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Adult Rehab > Week 4: Assessment of Sensation > Flashcards

Week 4: Assessment of Sensation Flashcards

1
Q

T/F: All clients w/ sensory dysfunction regardless of etiology should be evaluated to determine occupational impact of loss

A

True

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2
Q

CNS or PNS injury? Likely to have deficits in prop and stereognosis

A

CNS

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3
Q

CNS or PNS injury? Likely to have deficits in touch pressure awareness and 2 point discrimination

A

PNS

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4
Q

Respond to touch, pressure, stretch, vibration and stimulated by mechanical deformation

A

Mechanoreceptors

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5
Q

Respond to cell injury or damage and stimulated by substances that injured cells release

A

chemoreceptors

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6
Q

Respond to stimulation of heating or cooling

A

thermoreceptors

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7
Q

Three receptors are called…

A

nociceptors (chemo, mechano, thermo)

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8
Q

Tingling, electrical, prickling sensation

A

Paresthesia

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9
Q

carpal tunnel, tapping volar aspect of wrist creates parethesia, it is referred to as…

A

Tinel sign

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10
Q

Increased pain and may occur during nerve generation

A

Hyperalgesia

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11
Q

Increased sensory pain

A

Hypersensitivity (desensitization helps normalize this)

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12
Q

Unpleasant sensation that may be spontaneous or stimulated

A

Dyesthesia

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13
Q

Pain in response to stimulus that is not normally painful

A

Allodynia (ex. person with complex regional pain syndrome experiences pain with mere movement of air wafting over involved arm)

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14
Q

Area of skin supplied by one spinal dorsal root and spinal nerve

A

Dermatome

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15
Q

Dysfcuntion of peripheral nervous system

A

Neuropathy (order of impairment associated with peripheral neuopathy loss is light touch, cold, heat, and pain (reversed for sensory recovery)

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16
Q

What is order of testing for neuropathy?

A

light touch, cold, heat, and pain

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17
Q

Light touch, cold, heat and pain testing for…

A

neuropathy

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18
Q

Order of testing for sensory recovery…

A

Pain, heat, cold, light touch

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19
Q

Pain, temperature, an touch are called _____ sensation

A

Cutaneous

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20
Q

T/F: proximal parts have higher density of receptors

A

False. Distal parts have higher density of receptors

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21
Q

What are indicators of sensory problems on skin?

A

blisters, altered sweat patterns, calluses, shiny or dry skin, scars , wounds

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22
Q

T/F: lack of sweating correlates with lake of discriminative sensation

A

True

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23
Q

T/F: Nerve damage results in atrophy of soft tissue

A

True

24
Q

Before any sensory testing, what should you do?

A

Occupational profile: history, name, age, hand dominance, sex, occupation, date of injury, client description of sensory problem, screening of motor function, grip, and pinch tests if appropriate

25
Q

How to test for pain?

A

Pinching digit firmly or by pinprick

26
Q

What does pinprick rule out?

A

Digital nerve laceration

27
Q

How does pain test work?

A

Test on uninvolved and to see how much pressure needed. Then press sharp and dull sides. If client indicates both they have intact protective sensation. Incorrect indicates absent protective sensation

28
Q

How does temperature awareness testing work?

A

Also protective sensation (pinprick most used), have hot and cold water in tubes, on forearm, if they sense both, they have intact protective sensation.

29
Q

How do you test for touch sensation?

A

two point discrimination

30
Q

How do you test for protective sensation?

A

Pain (pinprick) and temperature awareness (tubes)

31
Q

How does static two point discrimination work?

A

Using disk criminator, test on fingertips beginning at 5mm apart and do 10 applications, client will respond if they can feel 1 or 2. 1-5mm is normal, 6 -10 is fair, 11 to 15mm is poor

32
Q

What is normal static 2 point discrimination?

A

1-5mm

33
Q

How do you test moving 2 point discrimination?

A

Here, you can move distance between two points until client find the smallest distance. 2-4 mm is normal.

34
Q

How do you test touch pressure?

A

Using a monofilament

35
Q

How do you test proprioception?

A

Hold lateral aspect of elbow, wrist, or digit and flex or extend. If client can tell what movement it is, their prop is intact

36
Q

What does the Dellon Modification of Moberg Pickup test test?

A

Stereognosis

37
Q

What tests functional sensation?

A

Localization of touch (different from touch pressure because it tests tactical discrimination requiring cognitive components)

38
Q

How do you test localization of touch?

A

Using monofilament, touch on hand grid and they point where you touched. If they can ID within 1 cm of actual placement, they have intact touch localization

39
Q

This phenomenon inches processes of habituation, learning, memory, and cellular recovery following injury

A

Neuroplasticity

40
Q

Regarding neuroplasticity… T/F? Sensory perception is dynamic process that is experienced in the PNS

A

False. Sensory perception is dynamic process that is experienced in the CNS

41
Q

Regarding neuroplasticity… T/F? Receptor morphology is affected by hand use.

A

True. “Use it or lose it”

42
Q

Regarding neuroplasticity… T/F? Single stimulus can excite different receptors

A

True

43
Q

How does desensitization work?

A

Through habituation, decrease in response following repeated benign stimuli. ex) rubbing hand on textured shirt is desensitizing and can be performed everyday

44
Q

T/F: stimulation and use of body part affect the cortical map

A

True

45
Q

T/F: sensory re-education shown to improve sensation of fingertip replantations even without repair of nerves

A

True

46
Q

What are some ways of protective sensory re education?

A
  • don’t expose to sharp or cold/heat items
  • soften amount of pressure when gripping
  • use built up hands to distribute grip area
  • examine skin for edema, redness, warmth, blisters, cut
  • moisturize
47
Q

T/F: a client who is not able to localize stimulus but can feel it is not candidate for discriminative sensory re education

A

False. Client can do discriminative sensory re education if they can feel pressure but not able to localize stimulus

48
Q

If you can’t fasten bra, braid own hair, locate wallet, what sensation are you lacking?

A

Discriminative

49
Q

What’s one way to do discriminative sensory re education?

A

Grade grossly dissimilar objects like spoon vs. penny and over time to more similar objects like dime and penny

50
Q

T/F: Localization of moving touch tends to return after localization of constant touch

A

False. Localization of moving touch tends to return before localization of constant touch.

51
Q

What are 3 categories of levels of difficulty in discrimination?

A

1) same or different
2) how they are same or different
3) ID the material

52
Q

Examples of discrimination training?

A

Place object in part of hand and have patient and have them feel different items. ID objects out of box, retrieve objects from rice, perform ADLs with eyes closed

53
Q

T/F: Light touch must be intact for two point discrimination to be test

A

True

54
Q

What are 2 categories of sensory reeducation?

A

The two categories of sensory re-education are protective sensory re-education and discriminative sensory re-education. Protective sensory re-education is for people who cannot feel the sensation of the pain such as a prick, blisters forming, or hot and cold temperatures. Discriminative sensory re-education is when people can feel the sensation, but do not know which part of their body is feeling it

55
Q

Name three signs that represent altered sympathetic nervous system status

A

Paresthesia, the tingling sensation, Hyperglesia, increased pain during nerve regenerated, and Dysethesia, the unpleasant sensation that can be spontaneous or stimulated.

56
Q

Explain why finger tips have enhanced sensation when compared with more proximal body parts.

A

Finger tips have enhanced sensation compared to proximal body parts because distal parts have higher density of receptors and smaller receptive fields.

57
Q

Explain how desensitization works.

A

Desensitization helps normalize the phenomenon of hypersensitivity. It is when the therapist uses stimulation and modalities that is a little more of an annoyance for the client as their tolerance increases.

Adult Rehab (16 decks)

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