NurseReview.Org - The Sensory System

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The Sensory System

<ul><li>Examining the sensory system provides information regarding the integrity of the Spinothalamic Tract , posterior...

Client preparation <ul><li>Examination gown </li></ul><ul><li>Sit comfortably on bed or exam table </li></ul><ul><li>Expla...

Equipment <ul><li>Cotton ball </li></ul><ul><li>Objects to feel, quarter or key etc. </li></ul><ul><li>Test tubes with hot...

Screening Test <ul><li>Only necessary to evaluate the following </li></ul><ul><ul><li>Lateral aspect of upper thighs </li>...

Neural Pathways <ul><li>Sensory impulses travel to the brain via </li></ul><ul><ul><li>2 ascending neural pathways </li></...

Lateral Spinothalamic Tract <ul><li>Pain </li></ul><ul><li>Temperature </li></ul><ul><li>Crude & Light Touch </li></ul>

Posterior Columns <ul><li>Position </li></ul><ul><li>Vibration </li></ul><ul><li>Fine touch </li></ul>

Assessment <ul><li>Scatter stimuli over the distal and proximal parts of all extremities and trunk to cover most of the de...

<ul><li>Compare sensations on symmetric parts of the body </li></ul><ul><li>If decrease in sensation </li></ul><ul><ul><li...

<ul><li>Note if the pattern of sensory loss is “distal” </li></ul><ul><ul><li>Glove & stocking ( hands & feet) </li></ul>...

Dermatones <ul><li>L4 – Knee </li></ul><ul><li>L5 – Anterior ankle & foot </li></ul><ul><li>Dermatone = bandof skin innerv...

Light Touch Sensation <ul><li>Use wisp of cotton </li></ul><ul><li>Ask clients to close both eyes and tell you what they f...

Abnormal findings <ul><li>Disorders that can alter perception of sensations </li></ul><ul><ul><li>Peripheral neuropathies ...

Abnormal findings to Touch <ul><li>Anesthesia = absent </li></ul><ul><li>Hypoesthesia = decreased </li></ul><ul><li>Hypere...

Pain Sensation <ul><li>Pin prick </li></ul><ul><li>Tongue blade, dull & sharp </li></ul><ul><li>Ask to distinguish </li></...

Abnormalities to pain <ul><li>Analgesia = absence of pain sensation </li></ul><ul><li>Hypalgesia = decreased </li></ul><u...

Temperature <ul><li>Only tested when pain sensation is abnormal. </li></ul><ul><ul><li>Temp. & pain travel in the latera...

Vibration <ul><li>Low pitched tuning fork (128Hz) </li></ul><ul><li>Distal interphalangeal joint (finger & big toe) </li><...

Posterior Column Tract <ul><li>Vibration – often first sense to be lost in peripheral neuropathy. </li></ul><ul><li>Loss =...

Position ( Kinesthesia) <ul><li>Passive movement of extremity </li></ul><ul><li>Finger or big toe up and down </li></ul><u...

Tactile Discrimination <ul><li>Sensory cortex </li></ul><ul><li>Eyes closed during testing </li></ul><ul><li>Stereognosis=...

<ul><li>Number identification= Graphesthesia </li></ul><ul><ul><li>Used when stereognosis prevented due to motor impairmen...

<ul><li>Point Localization </li></ul><ul><ul><li>Touch pt’s skin </li></ul></ul><ul><ul><li>Open eyes and point to where t...

charting <ul><li>If normal </li></ul><ul><ul><li>Identifies light touch, dull and sharp sensations to trunk and extremitie...

<ul><li>Abnormal results in these tests indicate lesions of the sensory cortex. </li></ul><ul><li>These tests not done on ...

Infants and toddlers <ul><li>Little sensory testing </li></ul><ul><li>Hypoesthesia </li></ul><ul><li>Responds to pain by c...

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