Dizziness/Headaches Flashcards
1
Q
HA Subjective Info
A
- duration of episode
- mechanism of injury
- symptom description
- nature of symptoms
- latency of symptoms
- provoking/relieving factors
- previous episodes and/or treatment
- red flags
- PMH
2
Q
HA Red Flags
A
- facial symptoms
- HA
- UE/LE symptoms
- Lateropulsion
- Ataxia
- dysarthria
- dysphagia
- visual symptoms
- loss of consciousness
- drop attacks
3
Q
HA Objective Exam
A
- Sensation
- Posture
- Strength
- Balance
- Ambulation
- Cervical screen
- Oculomotor Exam
- Positional tests
- Special tests
4
Q
Conditions that Mimic Vestibular Conditions
A
- VBI
- CV Ligament disruption
- Orthostatic hypotension
- Cervicogenic dizziness
- Whiplash associated disorders
5
Q
Vertebrobasilar Insufficiency (VBI)
A
- stressed with rotation (tethered at C1 foramen transversaria & atlantoaxial membrane)
- Negative tests do NOT rule out
- end-range extension & rotation
- Hautant’s Test
6
Q
Symptoms of VBI
A
- HA (thunderclap)
- facial sensation changes
- blurred vision
- nystagmus
- nausea
- unsteady gait
- 5 D’s
7
Q
Hautant’s Test
A
- patient sits with shoulders flexed to shoulder height
- patient moves into extension quadrant
- could be VBI involvement if arm position changes
8
Q
CV Ligament Compromise
A
- RA
- prolonged corticosteroid use
- Down’s Syndrome
- trauma
- recent upper respiratory infection
9
Q
Symptoms of CV Ligament Compromise
A
- feeling of instability/heaviness
- sensation changes to lips/tongue
- ataxia
- severe HA
- cervical muscle guarding
- non-myotomal/bilateral weakness
- provocation with c-spine flexion
- unwilling to move
- Babinski/Clonus
10
Q
Cervicogenic Dizziness
A
- vertigo, disequilibrium, & lightheadedness caused by c-spine
11
Q
Causes of Cervicogenic Dizziness
A
- irritation of sympathetic vertebral plexus causing decreased blood flow to labyrinth
- sensitized receptors in joint capsules or upper cervical muscles causing msimatch of vestibular & proprioceptive inputs
- altered proprioceptive signals from c-spine
- inflammation of nerve roots or facet joints
- *sensory mismatch between input from c-spine, visual system, & vestibular system
12
Q
Description of Cervicogenic Dizziness
A
- off balance
- unsteady
- off
- swimmy
- movement within my head
13
Q
MS & Sensory Changes in Whiplash
A
- ROM
- Movement patterns
- Sensorimotor function (proprioception)
- pain threshold change
- Sympathetic nervous system (hyperexcitability)
- detection levels change
14
Q
Predictors of Poor Recovery from WAD
A
- NDI > 30
- Older age
- Female
- Decreased c-spine ROM
- Cold hyperalgesia
- Altered SNS function (pain, temp, pressure)
- Post-traumatic stress reaction
15
Q
WAD Objective Findings
A
- affected smooth pursuit with head rotated 45 degrees
- nystagmus with cervical (but not vestibular) movement
- inaccurate head repositioning (laser)
