Exam 4 - HA, Trigeminal Neurologia, Bells Palsy

Question 1

how many nerve pathways are in the face

Answer 1

3

2 in cheek; 1 in forehead

Question 2

trigeminal neuralgia usually affects the nerves located where

Answer 2

the cheek

maxillary, mandibular branches

Question 3

sudden, severe, unilateral pain along the trigeminal nerve

brief, stabbing, reoccuring

Answer 3

trigeminal neuralgia

Question 4

trigeminal neuralgia etiology

Answer 4

compression of the nerve as it exists the brainstem

Question 5

how is trigeminal neuralgia Dx

Answer 5

H&P

Question 6

medications for trigeminal neuralgia

Answer 6

antiseizure (Gabapentin)
tricyclic antidepressants (Lyrica)

Question 7

what to assess for trigeminal neuralgia pts

Answer 7

dental care

*may not brush their teeth on the affected side

Question 8

Bells Palsy is acute ___ ___

Answer 8

facial paralysis

Question 9

cranial nerve affected by Bells Palsy

Answer 9

CN VII - Facial

Question 10

how long does it take to recover from Bells Palsy

Answer 10

3-9 months

may have residual tearing, facial weakness

Question 11

etiology of bells palsy

Answer 11

unknown

could be r/t acute demyelination (like Guillian Barre), reactivation of HSV or HSZ, viral infection (Eptein-Barr, CMV, etc)

Question 12

s/sx of Bell’s Palsy

Answer 12

sudden unilateral facial paralysis
pain around ear
hearing deficit
tearing or dry eye
weak muscles - poor chewing
unilateral loss of taste
Bell's Phenomenon

Question 13

Bell’s Phenomenon

Answer 13

cannot close eyelid

upward movement of eye when attempted

Question 14

Bell’s Palsy treatment

Answer 14

most heat
gentle massage
electrical stimulation
Rx exercises
corticosteroids
**taper off, do not stop abruptly; take with food, water to prevent stomach irritation

Question 15

ways to protect the face with Bell’s Palsy

Answer 15

drafts, cold
chew on unaffected side
nutrition
oral hygiene
dark glasses
artificial tears, ointments, patches
tape lids shut
facial sling
coping measures r/t body image

Question 16

most common pain symptom

Answer 16

HA

Question 17

primary HA types

Answer 17

migraine
tension
cluster

Question 18

examples of secondary HA

Answer 18

sinus
alcohol/hangover
fever
tumor

Question 19

most painful HA

Answer 19

cluster

Question 20

pain is often around eyes and is woken in the middle of the night

Answer 20

cluster

Question 21

severe intense throbbing pain with pulsating character mostly localized on one side

Answer 21

migraine

Question 22

may occur one or a few times a week or continuous for several days

lasts 30 minutes to 7 days

Answer 22

tension

Question 23

tension HA pain location

Answer 23

bilateral band like pressure at the base of skull

Question 24

how to Dx tension HA

Answer 24

H&P

Question 25

preventative tension HA treatment

Answer 25

tricyclic antidepressants SSRIs biofeedback stress reducation

Question 26

abortive treatment tension HA

Answer 26

``` NSAIDS Tylenol ASA Muscle relaxants Combo meds: Excedrin, Goodies Powder ```

Question 27

associated s/sx of migraines

Answer 27

irritability sweating N/V photophobia/phonophobia

Question 28

premonitory (aura) symptoms with migraines

Answer 28

scotomas (dark spots in vision) | smells

Question 29

cause of migraines

Answer 29

idiopathic series of neurovasuclar events neural hyperexcitability genetics

Question 30

how to Dx migraines

Answer 30

H&P

Question 31

abortive treatment: migraines

Answer 31

``` ASA NSAIDS Combo drugs serotonin receptor agonists corticosteroids ```

Question 32

preventative treatment: migraines

Answer 32

``` beta blockers antidepressants antiseizure botox biofeedback -cognitive behavior therapy, relaxation therapy ```

Question 33

how long can cluster HA last

Answer 33

minutes to hours

Question 34

s/sx of cluster HA

Answer 34

``` eye edema tearing facial flushing nasal congestion pupil constriction aura ```

Question 35

cause of cluster HA

Answer 35

idiopathic hypothalamus -irregular melatonin, cortisol -circadian rhythm

Question 36

cluster HA triggers

Answer 36

``` smells weather changes napping alcohol drafts/cool breeze, wind ```

Question 37

Dx cluster HA

Answer 37

H&P

Question 38

abortive treatment: cluster HA

Answer 38

100% O2 via face mask alpha blockers serotonin receptor agonist

Question 39

preventative treatment: cluster HA

Answer 39

alpha blockers corticosteroids CCB biofeedback

Question 40

what can cause a rebound HA

Answer 40

overuse of pain meds