Sensory Examination LECTURE 1 Flashcards
Sensory Integration: What is it?
CNS takes in all sensory information
- Environmental input
- Movement, touch, body in space, sight, sound and smell
- The brain must take in and analyze the sensory input so the reaction to it can be appropriate
- Definition: “is the ability of the brain to organize, interpret, and use sensory information”
Movement
- Motor task is _______
- Learn to anticipate what will happen?:
- Feedback IS ?
- Feed forward IS?
- practiced
- correct movement will occur
- learning in the moment
- learning in the moment
- Guides the motor response to interact with the environment
- Adapt movements
- Protect the person from injury
Sensation
- Sensation received from skin and musculoskeletal system
- Test the sensory system: need to determine the patients ability to interpret and discriminate incoming sensory info
Somatosensory
If abnormal motor behavior, could be from poor______ ________.
sensory input
What does the brain do with the information??
- Correlate sensory input with motor output
- Assess and control body’s interaction with the environment
Clinical Indications for sensory testing
- Depends on information provided in the intake
- Symptoms described by the patient
- Signs elicited during other testing and observations
- Other information
- Associated with pathology or injury
- May affect peripheral nervous system or central nervous system, or both
- Can affect ANY PART of the nervous system
- Injury, infection, compression, nutritional deficiency, injuries to nerves, CVA, TIA, MS, TBI
- Look at the PATTERN of sensory involvement
- Does it follow a peripheral or central pattern??
Sensory dysfunction
Crosses more than one dorsal root
Examples: ulnar nerve injury vs C-8
Supraclavicular nerve vs C 5,6,7
Peripheral nerve innervation
Specific nerve injuries
- Diabetic: glove and stocking distribution
- Multiple Sclerosis: scattered pattern of involvement
- Spinal Cord Injury: diffuse pattern of sensory involvement
- Can by symmetric or asymmetric
- Guillen barre syndrome
Spinal cord tracts
- Anterolateral tract
- Dorsal column
- Nerve root
- CNS lesion
Spinal cord tracts carry somatosensory and special sense information- can have damage at the tract which will manifest into various signs and symptoms
Age related changes
- Normal age related changes versus changes specific to illness/pathology
- Normal aging affects vision, hearing and somatosensory system
- Changes affect the health of the elderly patient
With aging what might you see due to sensory changes?
- Postural instability
- Increased body sway
- Balance issues
- Wide based gait
- Decrease in fine motor abilities
- Can’t recognize body positions
- Decrease in muscle mass
How do we accurately test a patient?
Testing for sensory problems
- Do preliminary testing to determine if sensory testing will be accurate
- What do you need to know?
What are the states of arousal?
Alert:
Lethargic:
Stupor/semicoma:
Coma:
Alert and attentive
- If alert: can obtain reasonable information about somatosensory system
- Attention: selective awareness of environment
- can respond to a task without being distracted by other stimuli
Increase attention by having patient repeat longer lists of items