Sensory Basics

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Study Tools For Sensory Basics

Tactile Receptors in Skin (Image)
Sensory Pathway (Image)
Sensory Receptors (Cheatsheet)
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Outline

Overview

  1. Basic unit = sensory unit
    1. Receptor – detect stimuli
      1. Single structure
      2. Modified part of a sensory neuron
      3. Create and send out APs
      4. Characteristics
        1. Specificity
          1. Usually respond to one kind of stimulus
      5. Function
        1. Respond to stimulus
        2. Create generator potentials (local depolarizations)
        3. Summation of GPs to become APs in sensory neurons
    2. Neural pathway – send AP to brain
      1. Sensory neuron + Series of interneurons
      2. Cranial nerve → brain
      3. Spinal nerve → spinal cord → brain
    3. Interpreting center in brain
      1. In cerebrum
      2. Part of cerebral cortex in a specific lobe
        1. Ex: optic center in occipital lobe

Nursing Points

General

  1. Types of Receptors
    1. Exteroreceptors
      1. Respond to stimuli from external environment
        1. Light, sound, chemicals, cutaneous (skin & tongue)
      2. Cutaneous – in dermis or tongue
        1. Tactile (light touch)
          1. Various types of nerve endings:
            1. Meissner’s corpuscles
            2. Ruffini’s corpuscles
            3. Krause end bulbs
            4. Merkel’s discs
            5. Free nerve endings in hair follicles
          2. Difference perception
            1. i.e sharp v. dull
          3. Density – high→more sensitive
          4. Density – low→less sensitive
        2. Deep pressure
          1. Pacinian corpuscles in subcutaneous tissue
        3. Temperature – free nerve endings
          1. Heat – responds to change in temp from 30 → 45 deg. C
          2. Cold – responds to change in temp from 40 → 10 deg. C
        4. Pain
          1. Nocireceptors – free nerve endings
      3. Pain
        1. Somatic
          1. Superficial – skin, tongue
          2. Deep – muscles, tendons
        2. Visceral
          1. Deep internal body organs
          2. Lack of blood supply
          3. Overstretching
        3. Referred ((deep somatic or visceral, never superficial somatic))
          1. Pain originates in one region and is perceived from a different area
            1. Common interneuron
          2. Angina
            1. Perception = left arm
            2. Origin = coronary arteries
    2. Proprioreceptors – responds to position and movement
      1. Muscle spindles
      2. Golgi tendon organs
    3. Interoreceptors – respond to internal stimuli
      1. Baroreceptor
        1. Respond to change in BP
        2. R. atrium, aorta, superior and inferior VCs, carotid sinus
      2. Chemoreceptors
        1. Respond to change in chemical composition of ECF or blood plasma
        2. Medulla oblongata and the internal carotid artery monitor [CO2] and [O2] in the blood
        3. Hypothalamus – gastric concentrations
      3. Osmoreceptors
        1. Hypothalamus – water content in blood
      4. Temperature receptors
        1. Hypothalamus
      5. Nociceptors – pain
        1. Lack of blood supply or overstretching of the hollow organs
      6. Stretch receptors
        1. Change in lung volume
  2. Special senses
    1. Gustation (taste)—tongue
      1. Respond to chemicals which dissolve in saliva
        1. Taste buds
          1. Cluster of taste cells
          2. Types of taste cells
            1. Salt
            2. Sweet
            3. Bitter
            4. Sour
            5. Umami – meat proteins
    2. Olfaction (smell)—nose
      1. Detectors odors (chemicals) that are volatile
      2. Olfactory epithelium high in nasal cavity…axons → foramina in cribiform plate → olfactory bulb
      3. Mitral cells—form olfactory tract

References
Betts, J.G., et al. (2017). _Anatomy and physiology_. Houston, TX: OpenStax, Rice University. Retrieved from https://openstax.org/details/books/anatomy-and-physiology?Book%20details

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Transcript

Okay guys in this lesson we’re going to talk about the basics of our senses and how they work

So what the heck are senses anyways? A sense is just a neural pathway that receives a signal and sends it up to the central nervous system for interpretation. So you get some sort of signal – like feeling hot water in your skin. That sensory nerve sends a signal to the spinal cord or through the spinal cord to the brain where the signal gets interpreted. That’s your senses. Now this is just part of the process – the second half is the motor or reflex process, but for this lesson we’re just going to focus on the sensory part.

So everything starts down in the sensory receptors. These are just modified parts of the sensory neuron that is designed to receive and respond to a stimulus. With most sensory neurons we actually see something called specificity – which means these receptors are designed to detect and respond to just one specific kind of stimulus. Once it detects that stimulus, it starts these little local depolarizations – we talk about those in the neuro section. As those start summating or adding together, we’ll be able to create an action potential and off we go. The signal will propagate or conduct down the neuron towards the central nervous system so our brain or spinal cord can react to it!

There are 5 major senses – touch, which we are going to talk about in detail in this lesson. Vision, which is controlled by cranial nerve 2 and hearing which is cranial nerve 8. We also have taste, or gustation – which is cranial nerves 7 and 9. Basically the chemicals in our food get dissolved in our saliva and our taste buds are able to sense and respond to those chemicals. Taste buds are just a cluster of taste cells and we have 5 types. Salty, sweet, bitter, sour, and umami – umami is the flavor of meat proteins. And last we have smell or olfaction. This is cranial nerve 1 – the olfactory nerve. The way it works is there are volatile chemicals in the air. Volatile just means the chemicals evaporate and we can breathe them in. Then the sensory neurons and receptors in the epithelium in our nose will detect and respond to those chemicals and send the signals through that olfactory nerve into the brain to interpret. Now I’ve mentioned sensory receptors, so let’s look a little closer at those receptors.

There are three main types of receptors. Exteroreceptors respond to external stimuli – things like sight, sound, smell, taste, and touch – these are the main things we think of when we think of senses. This could be things in our skin and mucus membranes – cutaneous receptors – or pain receptors – and we’ll look at that in more detail in just a second. We also have proprioceptors which are responsible for helping us interpret position and movement. Basically it helps us know our position in the world – physically. Like … am I hanging upside down? Am I spinning in circles? Turning left? Turning right? etc. Then finally we have interoreceptors which help us to detect internal stimuli that comes from within our bodies. So let’s look a little closer at these two, exteroreceptors and interoreceptors.

So remember exteroreceptors respond to external stimuli and that includes cutaneous or receptors in our skin and mucus membranes. There are 4 different things they respond to – and I’ve given you details about those receptors in your outline. We see tactile receptors that respond to light touch and help us perceive the difference between things like sharp, dull, and soft. We also have receptors in our subcutaneous tissue to help us detect deep pressure. Free nerve endings can help us detect temperature changes and determine hot versus cold. And finally we have other kinds of free nerve endings called nocireceptors that help us to detect pain in our skin.

We also have sensory receptors that help us to detect pain and there are 4 types of pain you need to know about. First is superficial somatic – this is physical pain felt in our skin or tongue. This would be like getting a cut or an ulcer or a burn. Deep somatic pain is felt in our muscles, tendons, ligaments, and bones – it’s obviously deeper and usually more intense than superficial somatic pain. This might be from a fracture or torn ligament. Then we have visceral pain – any time you see visceral, think ‘organ’. So visceral pain is pain felt from the internal organs – this could be like stretching your stomach when it’s too full, or lack of blood flow – which is what ischemia means. It’s very internal and sometimes hard to pinpoint. And the last kind is unique – it’s called Referred pain. This is when pain from one area is actually felt in another. Let me give you an example. The heart and the left arm’s sensory neurons come together and come into the spinal cord through the same spinal nerve. So the theory here is that when something happens to the heart, like a heart attack – and it sends that signal. The brain gets confused because it hasn’t seen that signal before. So it interprets it as being left arm pain – because it understands that. So a heart attack may present with left arm or jaw pain. We can also see liver damage present with right shoulder pain – again it’s called Referred pain.

Lastly we have interoreceptors – remember these are responding to internal stimuli. I’m not going to go into super deep detail here, because in other lessons we talk about how these actually impact the body – let’s just run through them quickly. Baroreceptors respond to changes in blood pressure – baro means pressure. Chemoreceptors respond to chemical changes in the blood or body fluids like a lack of oxygen, too much CO2, a change in pH or changes in the gastric acid concentration. Osmoreceptors detect and respond to the concentration of blood and how much water is in it.

Temperature receptors respond to changes in internal body temperature and the response to that is controlled by the hypothalamus. We see nocireceptors in internal organs again detecting ischemia or stretch in the organs – that’s that visceral pain. And finally we see stretch receptors in the lungs that detect changes in lung volume so your body can respond to that. So, again, these are sensory receptors that respond to internal stimuli in the body.
So let’s recap quickly. Sensory receptors function to detect and respond to specific types of stimuli and send those signals to the central nervous system for interpretation. We have 5 main senses – touch, vision, hearing, taste, and smell. We have exteroreceptors to respond to external stimuli, both pain related and through the skin and mucus membranes. Proprioceptors help us determine our position and movement – so you know if you’re upside down even if you can’t see. And we have interoreceptors to respond to internal stimuli like blood pressure or chemical changes, visceral pain, temperature, and stretch of the lungs.

So that’s it for the basics of how our bodies detect and respond to stimuli, both externally and internally. Make sure you check out all the resources attached to this lesson. Now, go out and be your best self today. And, as always, happy nursing!

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Codeine (Paveral) Nursing Considerations
Combative: IV Insertion
Complex Calculations (Dosage Calculations/Med Math)
Cyclosporine (Sandimmune) Nursing Considerations
Dark Skin: IV Insertion
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Diphenoxylate-Atropine (Lomotil) Nursing Considerations
Drawing Blood from the IV
Drawing Up Meds
Drug Interactions Nursing Mnemonic (These Drugs Can Interact)
Epoetin Alfa
Eye Prophylaxis for Newborn
Fentanyl (Duragesic) Nursing Considerations
Geriatric: IV Insertion
Giving Medication Through An IV Set Port
Glipizide (Glucotrol) Nursing Considerations
Guaifenesin (Mucinex) Nursing Considerations
Hanging an IV Piggyback
How to Remove (discontinue) an IV
How to Secure an IV (chevron, transparent dressing)
Hydralazine
Hydrocodone-Acetaminophen (Vicodin, Lortab) Nursing Considerations
Hydromorphone (Dilaudid) Nursing Considerations
IM Injections
Injectable Medications
Insulin
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin Drips
Insulin Mixing
Interactive Pharmacology Practice
Interactive Practice Drip Calculations
IV Catheter Selection (gauge, color)
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
IV Drip Administration & Safety Checks
IV Drip Therapy – Medications Used for Drips
IV Infusions (Solutions)
IV Insertion Angle
IV Insertion Course Introduction
IV Placement Start To Finish (How to Start an IV)
IV Pump Management
IV Push Medications
Ketorolac (Toradol) Nursing Considerations
Labeling (Medications, Solutions, Containers) for Certified Perioperative Nurse (CNOR)
Lidocaine (Xylocaine) Nursing Considerations
Magnesium Sulfate
Magnesium Sulfate in Pregnancy
Maintenance of the IV
Mannitol (Osmitrol) Nursing Considerations
MAOIs
Medication Errors
Medication Reconciliation Review for Certified Perioperative Nurse (CNOR)
Medications in Ampules
Meds for Postpartum Hemorrhage (PPH)
Meperidine (Demerol) Nursing Considerations
Methadone (Methadose) Nursing Considerations
Methylergonovine (Methergine) Nursing Considerations
Metoclopramide (Reglan) Nursing Considerations
Montelukast (Singulair) Nursing Considerations
Mood Stabilizers
Nalbuphine (Nubain) Nursing Considerations
Needle Safety
Neostigmine (Prostigmin) Nursing Considerations
NG Tube Med Administration (Nasogastric)
NG Tube Medication Administration
Nitro Compounds
NRSNG Live | The S.O.C.K Method for Mastering Nursing Pharmacology and Never Forgetting a Medication Again
Nystatin (Mycostatin) Nursing Considerations
OB Pharm and What Drugs You HAVE to Know – Live Tutoring Archive
Olanzapine (Zyprexa) Nursing Considerations
Opioid Analgesics in Pregnancy
Oral Medications
Oxycodone (OxyContin) Nursing Considerations
Pain Management for the Older Adult – Live Tutoring Archive
Pain Management Meds – Live Tutoring Archive
Parasympathomimetics (Cholinergics) Nursing Considerations
Patient Controlled Analgesia (PCA)
Pediatric Dosage Calculations
Pentobarbital (Nembutal) Nursing Considerations
Pharmacodynamics
Pharmacokinetics
Pharmacokinetics Nursing Mnemonic (ADME)
Pharmacology Course Introduction
Phenobarbital (Luminal) Nursing Considerations
Phytonadione (Vitamin K) for Newborn
Pill Crushing & Cutting
Positioning
Procainamide (Pronestyl) Nursing Considerations
Propofol (Diprivan) Nursing Considerations
Quetiapine (Seroquel) Nursing Considerations
Ranitidine (Zantac) Nursing Considerations
Rh Immune Globulin in Pregnancy
Sedatives-Hypnotics
Sedatives-Hypnotics
Selecting THE vein
Spiking & Priming IV Bags
Starting an IV
Streptokinase (Streptase) Nursing Considerations
Struggling with Dimensional Analysis? – Live Tutoring Archive
SubQ Injections
Supplies Needed
Tattoos IV Insertion
TCAs
The SOCK Method – C
The SOCK Method – K
The SOCK Method – O
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method of Pharmacology 1 – Live Tutoring Archive
The SOCK Method of Pharmacology 2 – Live Tutoring Archive
The SOCK Method of Pharmacology 3 – Live Tutoring Archive
Tips & Tricks
Tips & Advice for Newborns (Neonatal IV Insertion)
Tips & Advice for Pediatric IV
Understanding All The IV Set Ports
Using Aseptic Technique
Verapamil (Calan) Nursing Considerations