Term
| What are 5 primary headaches |
|
Definition
tension
cervicogenic
classic migraine
common migrane
cluster |
|
|
Term
| What is the second most common complaint in the primary care setting ? |
|
Definition
|
|
Term
| Less than ___ of headaches are due to serious underlying intracranial pathology |
|
Definition
|
|
Term
| What is the subject of discomfort in the region of the head or the face? |
|
Definition
|
|
Term
| What are the red flags of headaches |
|
Definition
Systemic, weight loss
Neurological symptoms or signs
Onset or sudden
Onset late in life
Pattern change |
|
|
Term
| Sudden onset of headache is a sign of a ____ |
|
Definition
|
|
Term
| Onset of headache later in life is a sign of ___ |
|
Definition
|
|
Term
| Pattern changes of the headache is indicative of ___ |
|
Definition
|
|
Term
| Tight, band-like, bitemporal non-throbbing pain |
|
Definition
|
|
Term
| Occipital headaches worse with neck movement |
|
Definition
|
|
Term
| Aura followed by unilateral throbbing headache |
|
Definition
|
|
Term
| Unilateral throbbing headache without an aura |
|
Definition
|
|
Term
| Unilateral throbbing headache, red teary eye and nose |
|
Definition
|
|
Term
| Tender swollen superficial temporal artery |
|
Definition
|
|
Term
| Blood pressure greater than 200/120 |
|
Definition
|
|
Term
| Tenderness over sinus; worse with bending forward |
|
Definition
|
|
Term
| Headache worse in the morning, positive Dejerine’s triad |
|
Definition
|
|
Term
| Trigger points with specific referred pain pattern |
|
Definition
|
|
Term
| Scalp tenderness followed by a vesicular rash |
|
Definition
|
|
Term
| Sudden onset of severe headache with neck stiffness |
|
Definition
|
|
Term
| Pain and clicking on movement of the jaw |
|
Definition
|
|
Term
| Severe cutting pain in the distribution of CN V |
|
Definition
|
|
Term
| Neck stiffness, fever and/or convulsions |
|
Definition
|
|
Term
| To diganose a migrane a patient will describe ___ headaches with or without aura lasting ____ |
|
Definition
|
|
Term
| What is the predisposition for migrane headaches |
|
Definition
genetics
caffeine, alcohol, chocolate, cheese |
|
|
Term
| Migrane with aura is defined as a |
|
Definition
|
|
Term
| What is the minimum attack to diganose a classic migrane |
|
Definition
|
|
Term
| What are the 3 other factors necessary to identify a classic migraine |
|
Definition
reversible aura
aura develops gradually over 4+ min
Aura does not last more than 1 hr
Unilateral headache follows Aura |
|
|
Term
| If a classic migraine is diagnosed what 1 factor may also must be present |
|
Definition
Nausea or vomiting
phonophobia or photophobia
aura shows blind spot
surrounded by flashing lights
may have old time move appearance |
|
|
Term
| An aura showing a blind spot is also called |
|
Definition
|
|
Term
| An aura surrounded by flashing lights is called |
|
Definition
|
|
Term
| Migraine without an aura is known as |
|
Definition
|
|
Term
| Common migraine needs a minimum of ___ attacks |
|
Definition
|
|
Term
| What other 2 factors are necessary to diagnose a common migraine |
|
Definition
unilateral location
pulsatile quality
worse on climbing stairs |
|
|
Term
| What factors do you need at least 1 of to diagnose a common migraine |
|
Definition
nausea or vomiting
photophobia
phonophobia |
|
|
Term
| What 2 factors will classify a migraine as complicated |
|
Definition
|
|
Term
| If a migraine is complicated what may be implicated |
|
Definition
|
|
Term
| Can you adjust a patient with a classic or common migraine |
|
Definition
| yes with nutrition advice |
|
|
Term
| What is a chronic recurrent headache that is common in men |
|
Definition
|
|
Term
| Tension type headaches may be related to |
|
Definition
| muscle tension and stress |
|
|
Term
| To diagnose a tension type headache how many headaches does the patient need to have and for how long |
|
Definition
| 10 episodes lasting for 30 min to 7 days |
|
|
Term
| What 2 additional criteria do you need to have to diagnose a tension type headache |
|
Definition
bilateral location
pressing or tightening or squeezing in character
mild or moderate intensity
not aggravated by activity |
|
|
Term
| what should not be present in a tension type headache |
|
Definition
nausea
photophobia
phonophobia |
|
|
Term
| What time is tension type headaches usually the worst |
|
Definition
|
|
Term
| Can you adjust a tension type headache |
|
Definition
yes with stress reduction, exercise
* refer if chiropractic is unsuccessful or headache worsens** |
|
|
Term
| Discomfort or pain in the head originating from the cervical spine |
|
Definition
|
|
Term
| Cervicogenic headaches may be related to neck movement with possible aberrant firing of cervical mechanoreceptors with interneuronal connections with the ___ nucleus |
|
Definition
| spinal trigeminal nucleus(sensory to eye) |
|
|
Term
| Spinal trigeminal nucleus extends into the cervical region of the spinal cord to __ |
|
Definition
|
|
Term
| What dermatomes do cervicogenic headaches refer pain to |
|
Definition
|
|
Term
| What 3 areas do cervicogenic headaches radiate to |
|
Definition
|
|
Term
| Cervicogenic headaches radiate and needs one of what other criteria |
|
Definition
abnormal tenderness of neck muslces
limitation of passive neck movements
changes in tone or texture of neck muscles in response to active and passive stretching with or without vertigo |
|
|
Term
| What orthoneuro tests are positive for cervicogenic headaches |
|
Definition
| neck movements aggrivate pain |
|
|
Term
| What does xray show in cervicogenic headaches |
|
Definition
| abnormal movement in flexion/extension or abnormal posture |
|
|
Term
| Can you adjust a cervicogenic patient |
|
Definition
|
|
Term
| Syndrome with recurrent paroxysmal episodes of sudden, severe, unilateral headaches |
|
Definition
|
|
Term
| cluster headaches last for ___ |
|
Definition
|
|
Term
| what is the etiology of cluster headaches |
|
Definition
alcohol
smoking
barometric pressure changes
napping in the afternoon |
|
|
Term
| cluster headaches are more common in |
|
Definition
|
|
Term
| cluster headache are due to activation of |
|
Definition
|
|
Term
| cluster headaches are due to impairment of |
|
Definition
|
|
Term
| What is the minimum attacks of cluster headaches |
|
Definition
| 5 in a predictable mannor (time everyday) with severe unilateral periorbital pain peaking in 10-15 min lasting up to 3 hrs |
|
|
Term
| What are other symptoms do you need at least one of in cluster headaches |
|
Definition
| ptosis, red eye, constricted pupil, tearing, nasal congestion and a runny nose. |
|
|
Term
| cluster headaches can occur ___ for ___ weeks |
|
Definition
| several times per day, for one to several weeks |
|
|
Term
| What investigations are needed for cluster headache |
|
Definition
| none, but you may do CBC/ESR to rule out underlying pathology |
|
|
Term
| How do you manage a cluster headache |
|
Definition
refer to the hospital
give advice on avoiding alcohol, afternoon naps
suicide (advice that they decrease with age) |
|
|
Term
| headache with Part of a giant cell arteritis condition |
|
Definition
|
|
Term
| what is the eitology of temporal arteritis |
|
Definition
| autoimmune disease affecting the tunica media of the medium sized vessels |
|
|
Term
| Temporal arteritis is more common in |
|
Definition
|
|
Term
| What headache is associated with polymyalgia rheumatica |
|
Definition
|
|
Term
| polymyalgia rheumatica is |
|
Definition
joint muscle aches/fatigue
(fibromyalgia w/out trigger points) |
|
|
Term
| Temporal arteritis is a temporal headache with |
|
Definition
| scalp tenderness and jaw claudication |
|
|
Term
| The temporal artery in temporal arteritis may be |
|
Definition
| nodular, enlarged, tender |
|
|
Term
| With temporal artertitis there may be a sudden onset of |
|
Definition
|
|
Term
| what percentage of pain in temporal arteritis is in the temples |
|
Definition
|
|
Term
| What percentage of pain in temporal arteritis has scalp tenderness |
|
Definition
|
|
Term
| What percentage of temporal artertitis patients have polymyalgia rhuematica |
|
Definition
|
|
Term
| An elderly women with headache and opthalamologic symptoms has |
|
Definition
| temporal arteritis until proven otherwise |
|
|
Term
| What investigations would be preformed with temporal artertitis patients |
|
Definition
ESR (>50mm/hr)-rate that RBC fall
Biopsy of temporal artery
MRI confirms diagnossis |
|
|
Term
| ESR is the rate at which ___ fall |
|
Definition
|
|
Term
| If the ESR is high it will show |
|
Definition
|
|
Term
| What is the management for temporal arteritis? |
|
Definition
| Refer to the hospital as fast as you can for treatment of corticosteroids |
|
|
Term
| Infection of the air sinuses in the skull; may be acute or chronic |
|
Definition
|
|
Term
| What are 3 eitologies of sinusitis |
|
Definition
Bacterial infections due to obstruction of the sinus
Strep pneumonia
Haemophilus Influenza |
|
|
Term
| What is the clinical picture of sinusitis |
|
Definition
| Fever, headache, facial pain, or pain between the eyes made worse with bending forwards |
|
|
Term
| In Sinusitis There may be ___ of the inflammed sinus along with a ___ |
|
Definition
| tenderness upon percussion; purulent nasal discharge |
|
|
Term
| Tranillumination of the affected sinus in sinusitis will be |
|
Definition
|
|
Term
| What may complicate a sinusitis headache |
|
Definition
| brain abcess may be present with headache, fever, or convulsions |
|
|
Term
| What will xray show in a sinusitis headache |
|
Definition
| mucosal thickening, air fluid levels, loss of air space or opacification of one or more sinuses [60% sensitivity] |
|
|
Term
| What is the gold standard of diagnosing a sinusitis headache |
|
Definition
|
|
Term
| What is the management of a sinusitis headache |
|
Definition
otorhinolaryngologist
adjustments and heat |
|
|
Term
| Elevated blood pressure >140/90 on at least 3 consecutive occasions will have a |
|
Definition
|
|
Term
| What is the etilogy of a hypertensive headache |
|
Definition
|
|
Term
| what are contributing factors of a hypertensive headache |
|
Definition
diet
lack of exercise
obesity
alcohol
smoking |
|
|
Term
| What are the known causes of a hypertensive headache |
|
Definition
Renal
Endocrine (hyperthyroidism, Cushings, hyperaldosterone, pheochromocytoma)
Cardiovascular (coarctation of the aorta)
Pregnancy
NSAIDS |
|
|
Term
| Hypertensive headaches are more common in |
|
Definition
increases of age
African Americans |
|
|
Term
| Most hypertensive patients are ___ |
|
Definition
|
|
Term
| What do you need to beware of with hypertensive headaches |
|
Definition
| ausculatory gap in which the systolic pressure is underestimated |
|
|
Term
| When will hypertensive headaches present |
|
Definition
walking in the morning
(BP is higher around 9 AM) |
|
|
Term
| In hypertensive headaches there may be evidence of |
|
Definition
|
|
Term
| End organ damage will show |
|
Definition
cardiomegaly with a displaced apex beat
Silver wiring of vessels on funoscopy |
|
|
Term
| What are some addtional findings found with hypertensive headaches patients |
|
Definition
purple striae & buffalo hump (Cushings)
goiter and bulging eyes (hyperthyroidism)
pain on the vertex of the head or back of the head |
|
|
Term
| In hypertensive patients xrays will show |
|
Definition
| cardiomegaly (increased cardiothroacic ratio) |
|
|
Term
| What will blood work evaluate in hypertensive headache |
|
Definition
BUN and Creatinine to evaluate renal function
TFT (hyperthyroidism)
Serum electrolytes (Conns disease)
VMA (pheochromocytoma) |
|
|
Term
| What is the management of a hypertensive headache |
|
Definition
comanage with a primary care physician
upper cervical adjustment
weight loss, diet, smoking cessation |
|
|
Term
| Headache caused by bleeding into the subarachnoid space |
|
Definition
|
|
Term
| What is the etiology of a subarachnoid hemorrhage |
|
Definition
| rupture of an aneurysm or arteriovenous malformation in the brain |
|
|
Term
| Sudden onset of “the worst headache ever” with neck stiffness, nausea and vomiting; there may be loss of consciousness, no fever is the clinical picture of a |
|
Definition
|
|
Term
| What ortho tests are positive with a subarachnoid hemorrhage? |
|
Definition
|
|
Term
| What will confirm subarachnoid hemorrhage |
|
Definition
|
|
Term
| What is the management with subarachnoid hemorrhage |
|
Definition
|
|
Term
| A group of disorders affecting the TMJ |
|
Definition
|
|
Term
| What is the etiology of TMJ dysfunction |
|
Definition
| multifactoral including DJD, trauma, stress |
|
|
Term
| What are 3 symptoms that show the clinical picture of TMJ disfunction |
|
Definition
Pain in the ear or temporal region
clicking or popping sounds on opening of the jaw
tenderness on palpation and limiting opening (unable to put 2 knuckles between teeth) |
|
|
Term
| What would an xray show in TMJ dysfunction |
|
Definition
|
|
Term
| What would a CT scan diagnose for TMJ dysfunction |
|
Definition
| disc, or osseous derangements |
|
|
Term
| What is the management for TMJ dysfunction? |
|
Definition
Manipulation
Trigger point therapy in muscles of mastication |
|
|
Term
| Disorder of the trigeminal nerve producing excruciating pain in the face |
|
Definition
|
|
Term
| What is the etiology of trigeminal neuralgia |
|
Definition
unknown
(may be related to aberrent blood vessel in close relation to the trigeminal nerve or to one of its branches) |
|
|
Term
| Trigeminal neuralgia is more common in |
|
Definition
| middle aged or older females |
|
|
Term
| What is trigeminal neuralgia triggered by |
|
Definition
| cold, touch, wind, or chewing |
|
|
Term
| What is the clinical picture often seen with trigeminal neuralgia |
|
Definition
| sudden onset of severe excruciating, lancinating pain |
|
|
Term
| Trigeminal neuralgia will last |
|
Definition
| a few seconds to 2 minutes along the trigeminal nerve distribution. |
|
|
Term
| What other investigations may be seen with trigeminal neuralgia |
|
Definition
| vascular studies may be seen with aberrant vessels |
|
|
Term
| What is the management of trigeminal neuralgia |
|
Definition
co manage with a neurologist
Adjustments of the cervicals may be helpful for the trigeminal nucleus |
|
|
