What are the superficial sensations?
- temperature
- light touch
- pain
- pressure
- Get info from the exteroreceptors in skin and subcutaneous
What are the deep sensations?
-proprioception
-kinesthesia
-vibration
Get info from muscles, tendons, ligaments, joints, and fascia
What are the cortical (combined) sensations?
-bilateral simultaneous stimulation
-stereognosis
-two-point discrimination
-barognosis
-tactile localization
-recognition of textures
Require info from both extero receptors and
What does the spinothalamic tract (anterior) do?
Senses light touch and pressure
What does the spinothalamic tract (lateral)
Senses pain and temperature
What does the dorsal column (medial lemniscal) tract on a whole do?
Discriminative (specific location):
- deep touch
- barognosis
- kinesthesia
- proprioception
- 2 point descrimination
- graphesthesia
- sterognosis
What does the spinothalamic tract do as a whole?
Non-discriminative (not specific location) sensations:
- pain
- temperature
- tickle
- itch
- sexual senations
What sensory tests test the spinothalamic tract? (not sure if sensory testing truly can tell this?)
- hot and cold
- sharp and dull
- brush test?
When does the spinothalamic tract cross over?
-1-2 vertebrae above where the sensation enters the spinal cord, then ascends
When does the dorsal tract cross over?
-ascends then crosses in the brain stem
What sensory tests test the doral tracts?
- proprioception
- kensthesia
- 2 point discrimination
- stereognosis
- barognosis- perceive the weight of diff objects in hand
What sensory tests test the superficial sensations?
- hot/cold
- sharp/dull
- brush test?
What sensory tests test the deep sensations?
- proprioceptive- moving toes and fingers up and down, pt identifies static movment
- kinesthesia- moving or not moving limb, direction of movement
What aspect of the brachial plexus is involved in thoracic outlet syndrome?
commonly C8 and T1
-see issues in the ulnar nerve distribution
second most common: C5, C6, C7
-see issues in radial nerve n. distribution
Where does the anterolateral spinal tract originate?
Skin:
- mechanoreceptors
- thermoreceptors
- nociceptors
What is damaged if there is contralateral loss or pain and temperature?
spinothalamic tract
What is damaged if there are deficits with discriminate sensations?
Discriminative sensations: two point discrimination, vibration, etc Dorsal columns (medial lemniscus) damaged
What is damaged if there is both sensory and motor issues?
damage to spinal nerve root (remember, dorsal and ventral roots converge to make spinal nerves)
What is damaged if severe sensory impairment with diffuse pattern of involvement?
Lesions of the CNS
