis

Answer 17

pick three objects, test one hand at a time, intact, impaired, or absent

Question 18

How do you test graphesthesia

Answer 18

draw numbers or letters on palm on hand, do both, intact, absent, or impaired

Question 19

How do you test double stimulation

Answer 19

Ask if you are touching them on both sides or one

Question 20

Name 9 somatosensation tests

Answer 20

Light tough 
Sharp and dull 
Vibratory sense 
Two point discrimination 
Thermal test 
Joint position sense 
Stereonosis 
Graphesthesia 
Double stimulation

Question 21

Rx if somatosensation is impaired

Answer 21

• educate limb protection and skin care
• use available somatosensation
• balance exercises
• minimize edema
• promote active movement
• desensitize hypersensitivity
• maximize visual and vestibular input (look at hand you are moving, use mirror to practice)
• adaptive equipment
• increase confidence