Somatosensory System Examination

Question 1

What does the accuracy of the information from the sensory examiniation rely on?

Answer 1

Patient’s ability to respond to applicatoin of multiple somatosensory stimuli

Question 2

What is an important limitation of the somatosensory examination?

Answer 2

Reliance on conscious awareness of sensory stimulation

Question 3

When testing senses are we testing for ability to use proprioceptive information to prepare for movement or the conscioius awareness of prioprioception?

Answer 3

Conscious perception of proprioception

Question 4

What does the somatosensory examination assess? (4)

Answer 4

• light touch
• conscious proprioception
• sharp vs. dull
• discriminative temperature

Question 5

How are signs of somatosensory dsyfunction categorized?

Answer 5

Loss of function or gain of function

Question 6

What is the purpose of the somatosensory examiniation?

Answer 6

evaluate the pt’s ability to perceive sensory modalities in order to determine the functional integrity of the dorsal column medial leminscus and anterolateral somatosensory pathways

Question 7

What are the types of sensations that can be impaired? (3)

Answer 7

• Superficial
• Proprioceptive
• Discriminative

Question 8

What are the types of severity that can take place with sensory impairment? (5)

Answer 8

• Absent
• Dimnished
• Intact
• Hypersensitive
• Delayed Response

Question 9

What is the testing sequence of the sensations?

Answer 9

Superficial, deep, then combined cortical

Question 10

Where do sensory deficits associated with the cerebrum or brainstem usually occur?

Answer 10

Unilateral distribution often involving both the arm and leg on the side of the body contralateral to the CNS

Question 11

What does sensory deficits in paraplegic distribution involving trunk and LE mean?

Answer 11

Spinal cord injury with sensory loss only in tissues innervated from below the injury level

Question 12

What sensory deficit are dermatomal distribution related to?

Answer 12

Nerve root lesion resulting in band-like areas of sensory loss

Question 13

A peripheral nerve lesion will result in what type of sensory loss?

Answer 13

Peripheral nerve distribution of sensory loss characteristic of the particular cutaneous nerve distribution for the lesioned nerve

Question 14

A general peripheral distribution of sensory deificts is also called what?

Answer 14

Stocking-glove distribution

Question 15

Where do sensory deficits of sporadic distribution usually occur?

Answer 15

Asymmetrical; affecting both sides but different regions on each side

Question 16

What is the following a defintion of?

Absence of sensation

Answer 16

Anesthesia

Question 17

What is the following a defintion of?

Hypoesthesia

Answer 17

Decrease in sensibility

Question 18

What is the following a defintion of?

excess/increased sensivity

Answer 18

Hyperesthesia

Question 19

What is the following a defintion of?

ordinary stimulus results in unpleasant sensation

Answer 19

Dysesthesia

Question 20

What is the following a defintion of?

Painful response to a stimulus that should not be painful

Answer 20

Allodynia

Question 21

What is the following a defintion of?

Abnormal negative sensation without apparent cause

Answer 21

Paresthesia

Question 22

What type of sensory exam is the following?

• Pain: testing sharp vs. dull discrimination or pinprick sensation
• Temp: testing discriminiative temperature sensation

Answer 22

Spinothalamic Tract

Question 23

What type of sensory exam is the following?

• Light touch localization
• vibraratory sensation
• conscious proprioception: joint position sense, joint movement sense
• Discriminative Sensation (tests DCML and Pareital Cortex): two-point discrimination, graphesthesia, stereognosis, bilateral simulatenous touch

Answer 23

DCML pathway

Question 24

What type of sensory exam is the following?

Purpose
- determine if the pt have protective sensation
- tests integrity of spinothalamic tract
- tests crude touch

Answer 24

Testing Sharp/Dull Discrimination

Question 25

# Sharp vs. Dull Discrimination Lesion is spinothalamic tracts or thalamortical radiations produces inability to distinguish ____

Answer 25

Sharp from dull

Question 26

# Sharp vs. Dull Discrimination Lesions of the primary sensory cortex interfere with the ability to ____ stimulus, but pt may be able to distinguish sharp from dull

Answer 26

Localize

Question 27

# What sensory exam is the following? - determine if pt has protective sensation - tests integrity of spinothalamic tract - assesses the ability to percieve the difference between hot and cold stimuli

Answer 27

Testing Temperature Sensation

Question 28

# What sensory exam is the following? Purpose - assess conscious proprioception - tests large peripheral axon and the DCML pathway neurons - important screen for neuropathy - useful to monitor sensory recovery in pt's with brachial plexues injuries or high peripheral nerve lesions

Answer 28

Testing vibration sense

Question 29

# What sensory exam is the following? Purpose - assess the nerve integrity of the DCML pathway - access conscious proprioception for relative static joint position of the upper extremities in space

Answer 29

Testing UE Joint Position Sense

Question 30

# What sensory exam is the following? Purpose - Assess the nerve integrity of the DCML pathway - Access consious proprioception for relative static joint position of the lower extremities in space

Answer 30

Joint LE Joint Position Sense

Question 31

# What sensory exam is the following? Purpose - Assess the nerve integrity of the DCML - Access conscious prioception for the ability to detect movement of the extremities in space - Requires additional temporal processing of the proprioceptive sensation in the CNS

Answer 31

Testing Joint Movement sense: kinethesia

Question 32

# What sensory exam is the following? Purpose - Testing the ability to localize or identify the site of touch sensation on the skin (topognosis) - Determine the integrity of the DCML pathway for light touch

Answer 32

Testing Light-touch localization

Question 33

# What sensory exam is the following? Purpose - assesses the ability to percieve two stimulaneously applied stimuli as two discrete sensations - measure of the smallest distance between two stimuli that can still be perceived as two distinct stimuli

Answer 33

Testing two-point discrimination

Question 34

# What sensory exam is the following? - tests the ability to use light touch, prioprioceptive, and movement information to identify an object placed in the hand - requires ability to discern size, shape, weight, consistency, and texture using combination of both tactile and proprioceptive sense

Answer 34

Testing Sterognosis

Question 35

# What sensory exam is the following? Purpose - determines the ability to recognize letters, numbers, or designs on the skin - tests the DCML system and parietal lobe

Answer 35

Testing Graphesthesia

Question 36

# What sensory exam is the following? Purpose - assesses whether a patient can attend to stimuli on both sides of the body simultaneously

Answer 36

Testing Bilateral stimultaneous touch

Question 37

# What sensory exam is the following? Purpose - Tests for neuropathic pain - tests for pain evoked by stimulus that is not normally painful

Answer 37

Bunch Allodynia