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Sensory Integrity
- Is the ability to organize and use sensory information.
- Normal sensation: the ability to organize and intergrate movement and touch sensation feedback into normal functional and safe activities
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Types of Sensory Integrity
- Peripheral: Sensitivity to touch
- Cortical: two point discimination, Sharp/dull discrimination
- Proprioception: Includes position sense and the awareness of the joints at rest
- Kinesthesia: awareness of movement
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Diagnostic Groups
Sensroy impairment can impose significant functional limitations for the Pt.
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Age Related Changes in Sensation
- Decreases in many senstaions occure
- Medications - can further influence the affects of aging on sensation
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Purpose of Testing Sensation
Determine the level of sensory feedback affecting Pt movement
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Superficial Sensation Tests
- Exteroceptors
- Revieve superfical sensation from the external environment throught the skin and subcutaneous tissue
- Pain
- Temp
- Light Touch
- Pressure
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Deep Sensation Tests
- Proprioceptors
- Reveive stimuli from muscles, tendons, and ligaments, joints, and facia
- Responsible for position sense and awaremess of joint at rest
- Movement awareness (kinesthesia)
- vibration
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Combines cortical Sensations
- Require infromation from both exteroceptors and propriceptors as well as intact function of cortical sensory association areas
- Stereognosis
- Two Point Discrimination
- Tactile localization
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Pathways
- Anterolateral spinothalamic
- Dorsal Column Medial lemniscal System
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Anterolateral Spinothalamic Tract
- initiates self protection reactions and responds to stimuli that are potentially harmfull in nature
- Slow conduction fibers of small diameter
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Dorsal Column
Medial Lemniscal systemInvolved in responses to more discriminative sensations
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Light Touch Test
Use cotton ball
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Pressure Test
use finger and have them tell you when they feel you touching them.
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Proprioception
- hold on sides of finger
- 3 stops
- Begining middle and end
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Kinesthesia
- Pt responds Up or Down
- Two stops
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Vibration
- Show test of sternum
- show on good side first
- tell me when u feel it and when it stops
- LE: distal phylanx of great toe, medial malleolus, knee, ASIS, spinous process of L-spine
- UE : Distal phalanx of index finger, ulnar syloid process, olecranon process, acromion process, spinous process of C-spine
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Stereognosis
give pt 5 items
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Tactile Localization
Top bottom inside outside
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Two Point Discrimination
use aesthesiometer
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Simultaneous Stimulation
Start distal and proximal and work your way in
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Deep Tendon Reflex Testing
- Biceps - C5 hand in supine
- Brachioradialis C6 hand in neutral
- Triceps C7
- Quadriceps L2-4
- Achilies S1-2
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Deep Tendon Reflex Testing Grading
- 0: no response
- 1+ minimal response - slight muscle contraction witout joint movement
- 2 + normal repsonse
- 3+ brisk response
- 4+ hyeractive reflex
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