Cervical Pathology Flashcards
What is the most common type of headache
Tension
What are the two types of tension headaches
1) suboccipital/retro-occipital
2) temporal
What is the cause of a suboccipital tension headache
Greater/lesser occipital nerve- C2/3
**must clear vertebral artery if dizziness is concurrent with headache
What is the cause of barometric headaches
Changes in barometric pressure
Vasoconstriction/dilation
Barometric Sx
Tight band, pain cantered around forehead/nasal bridge, pounding occipital pain
Are barometric headaches usually bilateral or unilateral
Bilateral
What is another name for migraines
Vascular headaches
Sx of migraines
Pulsating, nausea, vomit, sensitive to light/smell/sound, worse with activity
How long do migraines last
72 hours
Migraines with auras are usually
Bilateral
*disturbance of visual/sensory/motor
Migraines without auras
Unilateral
Precipitating factors for migraines
Hormones, food, alcohol, changes in temp/pressure/sleep/altitude, stress, fatigue, allergies
What is another name for cluster headaches
Trigeminal autonomic cephalgia (TACs)
Sx of cluster headaches
Attacks (30-40 min, 3-4x/day) Recurrent, severe Unilateral, around eye/temple Burning, stabbing Watering eyes/swelling, nasal congestion
Which are worse migraines or cluster headaches
Cluster headaches
Are cluster headaches usually bilateral or unilateral
Unilateral
What is a neurometabolic cascade
Pathophysiological pathway of concussion
-ionic, metabolic, physiological events accompanying axonal injury
How long do concussions usually last
7-10 days
Severe could be weeks, months, years
What are the 4 kinds of Sx of concussion
1) physical (headache, nausea, vomit, dizziness, fatigue)
2) emotional (irritable, sad, nervousness)
3) cognitive (fog, slowed response, difficult concentration/memory)
4) sleep (difficulty falling asleep, more/less than normal)
What is Second impact syndrome
Second concussion before fist concussion healed
**vascular dilation= increase intracranial pressure= coma/death
What is whiplash
Sprain/strain of cervical spine
What are all the pathologies
1) headaches (tension/barometric/migraines/cluster headaches)
2) concussion/post-concussion
3) Second Impact Syndrome (SIS)
4) whiplash
5) Transverse Ligament Injuries Classification
6) Vertebral Artery Dissection
7) TMJ
2 types of transverse ligament injuries classification
1) intersubstance tear
2) bony avulsion
Cause of transverse ligament injury
1) trauma
2) Down’s syndrome
3) rheumatoid arthritis
What is a transverse ligament injury
Dens travels posteriorly into spinal cord
Transverse ligament injury Sx
**lump in throat
Bilateral extremity paresthesia, Hoffmann sign, death
2 imaging for transverse ligament injury
1) lateral radiograph of altantodens interval (ADI)
2) open mouth Odontoid view= atlas fractures
Ranges of lateral radiograph of ADI
5mm= injured transverse/alar/tectorial ligament
Cause of vertebral artery dissection
1) trauma (strangulation/MVA)
2) insidious
Sx of vertebral artery dissection
Head pain- gradual, dull/pressure/throbbing
**Headache + dizziness
Neck pain
Intermittent/permanent stroke Sx (difficulty speaking)
Horner’s sign
What is Horner’s sign
1) miosis= constricted pupil
2) ptosis= droopy eyelid
3) anhidrosis= decreased sweating
4) exophthalmos= inset eyeball
What is Sequelae in vertebral artery dissection
Obstruction of blood flow through affected vessel may lead to dys of part of brain supplied by artery
1) temporary
2) permanent
Cause of TMJ
1) trauma
2) idiopathic
Dysarthria
Difficulty speaking
Dysphasia
Trouble swallowing
Anosmia
Loss of smell
Hyposmia
Decreased sense of smell
Parosmia
Perversion of the sense of smell
Cacosmia
Awareness of an offensive smell which doesn’t exist
Hyperacusia
Amplified sound
Aphonia
Hoarse voice
Brocas
Expressive dysphasia
Wernickes
Receptive dysphasia
Miosis
Constricted pupils
Apparent anhidrosis
Decreased sweating
Ptosis
A weak droopy eyelid
What’s the pathway of the vertebral artery?
Travels through the transverse foreman of C6 and up to form the circle of Willis
