Head and face pain Flashcards Preview

SBO6 > Head and face pain > Flashcards

Flashcards in Head and face pain Deck (23)
Loading flashcards...
1

What nerves give sensory supply to the face? 

2

What is SNOOP?

S= systemic symptoms: Fever, stiff neck, photophobia, vomiting

N= neuro Signs: Altered conscious state, focal neuro deficit, change in memory/ behaviour

O= onset: sudden or abrupt

O = old: +50

P = past HA history: change in pattern, frequency   

3

What is the difference between a primary and secondary headache?

Primary headache: the headache cause is known

Secondary headache: Due to a unkwon cause:  a headache atributed to other malignancy or illness

4

What are the primary headaches?

  • cluster
  • tension
  • migraine 

5

what are the more likely acute headaches?

upper respiratory tract infection 

sinusitis: asthma/ allergic / infection  

6

what are the most common chronic headaches? 

 

  • tension 
  • migraine
  • cervicogenic
  • combination headache: tension/ depression. cervical dysfunction, drugs  

7

what are the serious cardiovascular disorders related to HA? 

  • CAD
  • intracranial haemorrhage
  • myocardial ischaemia
  • hypertensive crisis

 

8

Other conditions related to HA?

  • neoplasia (brain tumour)
  • Severe infection (meningitis): rash, Cx stiffness, photophobia,   
  • TMJ dysfunction: sore jaw, grinding, clicking, bruxism, tenderness 
  • dental disorder: caries, gingivitis, bath breath, infection, under/over bite
  • Eye disorder: refractive error, glaucoma
  • trigeminal neuralgia: pain with temperature, icescream 
  • depression: 
  • anemia: pallor, fatigue
  • metabolic disorder (thyroid)
  • Drugs:  meds, alcohol, caffeine 
  • exertional: sex, excercise 

9

what drugs cause headaches?

alcohol

nicotine

caffeine

analgesic

antibiotics

vasodilators

 

10

What are the features of tension headache ?

Diagnosed after 10 episodes 

Lasts from 30min to 7 days

band pattern 

Must have two 

Bilateral location

•Pressing or tightening quality (non-pulsatile)

•Mild to moderate intensity 

•No aggravation with routine physical activity

 

NOT 

nausea 

vomiting 

more than one sensory deficit (photo / phonophobia) 

11

What are the features of cervicogenic HA

  • unilateral
  • occipital region 
  • dysfunction of Cx
  • Arise from a convergence of trigeminal sensory fibres

12

What are the features of migraine

  •  diagnosed after 5 attacks
  • last 4 – 72 hours

 two of the following characteristics:

  • •Unilateral location
  • •Pulsating quality 
  • •Moderate or severe intensity
  • •Aggravation by routine physical activity

•AND if I’m associated with at least one of nausea, vomiting, photophobia and phobia

13

What causes migraines and auras?

  1. Vascular desregulation
  2. spreding cortical depression: self propagating wave causes depolarization  
  3. neural sensitisation:
    • ​​​increased nociceptive actiovation 
    • reduced supraspinal modulaiton 

14

What are the features of cluster HA

•I can be diagnosed after 5 attacks if I fulfil the following criteria:

•I am unilateral in nature and cause severe to very severe pain in the orbital, supraorbital or temporal region

•If am accompanied by at least oneof the following:

•Lacrimation or rhinorrhea

•Eyelid, forehead or facial oedema

•Miosis &/or ptosis

•Restlessness or agitation

•I can last for 15 – 180 minutes 

•My frequency can vary from once every second day to 8 times per day

15

What are the features of CAD 

•I usually present with at least two of the following features:

•Sudden onset or “thunderclap” headache

•Unilateralpain: frontal, temporal, occipital or supraorbital region

•Unilateral neck or facial pain

•Constant and severe pain (ache/throbbing/sharp) – unlike anything ever experienced

•Neurological symptoms such as: 

•Upper or lower limb deficits

•Horner’s syndrome

•Cranial nerve neuropathy 

•Pulsating tinnitus

16

What is the acronym VINDICATE for Neck?

  • Vascular/ visceral: ischaemia
  • Infection / inflammation: sprain/ strain / meningitis 
  • Neoplasia: tumour 
  • Degenerative: spondilosis 
  • Idiopathic / iathrogenic: surgery/ 
  • Congenital: born different 
  • Autoimune:  MS/ RA
  • Trauma: fracture/ whiplash 
  • Endocrine: fibromyalgia 

17

What are the red flags fro acute neck pain?

Infection

fracture

tumour

neurological

vascular 

 

18

What are the most common cause of Cx pain? 

Vertebral joint dysfunction

musculoligamentous strains and sprains

cervical spondylosis

19

what are the serious neck dysorders 

cardiovascular 

  • CAD
  • Myocardial ischaemia
  • haemorrhage 

Neoplasia 

  • primary
  • metastasis 

Infection 

  • osteomyelitis
  • meningitis 

vertebral fracture 

20

What are other neck disorders often missed?

Radiculopathy: Nerve root damage 

Myelopathy: cervical Spinal cord damage 

Thoracic Outlet Syndrome: compresion of brachial nerve

Cervical lymphadenitis: hotchkins lymphoma/ glandular fever 

Psychogenic: stress/ depresion/ anxiety 

Rheumatology

21

What is somatic pain ?

Pain due to damage on the  in musculoskeletal structures

22

What are causes of cervical somatic pain 

Discogenic

spondylosis 

facet joint pain 

myofascial pain 

somatic refered pain 

23

what aspect of the disc is innervated by nociceptor?