Ndt- Sensory Function Chap 3

Front 1

Sensory integration (Jean Ayers)

Back 1

is the ability of the brain to organize, interpret and use sensory information

Front 2

What are the 3 things sensory integration does?

Back 2

Provides an internal representation of the environment that informs and guides motor responses.

Provide foundation on which motor programs for purposeful movements are planned, coordinated, and implemented.

Occurs automatically, without conscious effort (in normals).

Front 3

What's linked to sensation?

Back 3

motor learning and motor performance

Front 4

Feedback control:

Back 4

uses sensory information received during the movement to monitor and adjust output.

Front 5

Feedforward control:

Back 5

(proactive) signals are sent in advance of the movement allowing for anticipatory adjustments in postural control or movement

Front 6

Arousal

Back 6

-physiological readiness for activity. Definitions are given in your text (know them). These will come up on both exams.

Front 7

Alert:

Back 7

: Pt is awake and attentive to normal levels of stimulation.

Interactions with therapist: normal and appropriate.

Front 8

Lethargic:

Back 8

Pt appears drowsy and may fall asleep if not stimulated in some way.

Interactions with therapist: may get diverted.

Difficulty focusing or maintaining attention on question or task

Front 9

Obtunded:

Back 9

Pt is difficult to arouse from somnolent state and frequently confused when awake.

Interations with therapist may be largely unproductive.

Repeated stimulus is needed to maintain consciousness.

Front 10

Stupor (semicoma):

Back 10

Pt responds only to strong, generally noxious stimuli and returns to uncounscious state when stimulation is stopped. When aroused, the patient is unable to interact with the therapist.

Front 11

Coma (deep coma):

Back 11

The patient cannot be aroused by any type of stimulation. Reflex motor responses may or may not be seen.

Front 12

Attention

Back 12

selective awareness or responsiveness to a stimulus or task without being distracted by other stimuli know these, on both tests.

Front 13

What could you do to test attention?

Back 13

Asking the patient to repeat items on a progressively more challenging list.

Front 14

Cognition

Back 14

process of knowing and includes both awareness and judgment

Front 15

Fund of knowledge:

Back 15

the sum total of an individuals’ learning and experience in life; ie: who is the president? In what state is Boston in?

Front 16

Proverb interpretation

Back 16

the ability to interpret use of words outside of their usual context or meaning.

Front 17

cognition

Back 17

fund of knowledge, calculation ability, proverb interpretation

Front 18

What are the preliminary considerations?

Back 18

arousal, attention, orientation, cognition, memory long and short term, hearing, visual acuity

Front 19

Superficial sensation

Back 19

-exteroceptors responsible for superficial sensations (pain, temp, touch, pressure)

Front 20

Deep sensation

Back 20

proprioceptors responsible for deep sensations (muscles, tendons, ligaments, joints, facsia for awareness of joints at rest, movement awareness, and vibration)

Front 21

Somatosensory cortex:

Back 21

The primary and association areas are responsible for:

1. identifying location of stimulation,

2. discerning its size, shape and texture (as appropriate),

3. analyzing and integrating somatosensory info

4. contributing to MOTOR performance

Front 22

contributing to MOTOR performance because they:

Back 22

Determine initial position required before a movement occurs (voluntary normal movement)

Detect errors as movement occurs

Id movement outcomes to help shape learning

Front 23

What are the 3 major types of sensation that everyone should be tested?

Back 23

superficial, deep, and combined

Front 24

What do you have to screen for before you can do your sensory screening?

Back 24

Mental status, vision, and hearing acuity

Front 25

7 possible areas of sensory exam

Back 25

Pain

Temperature (a new toy) so hard to do

Light touch

Vibration

Stereognosis

2 point discrim

Recognition of texture

Front 26

What data should you collect?

Back 26

The modality tested

Quantity of involvement or body surface areas affected

Degree or severity of involvement ( absent, impaired, delayed)

Localization of the exact boundaries of the sensory impairment

Pt’s subjective feelings about changes in sensation

Potential impact of sensory loss on function

Front 27

kinesthesia :

Back 27

Move joint(s) passively thru small ROM

Be sure patient knows up, down, in, out, etc;

PT id’s in notes what part of ROM is examined: initial (beginning), middle, terminal (end). Don’t go into more detail unless needing to.

Patient should tell you which way joint is moving while it’s moving; therefore, if you use a small ROM, you have to go slowly

What types of other responses are acceptable? Duplication with other arm

Front 28

proprioception

Back 28

* Patient described held position or places opposite extremity in same position as tested one

Front 29

Vibration

Back 29

have to be careful that people aren’t just hearing the vibration

Base of vibrating fork over bony prominences

Auditory cues-hit the fork each time to make it vibrate but sometimes use your hand to stop the tines before you place it on the patient

Front 30

When testing combined cortical sensations, what 2 test should you always do?

Back 30

stereognosis and 2 point discrim

if in tact then no further testing is needed?

Front 31

If stereognosis weren't in take what are some further testing that you would do?

Back 31

tactile localization

NOT usually tested in isolation

You can combine it with similar tests such as pressure perception or touch awareness.

4. double (bilateral) simultaneous stimulation

Extinction phenomena: situation in which only the proximal stimulus is perceived with extinction of the distal or when both proximal stimuli are perceived (on both upper arms) but not perceived on both distal sites (e.g., both thumbs)

5. graphesthesia

Useful when paralysis prevents grasping an object

6. recognition of texture

7. barognosis

Front 32

reliability wanted?

Back 32

Interrater reliability

Front 33

Sensory Intgration approach

Back 33

POC enhances opportunities for controlled sensory intake within a framework of meaningful functional skills. Provide guided practice in planning and organizing motor behaviors using intrinsic and augmented feedback.

Front 34

compensatory

Back 34

patient education to accommodate limitations imposed by sensory deficit. Also think safety! Ie testing bath water, not going barefoot, regularly checking insensitive skin areas for cuts or bruises