[Lecture] Head Pain, TMJ, Migraines [Chou] Flashcards Preview

OS4 Exam 1 > [Lecture] Head Pain, TMJ, Migraines [Chou] > Flashcards

Flashcards in [Lecture] Head Pain, TMJ, Migraines [Chou] Deck (23)
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1

What is the differential diagnosis for headaches?

 

(From most common to least)

Tension type headache (80%)

 

Migraine (15%)

 

Medication overuse (3%)

 

Cluster/Trigeminal (0.1%)

2

 

 

What are examples of secondary causes of headache?

Subarachnoid hemorrhage - "Worst headache of life"

 

Stroke - (New onset focal neurologic weakness)

 

Meningitis/Encephalitis

 

Acute angle glaucoma - (Acute eye pain)

 

Hypertensive/preeclampsia - (High blood pressure)

3

THIS WILL BE A TEST QUESTION SO HELP ME

 

If you have a secondary cause of headache (subarachnoid hemorrhage, stroke, meningitis etc...), what is the NEXT BEST STEP to treating patient?

 

 

Send to the ED

4

What questions do you need to focus on during your HISTORY that will help you determine the type of headache your patient has?

Location: Unilateral vs. bilateral? Radiation?

 

Characteristics: Type of pain

 

Related symptoms: Photosensitivity? Aura? Tearing?

 

Temporal: Same time everyday?

5

Describe the characteristics of a TENSION type headache

Pain pattern : Bilateral tight/Achy pain

 

Radiation from the occipital/cervical region

6

What is THE defining characteristic of trigger points? (in comparison to tender points)

Trigger points RADIATE

7

What are examples of conservative therapies for treating tension type headaches?

Manual manipulation : ischemia compression

 

Physical thearpy

 

Spray and stretch (lengthen muscle, cold analgesic topical spray)

 

Dry needling

8

What are used in trigger point injections for tension type headache treatment?

Lidocaine and steroid

9

What type of pharmacologic interventions can you use to treat tension type headaches?

Muscle relaxers 

 

NSAIDS

10

5 Models Treatment

 

Biomechanical 

 

What do you want to think about?

Conservative therapies first!!!

 

(Splint, stretching, spray & stretch, dry needling, OMT, PT)

 

Or

 

Injections/radiofrequency ablation if conservative doesnt work

11

5 Models Treatment

 

Neurologic

 

What do you want to think about?

Pharmacology!

 

Muscle relaxors

 

Preventative : SSRI, Tricyclics ***

12

5 Models Treatment

 

Behavioral

 

What do you want to think about?

 

BTW THIS WILL BE A TEST QUESTION

***Smoking cessation*** (nicotine correlated to # headache days)

 

RICE

 

Prevent overuse

 

Biofeedback (CBT)

13

What are the three common causes of tension type headaches?

Myofascial Pain Referral

 

Cervical Facet Referral

 

Tamporal Mandibular Joint Dysfunction (TMJ)

14

What muscles are usually involved in TMJ?

Pterygoid muscle

 

Temporalis muscle

 

Masseter muscle

15

What is the most effective TMJ specific treatment?

Bite splint

16

Descibe the characteristics of a migraine

Pain pattern: Unilateral throbbing burning pain, has multiple phases

 

Associated sxs: Aura, nausea, photophobia, phonophobia

17

What is the most common migraine triggers? Top 5 in order

Emotional stress (80%)

Hormones (65%)

Irregular sleep (50%)

Diet (50%

Caffeine and Alcohol

18

What are some less common migraine triggers? (4)

Changes in weather

 

Dehydration

 

Smells

 

Medications

19

What is the major 5 model treatment consideration for migraine management?

 

**TEST QUESTION

Behavioral 

 

AVOID TRIGGERS

20

What is considered chronic pain medication use?

>15 days/month for 3 months

21

How do you help treat a patient with medication overuse?

Stop offending medication

 

 

Bridge the patient to another med to break the cycle

22

What is the classic presentation of a cluster headache?

Sweating, swelling, tearing, runny nose

 

"Its like there is sand in my eye"

23