1what are we assessing with sensation?
PNS or CNS
nervous system
2where is the sensory loss if pathology is in the spinal cord?
wherever spinal cord is cut - sensation loss below
3dorsal column
discriminatory touch
proprioception
vibration
4anterolateral system
crude touch
nociception
temperature
5documenting results for sensory test
% correct out of total
6sensory receptors
within the skin
within muscles and myotendinous junctions
within the joint capsule
7what are we testing when we test reflexes?
monosynaptic reflex loop
assessing the afferent and efferent limb of that spinal segment
pathology can be within the PNS or CNS
8deep tendon reflexes
receptor is in the muscle spindle
monosynaptic spinal response
with single afferent and efferent synaptic loop
PNS excitatory response of agonist, inhibitory response of antagonist
CNS controls intensity of response
9hyporeflexia
dysfunction/disorders in the sensory limb as the message travels from the periphery to the SC will result in diminished or absent reflex response (PNS)
Disorders in the lower motor neuron either due to compression or trauma - result will be dimished or absent reflex response (PNS)
local disease or dysfunction at the neuromuscular junction in a single muscle will result in dimished or absent reflex response (PNS)
10hyper-reflexia
dysfunction in the descending pathway due to disease or injury at brain or spinal cord will result in increased excitation to stretch without inhibition (CNS)
11myotome
group of muscles that are most representative of a single spinal nerve innervation
12dermatome
an area of skin supplied by nerves from a single spinal nerve root
13spinal cord injury (CNS) labeled by
last completely intact spinal nerve level
14Spinal nerve (PNS)
the impaired nerve
imapaired sensory distribution in that dermatome unilateral, reduced reflex response, impaired strength in myotome