Deck 26: Evaluation of Sensation and Intervention for Sensory Dysfunction

Question 1

Why is it important to support the client's hand fully when performing a sensory evaluation?

A) So the client remains relaxed
B) To prevent the hand from moving, which could provide sensory information that interferes with the testing
C) To be sure that the client pays attention
D) To be consistent in technique among all clients

Answer 1

B
It is important to support the client's hand fully,using either the examiner's hand or resting the client's hand against putty to prevent it from moving,which could provide sensory information that interferes with the test being administered.

Question 2

Which of these is not an example of protective sensory reeducation?

A) Using a screwdriver for 30 minutes without any gloves
B) Softening the amount of force used when gripping objects
C) Moisturizing the skin regularly to keep it supple
D) Checking for blisters or cuts

Answer 2

A
People who lack protective sensation are at risk for serious injury because they cannot feel pinprick or hot or cold exposures.They may develop blisters after holding objects and may not realize this until they visually examine the hand.After a cerebrovascular accident a person with left hemiparesis and left neglect may inadvertently move his or her left hand on top of a stove burner during a cooking task.Given the lack of protective sensation,the client will be burned without sensing the painful stimulus of the hot stove.The same thing frequently happens to individuals with C6 tetraplegia.The protective sensation in the thumb,index finger,and long finger may be intact whereas the sensation in the ring and little finger is absent.Callahan identifies the following protective instructions for sensory reeducation of these clients: Protect from being exposed to sharp items or to cold or heat; try to soften the amount of force used when gripping an object; use built-up handles on objects whenever possible to distribute gripping pressure over a greater surface area; do not persist in an activity for prolonged periods of time.Instead,change the tool used and the work task often; visually examine the skin for edema,redness,warmth,blisters,cuts,or other wounds (tissue heals more slowly when there has been a nerve injury); if there is tissue injury or damage,be very careful in treating and try to prevent infection; maintain skin suppleness as much as possible by soaking and applying moisturizing agents.
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Question 3

Why is it important to test temperature sensation before applying heat or cold modalities in the clinic?

A) To avoid burning the client
B) To know whether to adjust the thermostat in the room
C) To know whether to put a blanket on the client
D) To find out whether the client prefers heat over cold or vice versa

Answer 3

A
Thermal receptors detect warmth and cold.C fibers are associated with information about heat.A-delta fibers are associated with information about cold.In the clinic it is important to test temperature sensation before applying heat or cold modalities to avoid burn injuries.Thermal receptors are also critical for a person to be able to determine safe water temperature for bathing.The client with thermal sensory loss may need to learn compensatory strategies,such as testing the water temperature with an unaffected body part.

Question 4

Why is fingertip sensation enhanced compared with proximal parts of our bodies?

A) Because our fingers are more exposed to the environment
B) Because we need more sensation in our fingertips to prevent injury
C) Because fingertips have a higher density of receptors and smaller receptive fields
D) Because fingertips are glabrous

Question 5

Why is stereognosis important for hand function?

A) Without stereognosis our hands would not be able to sweat.
B) Without it we could not discriminate cold from hot.
C) Without it we could not identify an item with our vision occluded.
D) Without it we could not discern sharp items from dull items.