| Term | Definition |
|---|
| Sensory Integrity | The ability to interpret and discriminate incoming sensory information |
| Purpose of sensory integrity testing | Determines the patient's ability to interpret and discriminate incoming sensory information. The absence or impairment of a sensation gives an indication of what might be causing their problem. |
| Indications on impaired sensory integrity | 1)edema, lymphedema, effusion 2) impaired gait, balance, locomotion 3) impaired joint integrity, mobility 4) Impaired motor control, motor learning, 5) Impaired neuromotor development, sensory integration 6) Impaired muscle performance (power, strength, endurance), 7) Impaired reflex integrity, 8) Impaired posture 9) Impaired ventilation, respiration, and circulation, 10) pain |
| Sensory tests | 1) tactile sensations, 2) sharp/dull, 3) 2-point discrimination, 4) proprioception, 5) kinesthesia 6) vibration |
| dermatomes | cutaneous areas of that correspond to spinal segments providing their innervation. NOT discrete boundaries. VARY |
| Age-related sensory loss | 1) normal. cause not established, 2) tactile, vibratory stimuli, 3) 2-point discrimination, 4) kinesthetic awareness, 5) pain perception, 6) visual and hearing acuity |
| relation of sensation to motor control | motor learning (control) is dependent upon sensory information, feedback. Without proper relay of sensory information the muscle spindle fibers cannot exhibit motor learning |
| alert | Awake. Attentive to normal stimulation. Normal interactions *cognitive sense |
| lethargic | Appears drowsy. May fall asleep, get side-tracked. Difficulty focusing attention *cognitive sense |
| obtunded | Difficult to arouse. Frequently confused. repeated stimulation required to arouse. Interactions unproductive. *cognitive sense |
| stupor | Responds only to strong, noxious stimuli. Returns to unconscious state when unstimulated. (semi-coma) *cognitive sense |
| coma | Cannot be aroused. Reflex responses may or may not be present. *cognitive sense |
| Arousal | Level of consciousness *cognitive sense |
| Attention | Awareness of environment. Responsiveness to stimuli without distraction. *ask pt to repeat series of a)instructions, b) lists, c) spelling *cognitive sense |
| Orientation | Awareness of a) time, b) person, c) place *cognitive sense |
| Memory | SHORT TERM: recall short list of items 5 minutes later. LONG TERM: a) d.o.b, b) place of birth, c) # of siblings, d) anniversary, e) historical event *cognitive sense |
| Cognition | Process of knowing. Includes: a) awareness and b) judgment *cognitive sense |
| Superficial sensation | Receive stimuli from the external environment via skin and subcutaneous tissue. SENSATIONS: a) pain, b) temperature, c) Light touch, d) deep pressure *exteroceptors |
| Deep Sensations | Receive stimuli from: Muscles, tendons, ligaments, and joints SENSATIONS: Proprioception, kinesthesia, vibration *proprioceptors |
| Combined Cortical Sensations | Require information from both deep (proprioceptors) and superficial (exteroceptors) sensory mechanisms (aka INTEGRATION) and intact cortical sensory association areas (brain). SENSATIONS: a) stereognosis, b) bargonosis, c) graphesthesia, d) 2-point discrimination, e) tactile localization, f) recognition of texture, g) double simultaneous stimulation |
| Spinal Pathways | 2 methods of mediation of sensory information. a) Anterolateral Spinothalamic System and b) Dorsal column-medial Lemniscal System |
| Dorsal Column-Medial Lemniscal System | Discriminative Sensations: a) Discriminative touch, pressure, b) Vibration, c) Movement & position sense, d) Stereognosis, e) Barognosis, f) Graphesthesia |
| Antero-Lateral Spinothalamic System | Self Protective Reactions: a) Thermal, Nocioceptive Information, c) Pain, d) Temperature, e) Localized Touch, f) Tickle, g) Itch, h) Sexual Sensations |
| Thermoreceptors | Respond to change in temperature |
| Mechanoreceptors | Respond to mechanical deformation of receptor or surrounding areas |
| Chemoreceptors | Respond to chemical substances. RESPONSIBLE FOR: a) taste, b) smell, c) O2 levels in arterial blood, d) CO2 concentration, e) osmolality of body fluids |
| Photicreceptors | Respond to light |
| Cutaneous Receptors | Occur at the terminal ends of afferent sensory nerve fibers. Include: a) Free-Nerve Endings, b) Hair Follicle Endings, c) Ruffini's Endings, d) Krause's End-Bulbs, e) Meissner's corpuscles, f) Pacinian Corpuscles, and g) Merkel End Disks |
| Hair Follicle Endings | Sensitive to mechanical movement, touch. LOCATION: base of hair follicles. *cutaneous receptor |
| Free-Nerve Endings | Sensitive to pressure and pain. LOCATION: Muscle fascia *cutaneous receptor |
| Ruffini Endings | Sensitive to touch and pressure. Continuous state of skin deformation (something tight on the skin) LOCATION: deep in dermis *cutaneous recpetor |
| Krause's End-Bulbs | Perceive touch and pressure LOCATION: dermis *cutaneous receptor |
| Meissner's Corpuscles | Perceive discriminative (fine) touch and texture LOCATION: dermis of lips, fingertips, and toes *cutaneous receptor |
| Pacinian Corpuscles | Perceives rapid movement, deep touch, and vibration. Adapts quickly to stimuli and does not continue to be stimulated. LOCATION: subcutaneous tissue and deep tissues of the body (tendons and soft tissue around joints) *cutaneous receptor |
| Merkel's Disks | Perceive Low intensity, velocity touch. Continuous contact. EX: 2-point discrimination and localization of touch. LOCATION: below epidermis *cutaneous receptor |
| Deep Sensory Receptors | Involved in a) Posture and Proprioception, b) Muscle tone, speed, and direction of movement, and c) Muscle and joint receptors. LOCATION: Muscles, tendons, and ligaments |
| Muscle Spindles | Monitor change in length of muscle and velocity of change. Muscle spindle fibers (intrafusal fibers) run parallel to Muscle fibers (extrafusal fibers) EX: proprioception and kinesthesia and motor learning. *deep sensory receptor |
| Golgi Tendon Organs (GTOs) | Monitors tension within the muscle. Provides protective mechanism (preventing damage due to extreme tension by inhibiting muscle contraction and facilitating the antagonist) LOCATION: proximal and distal tendinous insertions of muscle. *deep sensory receptor |
| Sensory Integration Approach | The use of controlled sensory intake through functional skills. Promotes motor learning (re-learning). Involves guided practice in planning and organizing motor skills using intrinsic (natural) feedback and augmented (therapist) feedback. |
| Compensatory Approach | Traditional Method. Prevention. Involves educating the pt how to accommodate for the limitations resulting from their sensory deficit. EX: check bath water temperature and don't walk barefoot. |
Combine with other sets
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