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Spine Test 1 > Lecture 8 > Flashcards

Lecture 8 Flashcards

1
Q

What percent of people in america have headaches each day?

A

16%

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2
Q

what is the most common type of HA?

A

tension headaches

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3
Q

Describe a cluster HA symptoms. Duration, and which sex gets it more. Unilateral or bilateral?

A

Sharp stabbing or drilling pain

1 hour

unilateral - will be orbital, supraorbital and temporal area (just remember its around the eye)

men more affected by it

NOTE: Its a rare headache type (only .1 - .4% of people get it)

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4
Q

We know a cluster headache is that sharp pain around the eye. Give some other symptoms that go along with it (6)

A

Tearing of the eye
Nasal congestion / runny nose
Eyelid swelling
Forehead / facial sweating
Miosis (pupillary consitrction)
Ptosis

Think anything around eye area is pretty much affected (symptoms happen where the HA is)

memorize this of mneunomic

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5
Q

What is the cluster HA mnemonic?

A

CLUSTER

Conjunctival injection (bloodshot eyes)

Lacrimation (tears)

Unilateral

Severe or sudden onset

Triptan injections work best (medicine)

Eyelid Drooping / swelling (ptosis)

Restlessness or agitation (brings on HA)

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6
Q

Why do migraine pts feel numb of wiped after their HA

A

because their sensory system has been opened and closed so many times that they are numb to feeling

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7
Q

What nerve might be associated w/ migraines

A

Trigeminal

It does so much function w/ the face that it is thought to be involved

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8
Q

What percent of the population gets migrains?

A

10%

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9
Q

Does PT work well on migrains?

A

No - its more a neuro problem

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10
Q

What works best for help w/ migrains (since PT doesnt help much)

A

Meds

rescue meds / daily meds

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11
Q

are migrains unilateral or bilatearl?

A

Unilateral

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12
Q

Are migrains or cluster HA pulsitile?

A

Migrains - they go along w/ that opening and closing of those blood vessels

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13
Q

Why would PA affect migrains

A

People w/ migrains have that pulsitile blood flow already - so when you’re speeding this up the pulsing happens more and more

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14
Q

KNOW: Migrains are sensitive to light and sound and could present w/ nausa / vomitting

A
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15
Q

KNOW: migrains deal w/ pulsing of nerves / vessels

A
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16
Q

What kind of HA’s have a prodrome phase and a postdrome phase?

A

migrains

They feel weird before and hungover after

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17
Q

How long do migrains last?

A

4-72 hours

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18
Q

Differentitate abortitive and preventitive

A

Abortittive = rescue meds

Preventitive = daily meds

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19
Q

Preventitives are typically a low does of mediciation. What are the 3 associated w/ migrains?

A

Anticonvulsants (topirmate or valproate): these are typically prescribed for seziures and are used to calm down that rapid depolirzation reporlization if the NS - calms down electical activity

Beta blockers (lols): slows down HR and reduces BP –> taking away that pulsing

Antidepressants: Calms down NS

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20
Q

Abortitive medications, also known as rescue medicine is used to make the symptoms of a migraine better. Which 4 do we use for migrains?

A

Triptans (basically pain killer + caffine)

NSAIDs (acetaminophen) - treat the swelling that occurs w/ it

Antimetics - treat nausa and vomitting

Erotamine - causes constriction of blood vessles (maybe cutting off those pulsing vessels?)

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21
Q

What percent of HA’s are tension headaches

A

30-70% (this is most of HA’s)

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22
Q

How many head aches per month represents ipsodic? - talking about tension HA

how about chronic

A

less than 15

chronic = more 15

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23
Q

How long do tension HA’s last?

A

Up to 7 days

NOTE: It could be releated to muscles / stress causing them to last a long time

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24
Q

What is the diagnostic criteria for tension HA’s

A

Must have both of the following:
1) No nausea or emesis (because this is a symptoms of migrains)
2) Can’t have both photophobia (vision sensitivity) and phonphobia (hearing sensitivity)

At least two of the following:
1) Pressing or tightening quality (tight ring around head)
2) Mild or moderate intensity
3) Bilateral
4) Not aggravated by routine PA

So they need to have both of the first two and at least 2/4 of the second

NOTE: Tension HA are different than migrains / cluster HA because they’re bilateral)

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25
Q

Which HA is Bilateral: Migrain, Cluster, Tension

A

Tension

26
Q

What is the Tension HA mnemonic?

A

BAND

Bilateral
Anxiety and stress (go along w/ it)
No other signs/symptoms consistent w/ other types of HA’s
Dull Pressure (not sharp stabing or anything)

27
Q

Is a sudden onset thunder clap HA a red flag?

A

Yes

28
Q

Are new neurological deficits w/ HA a red flag?

A

Yes, I’m worried if something is changing - this is specifically talking about older because they would’ve already developed migrains at this point - think numbness / tingling / slurring

29
Q

What age group gets cluster HA’s

A

Males 20-40

Typically associated w/ binge drinkers

30
Q

Why would a HA triggered by cough / valsalva or sneeze be a red flag?

A

Makes me think its a blood supply issue. When those vessels get squeezed down on they’re causing the HA

Could be cardiac / arteries in head

31
Q

KNOW: other red flags w/ HA

HA triggered by EX (BP)
Orthrostatic HA (BP)
Age less than 20 and history of cancer
Vommitting without other cause
Giant cell arteritits
Substaintial change in HA charcteristics
Symptoms suggestive of acute glaucoma
* Misty vision, painful red eyes, nausea

A
32
Q

Red flag mneumonic for HA (proably memorize this insead of others)

A

SNOOP

Systemic signs and disorders (fever, weightless) or secondary risk factors (HIV< systemic cancer, inflammatory conditions)

Neurlogic symptoms - confusion, impaired alterness / loss of consciousness

Onset: suddent, abrupt, split second HA “like a thunder clap”

Older: New onset and progressive HA (giant cell arteritits)

Previous HA historypositional provation, precipitaed by exercise (think orthostatic hypotension)

33
Q

What is cervical artery disfunction?

A

Vertebral artery insufficiency

34
Q

For people with internal carotid issues and vertebral artery dysfunction what is the 1 thing that about 80% of them had

A

unilateral head / neck pain

35
Q

When do cervicogenic HA’s typically start in life?

A

Middle age

36
Q

Who gets more cervicogenic HA’s men or women?

A

Women

37
Q

What is the general location os cervicogenic HA’s?

A

Posterior head / neck

38
Q

Are cervicogenic heads unilateral or bilateral?

A

unilatearl

NOTE: ipsilatearl sholder / pain is also common

39
Q

What kind of HA potentially limits upper cervical mobility?

A

Cervicogenic HA’s

40
Q

KNOW: Cervicogenic HA’s cause a loss of AROM/PROM

A
41
Q

KNOW: About 50% of Hd rotation comes between C1-C0. We have a high density of nerves in that area providing us w/ proprioceptive input. This high density of nerves means it would be a realtively high pain generator area. These extra nerves give us reflexive stiffness / guarding to protect them. This leads to stiffness in the area - can lead to cervicogenic HA’s

A
42
Q

What is the most important peice of information to know before poking around trying to reproduce the pain w/ a cervicogenic HA?

A

Irritability - will i stir it up and will it hang around.

43
Q

What kind of HA’s lead to strength, endurance, and coordination deficits of the neck musculature?

A

cervicogenic HA

if you don’t use it / move it you lose it = strength / endurance problems (especially if they’ve had it for a long time)

44
Q

What test do we do to differentiate between cervicogenic HA’s and other HA’s

A

Cervical Flexion-Rotation test

(chin to sternum - tighten up everything posterior so rotation is isolated at upper cervical)

Positive = side to side difference > 10 degrees
One side not getting passed 32 degrees

45
Q

Do migrainers have muscle tightness?

A

No

46
Q

What two places hurt with a C0-C1 type HA

A

Pain is referred to the temporal region and the verticie (top) of head

47
Q

Where is pain referred w/ a C2 HA

A

RamsHorn

Temporal bone –> posterior and rapped down

48
Q

What causes a ramshorn HA?

A

C2 referred HA

49
Q

If I’m able to bring on their HA w/ poking what kind of HA do they have?

A

Cervicogenic (because this is the muscle HA)

50
Q

KNOW: cervicogenic HA’s typically Stem from C0-C1, C1-C2, C2-C3

Its the upper cervical stuff the referrs to the head

A
51
Q

How long do cervicogenic HA’s last

A

1 hour to weeks

52
Q

Which type(s) of HA’s have throbbing associated w/ them

A

Migraine

53
Q

What kind of pain do we see w/ tension-type HA’s?

A

Dull

54
Q

What kind of pain do we see w/ cervicogenic HA’s

A

Pain that normally starts in the neck - non throbbing

55
Q

What triggers cervicogenic HA’s?

A

Neck movements / pressure of C0-C3

56
Q

NOTE: For neck pain w/ HA’s we can do manip / mobilization

A
57
Q

NOTE: edurance / low load activities are good neck EX

Most neck issues are arises due to an endurance issue. They can sustain holding up your head all day - so do endurance style EX

Can do retraction EX / Elongation of cervical spin / isometrics / self SNAG / therpaist directed SNAG / NAGs

A
58
Q

Pain dominant mobilizations are what grades?

A

1 and 2

59
Q

Stiff dominant mobilizations are what grades?

A

3 and 4

60
Q

What is the name for being able to touch one body part and produce a change in another one?

A

regional interdependece

Spine Test 1 (14 decks)

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