Quiz 4 - headache and vertigo Flashcards Preview

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

4 things people actually mean by dizziness

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

2

vertigo is best described as...

an illusion of movement

3

presyncope best described as.....

faintness, lightheadedness

4

disequilibrium is best described as.....

- unsteadiness on one's feet
- often resolves by touching an object

5

peripheral vs central causes of vertigo

peripheral - damage to inner ear
central - damage to CNS

6

presentation of peripheral vertigo

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

7

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

- 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

object vs subject vertigo

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

9

PE for peripheral vertigo

- head thrust
- inability to maintain fixation indicates vestibular damage

10

central vertigo presentation

- 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

vestibular neuronitis/acute labrynthitis presentation

- monophasic attack of vertigo that lasts days to weeks
- type of peripheral vertigo

12

3 peripheral vertigos provoked by movement

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

13

2 peripheral vertigos provoked by noise

- meniere syndrome
- perilymph fistula

14

meniere pathophysiology and presentation

- increased pressure in endolymph from diminished resorption
- attacks minutes to hours
- long term damage, can't hear low tones
- low tone tinnitus

15

perilymph fistula pathophys and presentation

- leak between middle and inner ear
- associated with changes in pressure

16

what is chiari malformation?

cerebellum herniates through foramen magnum

17

chiari presentation

- central vertigo
- occipital headache
- downbeat nystagmus

18

causes of pre-syncope and presentation

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

only intracranial structures that are pain-sensitive

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

20

why does CSF drainage cause headache?

traction on venus sinuses as brain sinks