Flashcards in 8.24 General Limb Pain 3 Deck (37)
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1
What are the pathological neck conditions?
- cervical myelopathy
- neoplastic condition
- cervical ligamentous instability
- vertebral artery insufficiency
2
cervical myelopathies: What are the common s/s?
- sensory disturbance of hands
- muscle wasting of hands
- unsteady gait
- Hoffman's reflex
- hyperreflexia
- b/b issues
- multi-segmental weakness and sensory changes
3
neoplastic conditions: things to consider
- hx of cancer
- unexplained weight loss
- constant pain
- night pain
4
cervical ligamentous instability: often get c/o these types of headaches
occipital
5
What might a cervical ligamentous instability look like?
cervical myelopathy
6
What else can go on in the occipital region with cervical ligamentous instability?
occipital numbness
7
What is associated with vertebral artery insufficiency?
- 5 D's
- cranial nerve signs
8
What are the 5 D's?
- dizziness
- dysphasia
- dysarthria
- diplopia
- drop attacks
9
categories of dizziness
- vertigo and nystagmus
- dysequilibrium
- presyncope
- non-specific psychophysiologic
10
vertigo and nystagmus gives the sensation of
spinning
11
dysequilibrium
unsteadiness or imbalance without vertigo
12
presyncope
near-fainting or lightheadedness
13
If a pt has fullness in the ears, tinnitus, and hearing loss associated with dizziness, what would you think is the cause?
vertigo and nystagmus
14
If the pt has somatosensory, visual, decreased reaction time, lack of corrective ROM, an aging brain, or cerebellar issues associated with dizziness, what would you think is the issue?
dysequilibrium
15
Which categories of dizziness are associated with pallor, nausea, vomiting, diaphoresis?
- presyncope
- vertigo and nystagmus
16
What are some of the s/s of non-specific psychophysiologic dizziness?
- floating
- rocking or swimming sensations
- removed from body
- giddiness
17
What may cause presyncope?
- cardiovascular
- metabolic
- vasovagal
- medication
- stress
18
What may cause non-specific psychophysiologic dizziness?
- anxiety
- motion sickness
- pain disorders
- personality disorders
- depression
- agoraphobia
19
What are the likely causes of dizziness in infants/toddlers?
- BPPV and vestibular migraine
- vestibular neuritis
- brainstem or cerebellar tumor
- TBI
20
Children 0-4 y/o are at a high risk for
TBI
21
Percentage of cases where infant/toddler dizzines is caused by BPPV and vestibular migraine
50%
22
What action should be taken by the provider if an infant/toddler has dizziness? Why?
like need an MRI - prevalence of brain tumor in children
23
possible causes of dizziness in children and adolescents
- vertiginous migraine
- BPPV
- vestibular neuritis-ear infection
- anxiety
- orthostatic hypotension
- concussion
- seizure, syncope, nonspecific
24
percentage of cases that cause dizziness in children and adolescents: vertiginous migraine
39%
25
percentage of cases that cause dizziness in children and adolescents: BPPV
15%
26
percentage of cases that cause dizziness in children and adolescents: vestibular neuritis-ear infection
14%
27
percentage of cases that cause dizziness in children and adolescents: anxiety
13%
28
percentage of cases that cause dizziness in children and adolescents: orthostatic hypotension
9%
29
percentage of cases that cause dizziness in children and adolescents: concussion
3%
30
percentage of cases that cause dizziness in children and adolescents: seizure, syncope, non-specific
2%
31
dizziness in children and adolescents: actions by provider
- lab tests
- electroencephalography
- MRI
32
possible causes of dizziness in adults
- vestibular neuritis (labyrinthitis)
- BPPV
- presyncopal conditions
33
dizziness in adults: What might require ENT referral?
ear infection with acute dizziness
34
Aside from an ENT referral, what else may needed to determine the cause of dizziness in adults?
attempt to differentiate between central and peripheral vestibular conditions
35
possible causes of dizziness in adults over age 65
- BPPV
- presyncope
36
action by provider: dizziness in older adults
- rule out presyncopal conditions
- could be life-threatening
37
