keywords:
Bookmark and Share



Front Back
PRIMARY SOMATOSENSORY SYSTEM
Light touch
Pain
Temperature
Pressure
Vibration
Proprioception
Kinesthesia
Receptive
PRIMARY SOMATOSENSORY SYSTEM is Mediated by:
•Skin receptors
•Spinal nerves
•Spinal cord tracts
•Cortical somatosensory area 1
 
SECONDARY SOMATOSENSORY SYSTEM
Two-point discrimination
Stereognosis
Graphesthesia
Simultaneous stimulation 
Perceptive
 
SECONDARY SOMATOSENSORY SYSTEM is  
Mediated by:

Secondary somatosensory cortex
Posterior multimodel association area
SENSORY RECEPTORS 
Visceral
 
Chemoreceptors (chemicals in blood, osmoreceptors)
Baroreceptors (blood pressure)
 
 
SENSORY RECEPTORS  Somatic
Chemoreceptors (taste, smell)
Thermoreceptors (temperature)
Photoreceptors (vision)
Baroreceptors (sound, balance)
Proprioreceptors (muscle stretch)
 
SENSORY TRANSDUCTION  Receptors:
transform an external signal into a membrane potential
SENSORY TRANSDUCTION 
Two types of receptor cells:
    
- specialized epithelial cell
- nerve cell
 
All sensation begins with specialized cells that detect stimulus information and transmit it to ________________ and the _______________.


 
sensory (afferent) nerves, brain
Sense organs and sensory receptors fall into several main classes based on the type of energy that is being detected:
 
§Photoreception: Detection of light
§Mechanoreception: Detection of pressure, vibration, and movement
§Chemoreception: Detection of chemical stimuli, perceived as smell or taste.
Exteroceptors:
Respond to external stimuli. Related to special senses
Interoceptors:
§Respond to stimuli provided by internal organs


 
Proprioceptors:
Located in the muscles, tendons, ligaments, joints and inner ear. They detect changes in body position and movement
CRANIAL NERVE IMPAIRMENT 


Cranial Nerve 1

 
Smell & Taste


 
CRANIAL NERVE IMPAIRMENT  Cranial Nerve 5
Sensation to face, head, oral cavity & cornea
 
CRANIAL NERVE IMPAIRMENT 
Cranial Nerve 2
Visual acuity, Peripheral vision, Color detection


 
CRANIAL NERVE IMPAIRMENT 
Cranial Nerve 10
Viseral control
CRANIAL NERVE IMPAIRMENT 
Cranial Nerve 7
Detection of sweet food anterior portion of tongue
CRANIAL NERVE IMPAIRMENT 
Cranial Nerve 8
Hearing & Equilibrium


 
CRANIAL NERVE IMPAIRMENT 
Cranial Nerve 9
Detection of sour food anterior portion of tongue
DERMATOMES
An area of skin supplied by sensory neurons that arise from a spinal nerve ganglion


 
touch   Mechanoreceptors:
•Proprioreceptors in tendons, ligaments and muscles à body position
•Touch receptors in the skin: free nerve endings, Merkel’s disks and Meissner’s corpuscles (superficial touch), hair follicles, Pacinian corpuscles and Ruffini’s ending 
Thermoreceptors:
•Warm receptors (30-45oC) and cold receptors (20-35oC)


 
Nociceptors:
•respond to noxious stimuli


 
Fast pain
•sharp and well localized, transmitted by myelinated axons


 
Slow pain
•dull aching sensation, not well localized, transmitted by unmyelinated axons


 
General visceral sensory neurons monitor:
§Stretch, temperature, chemical changes, and irritation


 
General visceral sensory neurons Cell bodies are located in the _____________
dorsal root ganglia
Visceral pain – perceived to be somatic in origin
Referred pain
Visceral pain:  
not as well localized as pain originating from the skin à pain impulses travel on secondary axons dedicated to the somatic afferents à referred pain
TASTE
Receptors located on the tongue (papillea/bumps) which contain taste buds.


§Number of taste buds on average tongue = 10,000
§Replaced every two weeks.
§Decrease in number with aging
 
Traditionally thought to include sweet, sour, bitter and salty
New Research: Umami  = Japanese for delicious
 
Receptors for taste are ________________________ present in taste buds located on the tongue, roof of the mouth and pharynx


 
modified epithelial cell
Specialized neurons present in the olfactory epithelium in the nose. Each olfactory receptor is specialized for ______________________ 
1 odorant molecule
VESTIBULAR
Tells us if our head is tilted, moving, slowing down or speeding up. Semicircular canals of the inner ear contain the sensory receptors that detect head motion caused when we tilt or more our and /or body. The canals consist of right-left, up-down, and front-back planes and are fluid-filled. Pathway to the vestibular sense start in the auditory nerve which both the cochlear nerve(with sound information) and the vestibular nerve (with information about balance and movement).
KINESTHETIC SENSE
Provides information about movement, posture and orientation. This has no specific organ instead it’s imbedded in muscle fibers and joints. The sense you don’t notice till it’s gone, like walking with your leg asleep all the time.


 
STEREOGNOSIS
Perception of the solidity of objects and their size, shape and texture.


 

 
SENSORY ASSESSMENT
1.Assess the extent of sensory loss
2.Identify lesion location
3.Evaluate and document sensory recovery
4.Determine functional impairment & limitations
5.Guide treatment intervention
 
test to perceive skin sensation
THA
Total Hip Arthroplasty
TKA
Total Knee Arthroplasty
POD 1
Post Operative Day 1
WBAT
Weight Bearing as Tolerated
d/c
discharge
Arthroplasty Admission to Discharge
 
˜Admitted morning of surgery
˜Begin mobilizing on day of surgery or on Post Operative Day 1 (POD 1)
˜Usually Weigh-bearing as tolerated (WBAT)
˜Length of Stay < 5days (typical 2 to 3)
˜Discharge (d/c) is to home or inpatient rehabilitation.
˜PT usually starts day of surg OT day after
Standard THA
 


oIncision 3 to 4 inches or 8 to 12 inches
•Posterior lateral
•Anterior lateral
•Direct lateral
•Transtrochanteric
 
•Different precautions for different surg areas
 
DVT
Deep Vein Thrombosis
Focus of Rehab intervention
 


˜Early postoperative rehabilitation
oRestoring mobility, strength and flexibility
o(#1 concern is lack of mobility)
oReducing pain
oPreventing deep vein thrombosis (DVT) and other complications
oTeaching adherence to ROM and weight bearing precautions (goal; will recall 3/3 weight-bearing precautions by discharge)
oOrdering equipment (OT/OTA follow-up home safety)
oTeaching patients and families (using equp, precautions & functional mobility)
oTeaching functional mobility for participation in ADLs
 
THA complications
 


˜Deep venous thrombosis DVT

˜Leg length discrepancy

˜Component misalignment

˜Infection

˜Improper implant fixation to surrounding bone (bone does not adhere to prosthesis)

˜Nerve palsy

˜Prosthetic hip dislocation

 
Prosthetic Hip dislocation
˜4.8% of all THA with greatest risk in year 1
˜32% first dislocated 5 or more years after primary THA
˜Median years 11.3
 
Hip precautions
˜No hip adduction
˜No bending at the hip beyond 90⁰ oThe 90⁰ Rule ˜No Internal Rotation past midline oAlso charted as No Midline Crossing No external rotation – feet pointed up not out
x of y cards Next > >> >|