Quiz 4 - headache and vertigo Flashcards Preview

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Flashcards in Quiz 4 - headache and vertigo Deck (20)
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1
Q

4 things people actually mean by dizziness

A

1) vertigo
2) pre-syncopal lightheadedness
3) disequilibrium
4) other (floating)

2
Q

vertigo is best described as…

A

an illusion of movement

3
Q

presyncope best described as…..

A

faintness, lightheadedness

4
Q

disequilibrium is best described as…..

A
  • unsteadiness on one’s feet

- often resolves by touching an object

5
Q

peripheral vs central causes of vertigo

A

peripheral - damage to inner ear

central - damage to CNS

6
Q

presentation of peripheral vertigo

A
  • horizontal or rotary nystagmus
  • worsens when looking in direction of fast motion
  • possible hearing loss or tinnitus
  • no other neurologic signs
7
Q

nystagmus and room spinning in relation to side of peripheral vestibular damage

A
  • horizontal nystagmus will have tonic phase toward side of damage
  • room will be spinning away from side of damage in direction of fast phase
8
Q

object vs subject vertigo

A

object - seen in vestibular damage, appearance that room is spinning
subject - seen when eyes closed, feeling that patient is spinning

9
Q

PE for peripheral vertigo

A
  • head thrust

- inability to maintain fixation indicates vestibular damage

10
Q

central vertigo presentation

A
  • nystagmus in any direction
  • vertigo is milder than peripheral
  • nystagmus greater than person’s illusion of movement
  • no hearing loss
  • often other neurological signs
11
Q

vestibular neuronitis/acute labrynthitis presentation

A
  • monophasic attack of vertigo that lasts days to weeks

- type of peripheral vertigo

12
Q

3 peripheral vertigos provoked by movement

A
  • benign positional vertigo (BPV, liberated otoliths)
  • cervicogenic vertigo (sustained neck position)
  • vertebrobasilar insufficiency (cutting off of verterbrobasilar artery by neck movement)
13
Q

2 peripheral vertigos provoked by noise

A
  • meniere syndrome

- perilymph fistula

14
Q

meniere pathophysiology and presentation

A
  • increased pressure in endolymph from diminished resorption
  • attacks minutes to hours
  • long term damage, can’t hear low tones
  • low tone tinnitus
15
Q

perilymph fistula pathophys and presentation

A
  • leak between middle and inner ear

- associated with changes in pressure

16
Q

what is chiari malformation?

A

cerebellum herniates through foramen magnum

17
Q

chiari presentation

A
  • central vertigo
  • occipital headache
  • downbeat nystagmus
18
Q

causes of pre-syncope and presentation

A

all forms of cerebral ischemia

autonomic failure - orthostatic hypotension

vasovagal episode - low HR and BP, associated with high stress and anxiety

hyperventilation and cerebral vasoconstriction

migraine

19
Q

only intracranial structures that are pain-sensitive

A
  • meningeal arteries
  • proximal portions of cerebral arteries
  • dura at base of brain
  • venus sinuses
  • CN V, VII, IX, X
  • cervical nerves 1-3
20
Q

why does CSF drainage cause headache?

A

traction on venus sinuses as brain sinks