Sensory Systems and Conditions Flashcards
Sensory receptors: interoception
sensory receptors begin to decline in adulthood, slow and progressive may be unnoticed due to natural adaptation
Interoception: internal detection of changes throughout specific sensory receptors ie hunger/thirst
Visual diagnosis
most common is macular degeneration
cataracts, glaucoma, and daibetic retinopathy
Cornea
part of eye which light enters, tends to thicken over time, more rigid/flattened, change in curvature leads to astigmatism (distorted blurred image)
Sclera/pupil iris
scleral tissues loses water leading to decreased capacity and yellowish cast, increased fatty deposit, atrophy of muscles responsible for dilation lead to smaller more fixed pupils resulting in decreased light that pass through to retina resulting in senile miosis reducing depth perception
associated impairments are cataracts and presbyopia
Lens
decreases in elasticity and ability to transmit/focus ligjt effectively, decreased ability to focus on objects at different distances, lens becomes rigid/dense/opaque resulting in decreased near and far vision, and decreased color spectrum
associated impairment=cataracts and presbyopia
Macula
located central area of retina, used in color differentiation and fine detail, peripheral vision, and night vision
decreased rod density with age and thinning of retinal nerve fiber layer leads to narrowing field of vision, difficulty seeing in low light environments, increased sensitivity to glare, and increased time to adapt when transitioning to/from light and dark
Associated impairments are Age related Macular degeneration, dry non exudative and wet exudative
optic nerve
part of nervous system that processes visual stimuli, tends to slow with time requiring longer exposure to accurately identify objects, degeneration of areas of cortex affects contrast sensitivity, figure/foreground discrimination
associated with glaucoma
Types of hearing loss
hearing loss is the most condition of 70+ year olds
sensorineural loss
conducive hearing loss
Sensorineural Hearing loss
loss or damage to the sensory hair cells of cochlea or damage to nerve cells of cortex, cochlear ganglion, or brainstem tracts
caused by high BP, ototoxic medication, DM, TBI, prolonged exposure to loud noises
Types of Sensorineural Hearing Loss
presbycusis: age related hearing loss, progressive sensorineural loss, occurs in. both ears and primarily affects high frequency sounds
Noice induced hearing loss: caused by prolonged exposure to loud sounds leading to hair cell death, changes in hearing, tinnitus, muffled sounds, difficulty with sound clarity rather than amplification, occurs one ear
Conducive hearing loss
occurs when sound waves cannot reach the inner ear
common causes are punctured ear drum, fluid accumulation, earwax build up, medical tx can restore hearing
Central Auditory Processing Disorder
common in neurodegenerative disease like parkinson’s disease/dementia
affects comprehension of sound rather than ability to hear it
Results of untreated hearing loss
depression, falls, dementia, rehospitalizations, and decreased engagement in aDLs
What is the most common cause of hearing loss?
damage to stereocilia that line the cochlea of inner ear
hair cell may die naturally as pt ages leading to symmetrical loss of high pitched sound or sound
induced damage from prolong exposure to sound louder than 85 decibels, asymmetrical and accompanied by ringing, hissing, and pulsing sounds
may have both
Communication Devices
hearing aids, personal sound amplification systems, pocket talkers, loop systems, speech to text apps
hearing assistive technology categories
television: closed caption, wireless infrared head phones, amplify treble, turn off audio enhancements
telephone: caller ID, hearing aid compatible phone, noise cancellation phone, LED/vibrating rings, visual voicemail, captioned telephone, video calling
alerting devices: vibration, LED flashing lights, visual cues
modifications for hearing loss
volume without hearing loss is 6 decibel louder than background noise, persons with hearing loss need a 16 decibel difference than background noise
reduce background noise with home modifications blocking external noise including felt pads for cabinets, chairs, drawers, chair legs
remove source of noise, decibel measuring app to monitor noise, turn down volume on television when communicating
increase sound absorbing material, pillows, heavy curtains, thick blankets, noise absorbing panels, draft stoppers and door sweeps
Education techniques for hearing loss
strategies to facilitate communication including making eye contact, face individual with hearing loss, make sure room is well lit, use facial expressions and physical gestures for more visual information
avoid slowing or talking louder as it distorts your face
add more pauses and enunciate
when repeating, try rephrasing words
Hearing Loss Compensatory Strategies
maintaining eye contact by facing individuals
good lighting
increased gestures
wear clear face mask
add pauses and enunciate
avoid gum/mint in mouth
avoid dismissive comments
ChemoSensory System
taste and smell
with age, taste buds decrease and shrink in size, saliva production decreases leading to dry mouth
decrease smell due to loss of nerve endings and reduced mucus production, can be lack of sensory integration and comprehension in postcentral gyrus area (neuronal degeneration)
aging skin
decreased hair/thinning impairs heat retention
decreased hypodermis (subcutaneous fat) reduces ability to insulate heat, affecting temperature regulation
decreased rate of cell turnover of epidermis, epidermis becomes thinner and dryer more susceptible to tear/injury
degeneration of pacinian/messner’s corpuscles in the dermis resulting in reduced light touch and pressure, reduced response time, increased injuries, increased difficulty handling/grasping objects, balance issues, difficulty identifying and localizing stimuli
sweat glands reduce in size/numbers impairing thermoregulation and ability to dissipate heat
Peripheral Vestibular System
neuronal and hair loss affecting otolith organs and semi-circular canals
dysfunction in otoliths leads to BPPV
dysfunction in semi-circular cnaals lead to dizziness and increased falls
Central Vestibular System
aging leads to decreased cerebellar volume and Purkinje cell density which directly impacts perceptual functioning and vestibular reflexes
Dizziness
sensation of distortion of the spatial orientation without any perception of self/environmental motion and not unsteadiness
Vertigo
sensation of self-motion or environmental motion in absence of movement
Unsteadiness
sensation of being unstable in sitting, standing, or walking
Nystagmus
involuntary rhythmic eye movement of the eyes to either side, side to side, up/down, or circular
semicircular canals of inner ear are being stimulated when head not in motion
direction of ocular movement is which semi-circular canal that is being stimulated (L inner eye L beating nystagmus)
Vestibular Disorders
BPPV, Vestibular neuritis, Central Vestibular Disorder, Meniere’s disease, TBI, brain tumor, stroke
Vestibular rehabilitation
addresses compensation, adaptation, substitution, and movement retraining through exercise based activity
Sensory Impairments effects
increased social isolation, anxiety, paranoia, and depression
Vestibular Impairment symptoms
vertigo
oscillopsia
nausea
disequilibrium
spatial disorientation
visual motion sensitivity
reduced dynamic visual acuity
reduced concentration
reduced dual task performance
Functional triggers of vestibular system
getting out of bed, shifting weight to step into shower, bending to put shoes on, retrieving something from refrigerator, reading, driving/riding in car
Vestibular treatment techniques
nervous system habituation, gaze stabilization, and balance techniques
virtual reality, activity modifications, and environmental modifications
Vestibular Disorders ADL Scale
assess self-perceived disablement in individuals with vestibular impairment
Functional, ambulatory, instrumental subscale, 1-10 scale
CTSIB -Clinical Test of Sensory Organization and Balance
sensory interaction and balance in children and adults with fall risk, computerized, assess balance under sensory conditions that cause instability
CTSIB conditions
1) eyes open firm surfaces
2) eyes closed, firm surface (difficulty=rely on vision)
3) firm surfaces, visual conflict (difficulty = rely on vision)
4) Foam, eyes open (difficulty= rely on somatosensory)
5)foam and eyes closed (difficulty=rely on somatosensory, vision)
6) foam and visual conflict (rely on vision, somatosensory, and vestibular loss)
Vision Assessment
acuity, contrast sensitivity, detection of borders/shapes, VOR
Semmes Weinstein monofilament
tactile assessment and sensation
Sensory Interventions principles
top down approach maximizing client’s remaining capabilities
Vision: tactile cues, nightlights, magnifiers, training in scanning tech, AT
Hearing: visual cues/timers, modify acoustic environment, close caption, audiology assessment, educate/promote (I) with hearing aids
Smell: educated on fas/smoke detectors, awareness of expiration dates, encourage routine food smell checks
Balance: strengthening, balance training, fall prevention, and home modifications
