Sensations and Sensory Pathways General Senses Test Distribution of Sensory Receptors Procedure Use 9 (5x5mm) small squares

of graphing paper with a hole and place them in the volar surface of the forearm and the back or nape (avoid hairy portion) with the subject blindfolded. Test 5 spots on each square using fine bristle/horse hair, heated pin head, cooled pin head and pin or fine needle Normal Result Distribution of sensations: (Most) Pain result to stimulation of nociceptors(pain receptors) - Fast pain(occurs very rapidly usually within 0.1 second after stimuli is applied, because the nerve impulses propagate along medium-diameter, myelinated A fibers) Light Touch result from stimulation of tactile receptors in skin or subcutaneous layer (mechanoreceptors). - Meissner corpuscles (hairless skin); Hair roor plexuses (hairy skin) Cold result to stimulation thermoreceptors - Cold receptors located in the stratum basale and are attached to medium-diameter, myelinated A fibers. - Activation of receptors occur at 10-40C. Warmth result to stimulation of thermocreceptors - Not as abundant as cold receptors. - Activation of receptors occurs at 32-48C. (Least) At temperatures below 10C and above 48C, pain receptors are stimulated. Left index finger, from ice water, felt hot when placed in tap water; right index finger, from warm water, felt cold Abnormal Result Different distribution of sensations Hypalgesia decreased pain Analgesia absence of pain Hyperalgesia increased pain Hyperthesia decreased touch sensation Anesthesia absent touch Hyperesthesia increased touch sensation Clinical Interpretation Damage to posterior columnmedical leminiscal pathway, specifically the cuneeate fasciculus tract ( conveys nerve impulses for touch, pressure, vibration and conscious proprioception from upper limbs, trunk, neck, posterior head to the cerebral cortex) Damage to anterolateral or spinothalamic pathway (conveys nerve impulses for pain, cold, warmth, itch and tickle from limbs, trunk, neck, and posterior head to the cerebral cortex) Lesion in primary somatosensory area of cerebral cortex (receives nerve impulses for touch, pressure, vibration, itch, tickle, temperature (coldness and warmth), pain and proprioception)

Contrast

a. Fill three beakers with water: 1. B1: warm water (35OC) 2. B2: room temperature

No difference felt between left and right index fingers

Damage to posterior columnmedical leminiscal pathway, specifically the cuneate fasciculus

3. B3: ice water ~0 C b. Place left finger in beaker 3 and right index finger in beaker 1. ~20 seconds, place both fingers simultaneously in beaker 2. Compare the sensations during immersion in beaker 2.

when placed in tap water Successive contrast hot sensation to cold sensation Simultaneous contrast hot and cold sensations are felt at the same time Temperature sensations are not absolute but relative to the baseline previously established by sensory adaption.

tract Damage to anterolateral or spinothalmic pathway Lesion in primary somatosensory area of cerebral cortex.

Summation

Starting from the fingertips up to the wrist gradually immerses one hand in a basin full of war water for 10 seconds.

Extend of Immersion Fingers warm Palm warmer Wrist - warmest

No difference felt in extent of immersion.

Adaptation

Using the same basin the Summation test, immerse the whole hand for 5 minutes Have the subject blindfolded and place a piece of cork on the forearm for a minute or two. Observe,

Intensity of the sensation weakens.

Intensity of sensation remains the same. The sensation of touch or pressure continues to be unaltered.

Damage to posterior medial leminiscal pathway specifically the cuneate fasciculus tract Damage to anterolateral or spinothalmic pathway Lesion in primary somatosensory area of cerebral cortex Damage to anterolateral or spinothalamic pathway Lesion in primary somatosensory area of cerebral cortex.

The sensation of touch of pressure weakens at the end of the second minute. Adaptation characteristic of most sensory receptors - Generator or receptor potential decreases in amplitude during a maintained, constant stimulus. - Causes frequency of nerve impulses in the first order neuron to decrease The subject is able to detect two distinguishable blunt points. Approximate values for this two-point discrimination test :

Two-Point Discrimination

Blindfold the subject. Determine the threshold using two pins on the fintertip, nape, back of hand and tip of tongue. A. Set two points of pins together then

One or none of the two points is felt by the subject

Damage to anterolateral or spinothalamic pathway. Damage to trigeminothalmic pathway (conveys nerve impulses

increase 2 mm at a time until the pints can be discriminated as two. Points should be applied gently, simultaneously and with equal pressure. B. Repeat procedure, but the two points should be above threshold value and should be worked backwards until the two points are felt as one

Aristotles Experiment

Blindfold the subject. Place a small round object between ends of the crossed (middle finger over right index finger) and uncrossed fingers. Let the subject roll the object on the table

Fingers 2-3mm Upper lip 4-5mm Cheek 6mm Nose 7mm Palm 10mm Forehead 35mm Foot 20mm Belly 30mm Forearm 35mm Upper arm 39mm Shoulder 41mm Thigh 42mm Calf 45mm The subject is able to perceive two objects when fingers are crossed. Perceptual Disjunction the brain has failed to take into account that the subject has crossed his/her fingers. - Because the object touches the outside of both fingers at the same time, the brain interprets it as two separate objects. Diplesthesia tactile diplopia - In touch, the illusory experience of two objects when only one is actually present. The subject is able to recognize and differentiate objects even when blindfolded.

for touch, pressure, vibration, pain, cold, warmth and tickle from the face, nasal cavity, oral cavity and teeth). Lesion in primary somatosensory area of cerebral cortex.

The subject is able to perceive only one object

Possible prior cognitive bias.

Stereognosis tests the individuals ability to perceive and integrate a variety of sensory modalities and to interpret the stimuli to identify small objects placed in the hand.) Vibration sense Vibration results from rapidly repetitive sensory signals from tactile receptors

Blindfold the subject. Prepare three objects that the subject needs to identify while blindfolded. Objects are given one at a time in the subjects hand and ask him to identify it. Record the results.

The subject is not able to distinguish objects (Astereognosis)

-Astereognosis of the abnormal hand -Lesion in the somatosensory area of the cerebrum

i. Place the base of a vibrating tuning fork against various bony prominences - the malleoli, patella and styloid processes. Time the duration the vibration can be felt.

-The subject is able to feel the normal vibrating sensations -patient is able to detect when vibration ceases

-not able to detect and feel the vibration

-damage to posterior columnmedial leminiscal pathway -lesion in primary somatosensory area of cerebral cortex for early detection of

Meissner corpuscles (touch) - rapidly adapting - detect lower frequency vibrations -fingertips, hands, eyelids, tip of tongue, lips, nipples, soles, clitoris, tip of penis Pacinian corpuscles (pressure) -rapidly adapting -detect high-frequency vibrations -dermis, hypodermis, submucosal tissue, joints, tendons, muscles, periosteum, mammary glands, external genitalia, pancreas, urinary bladder Muscle and Joint Senses Kinesthesia -sense that detects bodily position, weight, or movement of the muscles, tendons, and joints

ii. Repeat (i) on various muscular regions biceps, triceps, and gastrocnemius

Pallesthesia - ability of body to feel mechanical vibrations on or near the body

demyelinating disease and peripheral neuropathy (damage in peripheral nerves)

i. Blindfold the subject. Place the subjects arms at a certain position and measure the angle made by the arm from the trunk ii. The arm is then dropped to the side and subject is asked to try and duplicate the previously measured position. Measure the angle formed by the arm from the trunk. iii. Record the difference between the two angles measured. This is the angle of error of the subject iv. Repeat the procedure for 5 different angles

Angle difference between blindfolded and not is small

angle difference is large

-low/ no muscle memory -damage to cerebellum -lesion in primary motor area (lesion of parietal cortex or thalamocortical projections to the parietal lobe)

Static Position Sense

i. Ask 3 different subjects to balance themselves on one leg with eyes open. Observe any moments and record the time they are able to keep their balance ii. Ask the subjects to balance themselves on one leg with eyes closed. Observe any movements and record the time they are able to keep their balance iii. With eyes closed, and balanced on one leg, ask the subjects to bend the head to the left side. Observe and record what happens. iv. Repeat (iii) but this time, ask the subjects to bend the head to the right side. Observe what happens.

able to keep balance and posture is correct

excessive postural swaying or loss of balance

-present when eyes are opened or closed = cerebellar deficit or ataxia -present when eyes are closed =proprioceptive deficit Ataxia condition in which the cerebellum Is damaged through the trauma or disease thereby disrupting muscle coordination -Lesion in the primary motor area of cerebral cortex

Gait

i. Draw a straight line on the floor. ii. Let the subject walk on the line, heel to toe, with 1. Eyes open 2. Eyes closed iii. Observe and record what happens

normal walking patterns (can walk heelto-toe in a straight line)

swaying, pattern not in line, steps too far from each other

-myopathic and neuropathic disorders -damage to the cerebellum (ataxia) -lesion in primary motor area of cerebral cortex