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83 Cards in this Set
- Front
- Back
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Most common type of primary headache
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Tension headaches
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Second most common type of primary headache
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Migraine headaches
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Why are migraine headaches referred to as neurovascular headaches?
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It is most likely caused by an interaction between blood vessels and nerve abnormalities
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Migraine headaches have been associated with fluctuations in what?
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Cerebral perfusion
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In patients younger than 10 years old, migraine prevalence affects which sex more?
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Males
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After puberty, migraine headaches affect which sex more?
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Females
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Unilateral and throbbing pain describes what kind of headache?
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Migraine
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The partial paralysis of one side of the body. Which tract is involved?
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Hemiparesis
Involves the corticospinal tract |
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Usually described as a throbbing or pulsatile type of pain but can evolve into a chronic ache, or band-like pattern
Which headache? |
Migraine headache
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(3) Types of Migraine Headaches
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1. Migraine without aura (formerly common migraine)
2. Migraine with aura (formerly classic migraine) 3. Retinal migraine |
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Uniformed flashes of light or simple forms of visual hallucinations
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Photopsia
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Do tension headaches have auras?
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No
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Which headache can be described as dull, achy, and non-pulsatile; feeling of tightness or hatband-like
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Tension headaches
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Do tension headaches have photophobia, nausea or vomiting?
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No
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Most common form of trigeminal autonomic cephalgia
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Cluster headache
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Cluster headaches typically affect which sex more frequently?
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Men
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How long does a cluster headache typically last for?
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1 - 1.5 hours
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Chronic paroxysmal hemicrania usually effects which division of the trigeminal nerve?
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Ophthalmic division
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Characterized by one to three short lived attacks of periorbital pain per day over a 4 to 8 week period, following by a pain free interval that averages one year
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Episodic type cluster headache
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Which drug is helpful for cluster headaches but not migraine headaches?
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Lithium
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Which drug is helpful for migraine headaches but not effective for cluster headaches?
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Propranolol
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Pain is in and around one eye
Which headache? |
Cluster headache
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Pain is a band like squeezing the head
Which headache? |
Tension headache
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Pain, nausea, and visual changes are typical of classic form
Which headache? |
Migraine headache
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Most common root affected by spondylosis and degeneration
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C5
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Most common nerve root affected by herniated disc
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C7
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Cervical radiculopathy in an older patient is often the result of what?
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Foraminal narrowing
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Cervical radiculopathy in a younger patient is often the result of what?
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Disc herniation
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Which nerve root is the most common root affected by spondylosis and degeneration?
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C5
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A complete nerve lesion will result in what?
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Numbness
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A partial nerve lesion will result in what?
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Paresthesia
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Initial treatment of cervical disc?
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- NSAIDs
- Mild analgesics as needed - Cervical traction |
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Does McKenzie Protocol = Extension?
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NOOOOOOOOO!!
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What is the standard of surgical care for a herniated disc?
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Anterior cervical discectomy
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Normal diameter of the cervical spinal canal between C3 and C7
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17 - 18 mm
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Weakened response of the brachioradialis reflex and a reflex contraction of the SPASTIC finger FLEXORS
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Inverted Radial Reflex
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Symptoms of cervical radiculopathy are due to compression of what?
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Nerve root
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Cervical myelopathy symptoms are due to compression of what?
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Spinal cord
(possibly canal stenosis) |
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If a patient has stenosis, will there always be symptoms?
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No!
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Partial removal of the lamina
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LaminOtomy
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Complete removal of the lamina
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LaminECtomy
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Which is more stable- Laminotomy or Laminectomy?
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Laminotomy
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Refers pain to the posterior upper cervical region and head
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C2/C3
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Refers pain to the posterolateral cervical region without extension into the head or shoulder
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C3/C4
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Refers pain to the posterolateral middle and lower cervical region and to the top of the shoulder
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C4/C5
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Refers pain to the posterolateral middle and primarily lower cervical spine and the top and lateral parts of the shoulder and caudally to the spine of the scapula
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C5/C6
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Refers pain to the top and lateral parts of the shoulder and extends caudally to the inferior border of the scapula
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C6/C7
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An increased response to a painful stimulus
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Hyperalgesia
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Painful response to a normally innocuous stimulus
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Allodynia
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Flexion is limited by what in a whiplash injury?
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Chin on the chest
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Extension is limited by what in a whiplash injury?
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NO anatomical limit! Woaaah
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Hallmark symptom of whiplash injuries?
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Neck Pain! Duh silly bears.
(62% - 100% of all whiplash injuries) |
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Whiplash injuries typically result in a headache in what region?
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Suboccipital region
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Recent studies show that occipital neck pain in a whiplash injury is due to what?
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Stretch of the dorsal root ganglia (C1 - C2 - occipital neuralgia)
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Pathologic term referring to softening of the spinal cord
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Myelomalacia
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Complete loss of sensation
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Anesthesia
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Diminished sensation (very painful with enough stimuli)
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Hypesthesia
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Increased tactile sensibility
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Hyperesthesia
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Complete loss of pain sensibility
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Analgesia
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Increased sensibility to tenderness
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Hyperalgesia
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dIminished sensitiveness to pain
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Hypalgesia
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Higher threshold of pain with pressure, once reached is extremely painful
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Hyperpathia
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Electrodiagnostic studies reflect what?
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Neurologic functional status
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Best test for a radiculopathy?
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Electrodiagnostic testing
- Needle EMG - Peripheral nerve conduction studies - Sensory evoked potentials |
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SSEP is useful for the evaluation of what?
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Somatosensory Evoked Potential is useful for evaluation of MYELOPATHY
- It is not recommended to identify radiculopathy |
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What is important about Nerve Conduction Velocity tests?
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You MUST cross the entrapment site
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Nerve Conduction Velocity: Amplitude
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Reflects the size of the response to an electrical stimulus, or the number of conducting fibers (axons) and their degree of synchrony
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A single latency may be significant in evaluating what?
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A specific entrapment site
Example: Carpal Tunnel Syndrome |
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The time the wave is evident on the screen is dependent upon the synchrony of the conduction between the fastest and slowest conducting nerves
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Temporal Dispersion
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Complete severing of the nerve
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Neurotmesis
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Compression of the myelin sheath
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Neuropraxia
(Short term!) |
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Axonal loss, nerve sheath intact
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Axonotmesis
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In neurotmesis and axonotmesis, Wallerian Degeneration occurs proximal or distal to the entrapment sites?
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DISTAL
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Is latency affected with axonotmesis?
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No! Because as long as there are intact fibers, the fastest fibers will create the initiation of the action potential
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A motor response due to antidromis activation of a peripheral nerve
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F Waves
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Difference between orthodromic and antidromic?
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An orthodromic impulse runs along an axon in its normal direction, AWAY from the soma
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A technique for evaluating and recording the electrical activity produced by skeletal muscles
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Electromyography
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Measures conduction from periphery to cortex
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Evoked potentials
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Evoked potentials are motor, sensory or both?
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Strictly SENSORY
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Does needle EMG introduce any electrical stimulation?
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No!
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EMG can be used to localize what?
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PERIPHERAL nerve or root lesions by noting which muscles show denervation changes
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Reduced recruitment patterns in EMG indicate what?
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A decrease in functioning motor units
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Most common referring diagnosis in the EMG lab and the most common entrapment neuropathy
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Carpal Tunnel Syndrome
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