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47 Cards in this Set
- Front
- Back
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Somatosensation |
Sensation received from the skin and muscular skeletal system |
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What is sensory integrity Can PTAs collect data on this? |
Ability of the brain to organize, interpret, and use sensory information A neurological process Yes |
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What is sensory dysfunction associated with? How does aging affect this? |
Pathology or injury affecting either PNS or CNS Aging causes decreased acuity of all sensations |
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What kind of pathologies can affect sensation? (11) |
Peripheral nerve damage Metabolic disturbances Infections Impingement Burns Taxes Spinal cord injury Stroke Tumors MS Brain injury |
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Three divisions of sensory receptors |
Superficial, deep, combined cortical sensations |
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Superficial sensory receptors Name Where do they receive stimulus Responsible for? |
Exterorectors Stimulus from external environment via skin and subcutaneous tissue Responsible for perception of pain, temperature, light touch, diffuse pressure( can be deep) |
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Deep sensation Name Receive stimulus from? Responsible for? |
Proprioceptors Stimulus from muscles, tendons, ligaments, joint, Fascia
Responsible for proprioception, kinesthesia, vibration ( position sense, movement, mechanical vibration) |
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Combined cortical sensations Combination of? Require what? Include what? |
Deep and superficial and the brain
Requires info from Exteroceptors and proprioceptors Plus intact cortical sensory system
Includes stereognosis, two point discrimination, baragnosis, graphesthsia, touch localization, recognition of texture and double simultaneous stimulation |
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Types of sensory receptors |
Mechano receptors, Thermo receptors, nocioceptors chemo receptors, photic receptors |
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What sensory receptors do PTs and PTAs work with? |
Mechanoreceptors, thermo receptors, nocioceptors |
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Nocioceptors respond to? Chemoreceptors? Photic? |
Pain Taste, smell, O2 levels, CO2 concentration, osmolality of body fluids Light in visible spectrum |
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Mechanoreceptors: cutaneous sensory ( 7) |
Nerve endings Hair follicles Merkel's discs Ruffini endings Krauses end bulb Meissners corpuscles Pacinian corpuscles |
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Functions of: Free nerve ending Hair follicle Merkle's disc Ruffini endings |
Pain, temp, touch, itch Mechanical movement Low intensity touch, velocity of touch, indentation Touch/ pressure, Deformation and stretch |
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Krause's end bulb Meissners corpuscles Pacinian corpuscles |
Touch and pressure Discriminative touch and movement (fingertips and toes) Deep touch and vibration |
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Mechanoreceptors Deep sensory: Muscle (4) Joint(4) |
Muscle: Muscle spindles Golgi tendon organs Free nerve endings Pacinian corpuscles
Joint: Golgi type endings Free nerve endings Ruffini endings Paciniform endings |
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Mechanoreceptors Deep sensory: Muscle (4) Joint(4) |
Muscle: Muscle spindles Golgi tendon organs Free nerve endings Pacinian corpuscles
Joint: Golgi type endings Free nerve endings Ruffini endings Paciniform endings |
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Muscle spindles Golgi tendon organs Free nerve endings Pacinian corpuscles |
Monitor changes in muscle length, velocity, movement Monitor tension in muscle Pain and pressure Vibration and deep pressure |
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Joint receptors Golgi type endings Free nerve endings Ruffini endings Paciniform endings |
Detect rate of joint movement Pain and crude awareness of joint motion Direction and velocity of joint movement Rapid joint movement |
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Thermoceptors have? Nocioceptors have? |
Cold receptors and warmth receptors
Free nerve endings and extremes of stimuli (which can work with thermoreceptors) |
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Thermoceptors have? Nocioceptors have? |
Cold receptors and warmth receptors
Free nerve endings and extremes of stimuli (which can work with thermoreceptors) |
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Two pathways for transmission of somato sensory signals |
A LST: anterior lateral spinothalamic pathway
DCML: dorsal column medial laminiscal tract |
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ALST activated by? Compares how to DC ML? What kind of sensations of pain and temperature? What three major tracts? |
Activated by Mechanoreceptors, Thermo receptors and nocioceptors
More primitive then DC ML
Diffuse and non-discriminative of pain, temp, crudely localized touch
Anterior spinothalamic tract Lateral spinothalamic tract Spinoreticular tract |
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DCML transmits what? Sensations require? |
Transmit discriminative sensations received from mechanoreceptors
Require fine gradations of intensity and precise localization on the body |
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DCML perceives? |
Tactile pressure Proprioception Vibration Kinesthesia |
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What is required for combined cortical sensations? What does it include? (5) |
Requires intact cortical sensory system
Stereognosis 2 point discrimination Graphesthesia Touch localization Double simultaneous stimulation ( extinction) |
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How do you sensations move through the anterior lateral spinothalamic tract? |
Come into the cord, cross right away, process in thalamus, And get sent to cerebral cortex |
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How do you sensations move through dorsal column medial laminiscal tract? |
Come into cord, cross at level of medulla, then 2000 miss, then cerebral cortex |
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How do you sensations move through dorsal column medial laminiscal tract? |
Come into cord, cross at level of medulla, then to thalamus, then cerebral cortex |
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Where in the brain does the processing of sensory information happen? |
Somatosensory cortex |
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What conditions affect sensation testing and decision-making with thermal agents? (7) |
Arousal Attention Orientation ( time, place, person) Cognition Memory Hearing Visual acuity |
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Levels of arousal( 5) |
Alert Lethargic Obtunded ( needs repeated stimulation) Stupor ( responds to noxious rub) Coma |
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Sensory examination Check? Start with? Explain what? Do a? Which side to test? Proximal or distal? Application should be? |
Arousal, attention, orientation, cognition Start with superficial Explain intervention Trial run Test non-impaired side first Distally to proximally Random, unpredictable, varied |
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Superficial sensation test for pain Patient response? Apply fast or slow? |
Sharp or dull Slow |
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Superficial sensation of temperature awareness. What should temperatures be at? Why? What is the instrument? |
Test tube Cold: 41 – 50°F Warm: 104-113°F More or less than these extremes would elicit pain |
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Common measurement for tactile touch input? |
5.07 or 10 g of force Semmes-Weinstein monofilament |
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Pressure perception test |
Apply pressure firm enough to indent the skin with your finger or cotton swab |
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Kinesthesia awareness test |
Patient responds up, down, in, out Extremity or joint is possibly moved to a small range of motion |
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Pressure perception test |
Apply pressure firm enough to indent the skin with your finger or cotton swab |
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Kinesthesia awareness test |
Patient responds up, down, in, out Extremity or joint is possibly moved to a small range of motion |
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Proprioception awareness test |
Therapist places the patient's arm in a position, and the patient has to duplicate it on the other side, or verbally describe it, or repeat it on the same side |
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Vibration test |
Use earplugs Test bony prominences Vibration at 128 Hz |
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Stereognosis test |
Patient identifies small objects in their hands with their eyes closed |
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Tactile localization test ( topognosis) |
Tip, finger, or cotton swab Patient verbally describes the area being touched or points to it |
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Two point discrimination test |
Randomly apply two points with the circular two point discriminator or aesthesimeter.
Two tips are gradually brought closer together
Randomly alternate between one stimulus and 2 stimulus |
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Double simultaneous stimulation test ( extinction) |
Touch identical locations on opposite sides of body Proximal and distal locations on same side of body Proximal and distal locations on opposite sides of body |
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Double simultaneous stimulation test ( extinction) |
Touch identical locations on opposite sides of body Proximal and distal locations on same side of body Proximal and distal locations on opposite sides of body |
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Graphesthesia test |
Using fingers, trace letters, numbers, or designs on skin
Patient names them, or points to a picture |
