Sensory Assessment Flashcards
What is the importance of somatosensory function in the clinical setting?
It is crucial for assessing and diagnosing sensory impairments.
What are the common tests of the somatosensory system used in the clinical setting?
Tests include…
- touch awareness,
- sharp/dull discrimination,
- temperature sensation,
- vibration sense,
- proprioception,
- combined cortical sensations
What functions does the anterolateral (spinothalamic) pathway serve?
- Pain
- Temperature
- Crude touch sensations
What functions does the dorsal column-medial lemniscus (DCML) pathway serve?
It is responsible for light touch, two-point discrimination, pressure, vibration, proprioception, barognosis, graphesthesia, texture recognition, and stereognosis.
What are the types of superficial sensations?
- Pain (sharp/dull)
- Touch awareness
- Temperature
- Pressure
What are the types of deep sensations?
Kinesthetic awareness, proprioception, and vibration.
What are the types of combined cortical sensations?
Stereognosis, tactile localization, two-point discrimination, double simultaneous stimulation, graphesthesia, and barognosis.
What are the key considerations before starting a sensory exam?
Assess patient’s ability to participate, check arousal and orientation, request patient not to guess, and ensure the patient is in a comfortable position.
Why is it important to eliminate vision during sensory tests?
To ensure that the patient’s responses are based on sensory perception rather than visual cues.
How can you prevent a patient from anticipating stimuli during a sensory test?
By presenting the stimuli in a randomly variable sequence.
What is the procedure for testing touch awareness and tactile localization?
Apply light touch to the skin and ask the patient to respond when they feel the touch and to identify the location of the touch.
What is the procedure for the sharp/dull test and its interpretation?
Use a sharp and a dull object to apply to the skin, ask the patient to identify each stimulus, and interpret responses based on accuracy and consistency.
What is the procedure for the temperature test and its interpretation?
Use test tubes filled with warm and cool water, apply to the skin, ask the patient to identify the temperature, and interpret based on accuracy of identification.
What is the procedure for testing tactile threshold (pressure) and its interpretation?
Use a monofilament aesthesiometer, apply to the skin, ask the patient to respond to the touch, and interpret based on the filament force required for perception.
What is the procedure for testing joint movement sense?
Move the patient’s joint and ask them to identify the direction of movement.
What is the procedure for testing joint position sense?
Move the patient’s joint to a position and ask them to match the position with the opposite limb or describe the position.
What is the procedure for testing vibration sense and its interpretation?
Apply a vibrating tuning fork to bony prominences, ask the patient to identify if it is vibrating, and interpret based on accuracy of responses.
What is the procedure for the two-point discrimination test and its interpretation?
Use calipers to apply two points to the skin, ask the patient to distinguish between one and two points, and interpret based on the minimum distance at which two points are perceived as separate.
What is the procedure for the bilateral simultaneous touch test and its interpretation?
Touch one or both sides of the body, ask the patient to identify the side touched, and interpret based on accuracy of identifying unilateral and bilateral stimuli.
What is the procedure for the graphesthesia test and its interpretation?
Draw a letter or number on the patient’s palm, ask them to identify it, and interpret based on accuracy.
What is the procedure for the stereognosis test and its interpretation?
Place an object in the patient’s hand, ask them to identify it by touch, and interpret based on accuracy.
How does sensory testing aid in differential diagnosis?
It helps localize the extent and site of lesions, supporting or rejecting differential diagnoses.
What are the grading scales used in sensory examination forms?
0 = absent, 1 = impaired, 2 = normal, NT = not testable.
How do you document normal, impaired, and absent sensation?
Normal: 5/5 correct; Impaired: 3-4/5 correct or different intensity; Absent: 0-2/5 correct or no sensation.
