Intro to Sensory Examinations

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Questions and Answers

What is the primary purpose of performing a sensory examination in clinical practice?

To establish a diagnosis without considering patient symptoms

To assess the effectiveness of pharmaceutical treatments

To evaluate how sensory deficits influence movement and patient safety (correct)

To determine the neurological cause of pain in patients

Which of the following best describes the classification of combined sensation in sensory testing?

A method primarily used to gauge auditory stimuli response

An assessment that involves both mechanoreception and proprioception

A test exclusively measuring thermoreception and nociception

The evaluation that integrates both superficial and deep sensations to assess spatial awareness (correct)

What is an essential consideration for patient preparation before conducting a sensory examination?

Providing the patient with sedatives for relaxation

Clarifying the purpose of the sensory tests to reduce anxiety (correct)

Ensuring the patient is under anesthesia to prevent discomfort

Asking the patient to refrain from verbalizing any discomfort during the testing

Which of the following statements describes superficial sensory modalities most accurately?

They refer to the ability to perceive touch, pressure, pain, and temperature on the skin surface Signup and view all the answers

What neurological implications might arise from an intact sensory system?

Enhanced motor and cognitive learning without conscious effort Signup and view all the answers

Which method is used for assessing awareness of position in joints while at rest?

Proprioceptive awareness Signup and view all the answers

What is the primary purpose of the 'trial run' demonstration prior to testing?

To familiarize the patient with the testing method Signup and view all the answers

What does sharp/dull discrimination test assess in superficial sensory testing?

Pain perception Signup and view all the answers

In sensory testing, when a sensory deficit is noted, what is the next step?

Identify boundaries of impairment Signup and view all the answers

Which of the following is NOT a component of combined cortical sensation?

Pressure perception Signup and view all the answers

What physical obstruction might affect the testing results during sensory impairment assessments?

Visual feedback Signup and view all the answers

Which sensory test evaluates awareness of movement direction during passive range of motion?

Proprioceptive awareness Signup and view all the answers

In the context of diabetic peripheral sensory neuropathy, what is the detection threshold for normal perception using monofilaments?

6-gram monofilament Signup and view all the answers

Which sensory pathway is primarily responsible for transmitting crude sensations such as pain and temperature?

Anterior Spinothalamic Signup and view all the answers

What term describes the inability to recognize the shape and form of objects using touch?

Astereognosis Signup and view all the answers

During sensory testing, which method evaluates the ability to distinguish two closely spaced points on the skin?

Two-Point Discrimination Test Signup and view all the answers

What is the common pattern of sensory impairment associated with diabetes?

Glove and stocking distribution Signup and view all the answers

Which condition is characterized by increased sensitivity to sensory stimuli?

Hyperesthesia Signup and view all the answers

Which type of receptor is primarily involved in detecting pain from potentially damaging stimuli?

Nociceptors Signup and view all the answers

What occurs to sensory function as a result of aging that must be differentiated from pathological conditions?

Reduction in touch detection and balance performance Signup and view all the answers

Which pattern of sensory impairment typically indicates a lesion in a single nerve root?

Dermatomal distribution Signup and view all the answers

What term is used for the abnormal sensation without an apparent cause?

Paresthesia Signup and view all the answers

Which type of stimulus is detected by mechanoreceptors?

Touch and pressure Signup and view all the answers

Study Notes

Purposes of Sensory Examination

To identify the location and nature of a sensory impairment
To understand how a sensory deficit affects movement
To provide a justification for therapeutic intervention
To ensure patient safety
To establish goals and select intervention strategies
To re-evaluate the effectiveness of interventions

Sensory Integration

The neurological process that organizes sensation from a person's body and environment and makes it possible to use the body within that environment
In a healthy system, this process is automatic and unconscious
Influences both motor and cognitive learning
In a non-intact system:
- Identify impairments
- Assist with establishing a Plan of Care
- Help patient find relaxed, comfortable positions
When testing sensory integration, always:
- Encourage patients to avoid "guessing" the correct response
- Conduct a "trial run" demonstration before the test
- Occlude vision but consider the amount of time with eyes closed
Requires knowledge of dermatomes and peripheral nerve patterns
Typically test distal to proximal
Do not test every dermatome
Random application and varied timing of stimuli
Once a deficit is identified, carefully define the boundaries of the impairment

Superficial Sensory Testing

Includes pain perception (sharp/dull), temperature awareness, touch awareness (light tactile touch) and pressure perception (firm pressure)
Temperature awareness is not typically tested in a lab setting

Deep Sensation Testing

Includes kinesthesia, proprioception, and vibration
Kinesthesia: awareness of movement, patient describes the direction of movement during passive range of motion
Proprioception: joint position sense & awareness of joints at rest
Vibratory perception: use of tuning fork over bony prominence

Combined Cortical Sensation

Requires information from exteroceptors and proprioceptive receptors, as well as intact cortical sensory association areas (ie. the brain)
Includes stereognosis, tactile localization, two-point discrimination, double simultaneous stimulation (DSS), graphesthesia, and texture recognition
It is important to test sensation unilaterally for this reason

Conditions Affecting Sensation

Includes pathology, disease, or injury to peripheral nerves (ie. ALS), metabolic disturbances (ie. diabetes mellitus), infection, injury to nerve roots, spinal cord, toxins, tumors, TIA and CVA, brain injury or disease, nutrient deficits

Sensory Distribution

All sensation has a "relatively" specific pattern
Includes dermatomes (skin area supplied by one dorsal nerve root, larger area) and peripheral nerve distribution (skin area supplied by one peripheral nerve, smaller area)

Other Specific Patterns of Sensory Impairment

Diabetes: "glove and stocking"
Multiple sclerosis: “scattered pattern"

Alterations in sensory function occur with normal aging
Must be distinguished from illness, disease, or pathology
Examples include: reduced touch detection, vibration, and reaction time, decreased 2-point discrimination, reduced performance in timed balance testing

Sensory Disturbances Terminology

Anesthesia: loss of sensation
Paresthesia: abnormal sensation without apparent cause
Hyperesthesia: increased sensitivity to sensory stimuli
Hypoalgesia: decreased sensitivity to pain
Hyperalgesia: increased sensitivity to pain
Pallanesthesia: inability to perceive/recognize vibratory stimuli
Dysesthesia: abnormal, unpleasant sensation
Astereognosis: inability to recognize the form & shape of objects by touch

Receptors We Will Test

Mechanoreceptors: touch & pressure, deep: muscle and joint movement, position, vibration
Nociceptors: pain, stimulated by potentially damaging mechanical, chemical or thermal stimuli

Pathways

Anterior Spinothalamic: sensations do not require discrete localization of source or precise gradations in intensity, crude, more primitive system, fibers immediately cross midline at spinal cord to thalamus then somatosensory
Dorsal Column- Medial Lemniscal: Discriminative sensations from specialized mechanoreceptors, fine gradations of intensity and localization, fibers cross at medulla

The Somatosensory Cortex

The central processing unit of humans for sensory information

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Description

Test your knowledge on the importance and methodology of sensory examinations in clinical practice. This quiz covers key concepts like sensory modalities, patient preparation, and implications of sensory testing. Perfect for students in health sciences and practitioners.