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CSA > CSA Full > Flashcards

CSA Full Flashcards

1
Q

What blood vessels are involved in an Intracranial Aneurysm?

A

Anterior Cerebral A

Middle Cerebral A

Communicating Branches of Circle of Wilis

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2
Q

Signs/ Symptoms of Aneurysm

A
  • Headache (minor= impending or Severe= rupture)
  • Changes in Character
  • CN (Ocular, Diplopia, Squint, Facial pain, Visual Loss, Homonymous Hemianopsia)
  • Neurological Deficits
  • Vomiting, Dizziness, Alterations in pulse, Respiratory rate
  • Seuzure
  • Neck Stiffness

+ Kernigs, and bilateral Babinskis

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3
Q

Ancillary test to check for Aneurysm

A

CT scan (speed)

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4
Q

Treatment for Aneurysm

A

Surgery

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5
Q

Etiology of Benign Paroxysmal Positional Vertigo (BPPV)

A
  • Degenerative depris (otoconia) floating in semicircular canals
  • Causes inappropriate endolymph movement
  • Most common vertigo
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6
Q

Presentation of Benign Paroxysmal Positional Vertigo

A

Vertigo that occurs with certain head positions

Lasts seconds to minutes

Horizontal-rotational nystagmus

Diminished over month without hearing loss

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7
Q

Diagnosis of BPPV

A

Dix Hallpike maneuver (+ve= latency of secs before vertigo and nystagmus begin)

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8
Q

Treatment of BPPV

A

Eply’s Maneuver

Semont’s Maneuver

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9
Q

Etiology of Cervicogenic Headache

A

Referral from Soft Tissue and Articular structures in neck

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10
Q

Signs and symptoms of Cervicogenic headache

A

HA w/o neurological deficits

Reduced neck ROM with pain

Restrictions in C/S usually upper occiput

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11
Q

Treatment for Cervicogenic HA

A

CMT and STM

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12
Q

Signs/Symptoms of Classic Migraine (w/ aura)

A

Often femal presenting with unilateral throbbing HA that preceeded by prodrome (aura)

HA lasts several hours to 1-3 days

PT seeks quiet and dark environment

Associated nausea & vomiting

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13
Q

Treatment for Classic Migraine

A

May respond to SMT

Medical= Ergotamine Derivatives & sumatriptan

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14
Q

Signs and Symptoms of a Cluster HA:

A

Severe, Unilateral, Preorbital or Temporal

Painful orbital HA

Last 30 min, triggered by food or alcohol

Pt Hx of smoking

Pt agitated and animated (suicide)

Some have Horners syndrome (ptosis, miosis, anhydrosis)

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15
Q

Treatment for cluster headache

A

Similar to migraine with mets

Trial SMT

Management set A B or I

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16
Q

S&S of Common Migraine

A

Same as Classic, but w/o aura

Unilateral pulsatile severe HA

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17
Q

Supplemental MGMT of Migraine

A

Bromelain

Cal/Mag

Iron

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18
Q

CN I Lesion & Clinical Observation

A

Ethmoid bone

Olfaction sensation= Anosmia

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19
Q

CN II Lesion & Clinical Observation

A

^ pressure= papilledema

Transaction causes ipsil blindness and loss of light reflex

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20
Q

CN III Lesion & Clinical Observation

A

Oculomotor paralysis: diplopia, ptosis, eye looking down

Aneurysm of carotid & post communicating branch: dilated and fixed pupil

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21
Q

CN IV Lesion & Clinical Observation

A

Extorsion of eye & weakness looking down and in

Head tilting to compensate for extorsion

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22
Q

CN V Lesion & Clinical Observation

A

Loss of sensation to face

Loss of corneal Reflex

Flaccid paralysis of muscle of mastication

Deviation of jaw to weak side

Hypacusis (partial deafness to low pitched sounds) due to tensor tympani

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23
Q

CN VI Lesion & Clinical Observation

A

Inability to abduct eye

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24
Q

CN VII Lesion & Clinical Observation

A

Flaccid paralysis of muscle of facial expression

Loss of corneal blink reflex

Loss of taste anterior 2/3 tongue

Hyperacusis (acuity of sounds) due to stapedius m paralysis

Bells Palsy

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25
Q

CN IX Lesion & Clinical Observation

A

Loss of gag reflex

Loss of carotid sinus reflex

loss of taste from post 1/3 of tongue

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26
Q

CN VIII Lesion & Clinical Observation

A

Lesions result in disequilibrium vertigo, and nystagmus

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27
Q

CN X Lesion & Clinical Observation

A

Ipsil paralysis of soft palate leading to hoarsness, dyspnea, dysarthria, and dysphagia

Aortic aneurysms and tumors of neck or thorax often compress the vagus nerve

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28
Q

CN XI Lesion & Clinical Observation

A

Paralysis of SCM, Traps, and larynx if root is involved

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29
Q

CN XII Lesion & Clinical Observation

A

Hemiparaysis of tongue causing deviation to weak side

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30
Q

Etiology of Facet Syndrome/Joint fixation

A

Often traumatic onset

Facet or capsule may be source of pain

Meniscoid may be entrapped

Degenerative changes can cause pain from facets

31
Q

S&S of Facet Syndrome

A

Neck, upper back pain or stiffness

Sharp pain with motion possible

Scleratogenous referral

Tender restrictions upon motion palpation

Limited CS active and passive ROM

Absent nerve root tension signs

MM hypertonicit possible

Local pain with Kemp’s, Spurlings, and Jacksons

32
Q

Treatment for Facet Syndrome

A

SMT, Ice, PT mod (Ultrasound, IFC, TENS, Electrotherapy)

33
Q

Eiology of Glaucoma

A

Intraocular Pressure

MC cause of blindness

34
Q

S&S of Glaucoma

A

No early Sx

Once aware of visual field loss, atrophy of nerve is already present

Peripheral vision loss 1st, then central

35
Q

Tx of Glaucoma

A

Medication or laster therapy tried first (stabilize IOP)

Meds: Beta blockers

Refer to optometrist

36
Q

Sx of Hematoma

A

Focal neurological deficits or increased intracranial swelling and pressure.

37
Q

Types of Hematomas.

A

Subarachnoid:

  • Caused by berry aneurysm
  • Bleeding into subarachnoid space

Subdural:

  • Caused by venous bleeding between dura and Arachnoid
  • Gradual signs of cerebral compression occur over days-weeks after head injury

Epidural:

  • Arterial hemorrhage associated with skull fracture and laceration of middle meningeal aa
  • Short lucid period of consciousness followed by rapid Sx

Intracerebral:
- MC from hypertension

38
Q

Etiology of Herpes Zooster of Facial Nerve

A

Invasion of the ganglia of 8th (vestibulocochlear) nerve & Geniculate ganglia of VII (Facial) by herpes zoster

39
Q

S&S of Herpes Zoster of Facial Nerve

A

Pain often preceeds vsicle eruption by 2-3 days

Severe ear pain, hearing loss, vertigo, paralysis of facial nerve, vesicles on pinna & ear canal

40
Q

Diagnosis of Herpes Zoster of Facial Nerve

A

Elevated Lymphocytes & protein in CSF

41
Q

Treatment of Herpes Zoster of Facial Nerve

A

Antivirals (Acyclovir)

Corticosteroids (Prednisone)

42
Q

Etiology of Hypertension Headache

A

Benign intracranial hypertension characterized by increased intracranial pressure without evidence of intracranial space occupying lesion.

43
Q

S&S of Hypertension Headache

A

HA of Varying severity and Papilledema

44
Q

Dx of Hypertension HA

A

CSF pressure is increased but fluid is normal

CT, MRI, EEG are all normal

45
Q

S&S of Intracranial Mass

A

HA, Personality Changes, Neuro Deficits, Vomiting Drowsiness, Lethargy

Changes in temp, BP, pulse are usually just before death

46
Q

S&S of Medication Reaction

A

Chronic use of OTC at recommended higher doese.

Can cause or maintain chronic daily HA

Use or overuse of Analgesics

47
Q

Which meningitis is most common in Children?

Adults?

Immunocompromised?

A

Children= Meningococcal Meningitis

Adults= Pneumococcal Meningitis, especially in alcoholics, chronic otitis, sinusitis, mastoiditis.

G- Meningitis due to e.coli in immunocompromised

48
Q

Signs/Symptoms of Acute Bacterial Meningitis

A

Respiratory ilness or sore throat preceded by fever, HA, Stiff Neck, Vomiting

Adults become ill within 24 hours, kids sooner.

49
Q

Dx of Acute Bacterial Meningits

A

+ve Brudinzinsky’s sign, Kernigs Sign

Unilateral or bilateral Babinsky

Culture CSF +ve for bacteria

Lumbar puncture after CT excludes mass lesion

50
Q

Tx for Acute Bacterial Meningitis?

A

Antibiotics

51
Q

Etiology of Trigger Point of Suboccipital mm

A

Repetitive traume (postural strains)

52
Q

S&S of Suboccipital Trigger Points?

A

Tenderness and hypertonicity of suboccipital mm

TrPs in Suboccipitals

53
Q

Etiology of Otitis Media

A

Bacterial or Viral infection of middle ear

Organisms migrate from nasopharynx to middle ear via Eustachian tube

E.coli & Staph Aureus

54
Q

S&S of Otitis Media

A

Persistent, Severe earache initially

Hearing loss

Fever, nausea, vomiting, diarrhea

Red, bulging tympanic membrane

Acute mastoiditis, periostitis, labyrnthitis, conductive & sensorineural hearing loss

55
Q

Tx of Otitis Media

A

Antibiotics: Penicillin or Amoxiciin

Refer to GP for Tx

56
Q

Etiology of Nerve Root Irritation

A

MC Herniated disc

Osteoarthritis

57
Q

S&S of Nerve Root Irritation

A

Segmental neurologic Deficits

Ventral= motor deficits & atrophy

Dorsal= Sensory Deficits in dermatomal distribution

Corresponding DTR diminished

Pain aggravated by moving spine, coughing, sneezing, or Valsalva

Relieved pain by raising arm behind head (Bakodys)

58
Q

Dx of Nerve Root Irritation

A

Radiographs should include obliques

CT/MRI

59
Q

Tx of Nerve Root Irritation

A

Muscle relaxants, analgesics

Surgical

Mobs, Traction`

60
Q

Etiology of Sinusitis

A

Inflammation of paranasal sinuses due to viral, bacterial, or fungal infections or allergic reactions

Acute Sinusitis= Strep Pneumonia, Haemophilius Influenza, or staph and is usually precipitated by acute Viral respiratory infection.

61
Q

S&S of Sinusitis

A

Red, Translucent nasal mucous membrane; yellow or green purulent rhinorrhea

Maxillary sinusitis= pain in maxillary area, toothache

Frontal Sinusitis= pain in frontal area and HA

Sphenoid sinusitis= less well localized

Ethmoid Sinusitis causes pain behind and between eyes and “splitting frontal HA”

62
Q

Tx for Sinusitis

A

Steam inhalation for drainage

Antibiotic Therapy

63
Q

Temporal Arteritis Etiology

A

Primarily in Elderly

Concomitant with Polymyalgia Rheumatica (PMR)

64
Q

S&S of Temporal Arteritis

A

Severe HA, especially temporal & occipital

Scalp tenderness, visual disturbances

Blindness caused by ischemic optic neuropathy

Systemic symptoms similar to PMR

PA may reveal swolen and tender nodules in Temporal Arteries

65
Q

Dx for Temporal Arteritis

A

Increased ESR in active phase

Normochromic-Normocytic Anemia

Increased s-ALP

Biopsy may be required for Dx

66
Q

Tx for Temporal Arteritis “GCA”

A

Prednisone

67
Q

Sx of Polymyalgia Rheumatica

A

Pain and stiffness in shoulder and hips in the morning.

Is associated with Temporal Arteritis “GCA”

68
Q

S&S of TMJ Dysfunction

A

Clicking, Popping sound with opening and closing of the jaw

Pain when chewing hard foods

Musculature may be sore and have TrPs

69
Q

Tx for TMJ Dysfunction

A

Mild analgesics

Reposition splint or mouth guard

STT

70
Q

S&S of Tension Headache

A

Bilateral

30 min to 7 days, no pulsating, mild to moderate severity

71
Q

Trigeminal Neuralgia Etiology

A

Arterial or venous loops compressing trigeminal nerve root.

Disorder of Trigeminal nerve

72
Q

S&S of Trigeminal Neuralgia

A

Adults, especially elderly

Pain is often triggered by touching a trigger point or by activity

Bouts of excruciating, lancinating pain, lasting seconds to 2 minutes.

73
Q

Tx for Trigeminal Neuralgia

A

Carbamazepine meds

Peripheral nerve blocks provide temporary relief.

CSA (3 decks)

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