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MD1 PCP > Sensory Disturbance Interview > Flashcards

Sensory Disturbance Interview Flashcards

1
Q

What is sensation?

A

Stimuli detected by specialised receptors in skin/muscles/joints
Transmitted to brain via PNS

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2
Q

What does sensation allow the body to do?

A

Maintain posture
React to pain and other noxious stimuli
Provide info about surrounding envrio

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3
Q

Is sensation a continuous process?

A

Yes

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4
Q

Is sensation a conscious process?

A

Usually no

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5
Q

What can disordered sensation cause?

A

Considerable disability and distress

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6
Q

What are the three parts to gathering information about sensory disturbance?

A

What symptoms
Pattern
Underlying cause

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7
Q

What are the two main categories of sensory symptoms?

A

Positive

Negative

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8
Q

What are positive sensory symptoms caused by?

A

Heightened activity in sensory pathways

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9
Q

What are negative sensory symptoms caused by?

A

Loss of sensory function

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10
Q

What sort of descriptions will patients use when describing positive sensory symptoms?

A 
Tingling
Pins and needles
Pricking
Burning
Tightness
Band-like sensation around body
Electric shock
Pain - often sharp and stabbing
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11
Q

Do patients with positive sensory symptoms have sensory deficits on examination?

A

Usually no

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12
Q

Define paraesthesia

A

Abnormal sensation perceived without abnormal stimulus

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13
Q

Define hyperaesthesia

A

Abnormal increase in sensitivity to stimulus

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14
Q

Define dysaesthesia

A

All positive sensory changes whether due to stimulus or not

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15
Q

Define hyperalgesia

A

Heightened response to noxious stimulus

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16
Q

Define allodynia

A

Normal stimulus felt as pain

17
Q

What sorts of descriptions will patients use when describing negative sensory symptoms?

A

Numbness
Coldness
Loss of feeling in particular distribution

18
Q

Do patients reporting negative sensory symptoms have sensory deficits on examination?

A

Often, yes

19
Q

Define hypoaesthesia

A

Diminished ability to perceive pain/temperature/touch

20
Q

Define anaesthesia

A

Complete inability to perceive pain/temperature/touch

21
Q

Define analgesia

A

Complete insensitivity to pain

22
Q

What might a patient have if they have a sensory disturbance involving the receptors in the muscles, tendons and joints?

A 
Proprioception affected
Sensory ataxia
- Imbalance
- Unsteady gait
- Lack of precision with movements
23
Q

Why is it important to establish the pattern of sensory loss?

A

Helpful in determining likely site of underlying problem

24
Q

What are the patterns of sensory loss?

A

One side of the body
Whole limb or part of limb
Symmetric/asymmetric

25
Q

What are some common patterns of sensory loss?

A

Glove and stocking distribution due to peripheral neuropathy
Dermatomal pattern due to spinal cord/nerve root lesion
Area supplied by particular nerve
Hemisensory loss due to lesion of spinal cord/brainstem/thalamus/cortex

26
Q

What are some examples of CNS conditions that cause sensory disturbance?

A

Cerebrovascular disease
MS
Tumours

27
Q

What are some examples of PNS conditions that cause sensory disturbance?

A

Diabetes
Alcohol excess
Nerve entrapment syndromes

28
Q

What do you ask about the site?

A 
Where is the sensory disturbance?
Does it affect one half of the body?
A whole limb?
Part of a limb?
Is it symmetric or asymmetric?
29
Q

What do you ask about the quality?

A

Positive or negative sensory symptoms

Combination of both

30
Q

What do you ask about the severity?

A

Determine degree to which sensory symptoms disrupt patient’s life

31
Q

What do you ask about the time course?

A

Did it come on suddenly or over days to months?

Is it worse at night?

32
Q

What do you ask about context?

A

Is there anything in particular they noticed at the time the sensory disturbance started?

33
Q

What do you ask about aggravating factors?

A

Is there anything that makes it worse?

34
Q

What do you ask about relieving factors?

A

Is there anything that makes it better?

35
Q

What do you ask about associated features?

A 
Alcohol use
Medications
Past history
Muscle weakness
Gait disturbance
Have you sustained any injuries as a result?
36
Q

What are the three steps to respond to a patient who is emotional?

A

Identify
Acknowledge
Empathise

MD1 PCP (43 decks)

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