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8501 Clin Med > 8.24 General Limb Pain 3 > Flashcards

8.24 General Limb Pain 3 Flashcards

1
Q

What are the pathological neck conditions?

A
  • cervical myelopathy
  • neoplastic condition
  • cervical ligamentous instability
  • vertebral artery insufficiency
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2
Q

cervical myelopathies: What are the common s/s?

A
  • sensory disturbance of hands
  • muscle wasting of hands
  • unsteady gait
  • Hoffman’s reflex
  • hyperreflexia
  • b/b issues
  • multi-segmental weakness and sensory changes
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3
Q

neoplastic conditions: things to consider

A
  • hx of cancer
  • unexplained weight loss
  • constant pain
  • night pain
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4
Q

cervical ligamentous instability: often get c/o these types of headaches

A

occipital

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5
Q

What might a cervical ligamentous instability look like?

A

cervical myelopathy

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6
Q

What else can go on in the occipital region with cervical ligamentous instability?

A

occipital numbness

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7
Q

What is associated with vertebral artery insufficiency?

A
  • 5 D’s

- cranial nerve signs

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8
Q

What are the 5 D’s?

A
  • dizziness
  • dysphasia
  • dysarthria
  • diplopia
  • drop attacks
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9
Q

categories of dizziness

A
  • vertigo and nystagmus
  • dysequilibrium
  • presyncope
  • non-specific psychophysiologic
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10
Q

vertigo and nystagmus gives the sensation of

A

spinning

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11
Q

dysequilibrium

A

unsteadiness or imbalance without vertigo

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12
Q

presyncope

A

near-fainting or lightheadedness

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13
Q

If a pt has fullness in the ears, tinnitus, and hearing loss associated with dizziness, what would you think is the cause?

A

vertigo and nystagmus

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14
Q

If the pt has somatosensory, visual, decreased reaction time, lack of corrective ROM, an aging brain, or cerebellar issues associated with dizziness, what would you think is the issue?

A

dysequilibrium

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15
Q

Which categories of dizziness are associated with pallor, nausea, vomiting, diaphoresis?

A
  • presyncope

- vertigo and nystagmus

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16
Q

What are some of the s/s of non-specific psychophysiologic dizziness?

A
  • floating
  • rocking or swimming sensations
  • removed from body
  • giddiness
17
Q

What may cause presyncope?

A
  • cardiovascular
  • metabolic
  • vasovagal
  • medication
  • stress
18
Q

What may cause non-specific psychophysiologic dizziness?

A
  • anxiety
  • motion sickness
  • pain disorders
  • personality disorders
  • depression
  • agoraphobia
19
Q

What are the likely causes of dizziness in infants/toddlers?

A
  • BPPV and vestibular migraine
  • vestibular neuritis
  • brainstem or cerebellar tumor
  • TBI
20
Q

Children 0-4 y/o are at a high risk for

A

TBI

21
Q

Percentage of cases where infant/toddler dizzines is caused by BPPV and vestibular migraine

A

50%

22
Q

What action should be taken by the provider if an infant/toddler has dizziness? Why?

A

like need an MRI - prevalence of brain tumor in children

23
Q

possible causes of dizziness in children and adolescents

A
  • vertiginous migraine
  • BPPV
  • vestibular neuritis-ear infection
  • anxiety
  • orthostatic hypotension
  • concussion
  • seizure, syncope, nonspecific
24
Q

percentage of cases that cause dizziness in children and adolescents: vertiginous migraine

A

39%

25
Q

percentage of cases that cause dizziness in children and adolescents: BPPV

A

15%

26
Q

percentage of cases that cause dizziness in children and adolescents: vestibular neuritis-ear infection

A

14%

27
Q

percentage of cases that cause dizziness in children and adolescents: anxiety

A

13%

28
Q

percentage of cases that cause dizziness in children and adolescents: orthostatic hypotension

A

9%

29
Q

percentage of cases that cause dizziness in children and adolescents: concussion

A

3%

30
Q

percentage of cases that cause dizziness in children and adolescents: seizure, syncope, non-specific

A

2%

31
Q

dizziness in children and adolescents: actions by provider

A
  • lab tests
  • electroencephalography
  • MRI
32
Q

possible causes of dizziness in adults

A
  • vestibular neuritis (labyrinthitis)
  • BPPV
  • presyncopal conditions
33
Q

dizziness in adults: What might require ENT referral?

A

ear infection with acute dizziness

34
Q

Aside from an ENT referral, what else may needed to determine the cause of dizziness in adults?

A

attempt to differentiate between central and peripheral vestibular conditions

35
Q

possible causes of dizziness in adults over age 65

A
  • BPPV

- presyncope

36
Q

action by provider: dizziness in older adults

A
  • rule out presyncopal conditions

- could be life-threatening

37
Q

What are presyncopal conditions

A
  • orthostatic hypotension
  • vascular disease
  • arrhythmia

8501 Clin Med (102 decks)

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