Sensory Systems and Conditions

Question 1

Sensory receptors: interoception

Answer 1

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

Question 2

Visual diagnosis

Answer 2

most common is macular degeneration

cataracts, glaucoma, and daibetic retinopathy

Question 3

Cornea

Answer 3

part of eye which light enters, tends to thicken over time, more rigid/flattened, change in curvature leads to astigmatism (distorted blurred image)

Question 4

Sclera/pupil iris

Answer 4

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

Question 5

Lens

Answer 5

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

Question 6

Macula

Answer 6

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

Question 7

optic nerve

Answer 7

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

Question 8

Types of hearing loss

Answer 8

hearing loss is the most condition of 70+ year olds
sensorineural loss
conducive hearing loss

Question 9

Sensorineural Hearing loss

Answer 9

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

Question 10

Types of Sensorineural Hearing Loss

Answer 10

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

Question 11

Conducive hearing loss

Answer 11

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

Question 12

Central Auditory Processing Disorder

Answer 12

common in neurodegenerative disease like parkinson’s disease/dementia

affects comprehension of sound rather than ability to hear it

Question 13

Results of untreated hearing loss

Answer 13

depression, falls, dementia, rehospitalizations, and decreased engagement in aDLs

Question 14

What is the most common cause of hearing loss?

Answer 14

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

Question 15

Communication Devices

Answer 15

hearing aids, personal sound amplification systems, pocket talkers, loop systems, speech to text apps

Question 16

hearing assistive technology categories

Answer 16

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

Question 17

modifications for hearing loss

Answer 17

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

Question 18

Education techniques for hearing loss

Answer 18

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

Question 19

Hearing Loss Compensatory Strategies

Answer 19

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

Question 20

ChemoSensory System

Answer 20

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)

Question 21

aging skin

Answer 21

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

Question 22

Peripheral Vestibular System

Answer 22

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

Question 23

Central Vestibular System

Answer 23

aging leads to decreased cerebellar volume and Purkinje cell density which directly impacts perceptual functioning and vestibular reflexes

Question 24

Dizziness

Answer 24

sensation of distortion of the spatial orientation without any perception of self/environmental motion and not unsteadiness

Question 25

Vertigo

Answer 25

sensation of self-motion or environmental motion in absence of movement

Question 26

Unsteadiness

Answer 26

sensation of being unstable in sitting, standing, or walking

Question 27

Nystagmus

Answer 27

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)

Question 28

Vestibular Disorders

Answer 28

BPPV, Vestibular neuritis, Central Vestibular Disorder, Meniere’s disease, TBI, brain tumor, stroke

Question 29

Vestibular rehabilitation

Answer 29

addresses compensation, adaptation, substitution, and movement retraining through exercise based activity

Question 30

Sensory Impairments effects

Answer 30

increased social isolation, anxiety, paranoia, and depression

Question 31

Vestibular Impairment symptoms

Answer 31

vertigo
oscillopsia
nausea
disequilibrium
spatial disorientation
visual motion sensitivity
reduced dynamic visual acuity
reduced concentration
reduced dual task performance

Question 32

Functional triggers of vestibular system

Answer 32

getting out of bed, shifting weight to step into shower, bending to put shoes on, retrieving something from refrigerator, reading, driving/riding in car

Question 33

Vestibular treatment techniques

Answer 33

nervous system habituation, gaze stabilization, and balance techniques

virtual reality, activity modifications, and environmental modifications

Question 34

Vestibular Disorders ADL Scale

Answer 34

assess self-perceived disablement in individuals with vestibular impairment

Functional, ambulatory, instrumental subscale, 1-10 scale

Question 35

CTSIB -Clinical Test of Sensory Organization and Balance

Answer 35

sensory interaction and balance in children and adults with fall risk, computerized, assess balance under sensory conditions that cause instability

Question 36

CTSIB conditions

Answer 36

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)

Question 37

Vision Assessment

Answer 37

acuity, contrast sensitivity, detection of borders/shapes, VOR

Question 38

Semmes Weinstein monofilament

Answer 38

tactile assessment and sensation

Question 39

Sensory Interventions principles

Answer 39

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