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Applied Neuroanatomy: Sensory Tracts for Occupational Therapy Practice

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1.  James was cooking dinner and accidentally burned the palmar side of his left hand a few weeks ago. He notices that he can no longer feel temperature or the sensation of pain on the palm of his left hand. Which sensory spinal tract did James injure?
  1. Ventral Spinothalamic tract
  2. Lateral Spinothalamic tract
  3. Spinocerebellar tract
  4. Fasciculus Cuneatus tract
2.  If a patient is being seen in outpatient for a herniated disc and decreased coordination, which sensory spinal tract is most likely being affected?
  1. Fasciculus Gracilis tract
  2. Fasciculus Cuneatus tract
  3. Lateral Spinothalamic tract
  4. Spinocerebellar tract
3.  Which of the following interventions is most appropriate for an individual with an impaired Fasciculus Cuneatus tract?
  1. Educate the patient to visually scan an area for potential tripping hazards and terrain changes as they walk.
  2. Have the patient search for specific objects in their briefcase or pocket using their hand to feel for different sensations.
  3. Teach the patient proper body mechanic principles to manage symptoms.
  4. Educate the patient on the importance of protecting themselves from extreme temperature or harmful objects.
4.  An occupational therapist is evaluating a patient by having them close their eyes, applying pressure to one of the patients arms, and having the patient identify if they can feel the touch and which arm it is on. Which tract is the OT assessing?
  1. Ventral Spinothalamic tract
  2. Lateral Spinothalamic tract
  3. Fasciculus Cuneatus tract
  4. Fasciculus Gracilis tract
5.  Which of the following types of sensation are NOT associated with the ventral spinothalamic tract?
  1. Pressure
  2. Pleasant touch
  3. Temperature
  4. Tickle
6.  Which of the following is NOT a protective sensory re-education technique for a patient who lacks protective sensation due to a damaged Lateral Spinothalamic tract?
  1. Encourage the patient to wear slip-proof socks or slippers while walking on hardwood floors.
  2. Introduce built-up handles to distribute gripping pressure over a wider surface area of the hand.
  3. Teach patient how to visually scan their skin for redness, irritation, blisters, edema, etc.
  4. Do not continue the same activity for prolonged periods of time, incorporating breaks and alternating tools that are held in the hand.
7.  An occupational therapist is evaluating a patient who cannot identify if his lower extremity is placed in a flexed or extended position with his eyes closed. In addition, he scores poorly on the 2-point discrimination test for each toe. What tract is most likely affected?
  1. Lateral Spinothalamic
  2. Ventral Spinothalamic
  3. Fasciculus Gracilis
  4. Fasciculus Cuneatus
8.  Which of the following is the major function of the Spinocerebellar tract?
  1. Epicritic sensory
  2. Coarse touch
  3. Protective sensory responses
  4. Unconscious proprioception
9.  Which of the following interventions is most appropriate for an individual with an impaired Ventral Spinothalamic tract?
  1. Have the patient perform tasks, such as carrying lightweight objects, while watching themselves in the mirror.
  2. Have the patient retrieve items such as a nail file or feather from a bucket of rice using their sensation to differentiate between surfaces.
  3. Educate the patient on simple home modifications, such as removing rugs and clutter around the home.
  4. Educate the patient to protect themselves from exposure to sharp items or those of extreme temperature.
10.  Which of the following is a major function of the Fasciculus Cuneatus tract?
  1. Epicritic sensory
  2. Coarse touch
  3. Protective sensory responses
  4. Unconscious proprioception

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