HA Flashcards
Where can HA originate
Extracranially - Skin - Muscle - Blood vessels - Periosteum Intracranially - Venous sinuses/arteries - Dura - Falx cerebri
Migraine types
Common migraine classic migraine with aura - visual - sensory - motor
Migraine clin
SS: W>M lasts 4-72 hrs unilateral pulsating intensity moderate to severe aggravated by physical activity N/V photophobia phonophobia
Eval:
Have to have 5 attacks before dx
debilitating
Txt:
- pharm
Migraine prophylaxis
BB CCB SSRI TCA anti-seizure meds
Migraine abortive txt
OTC analgesics vasoconstrictors/ergots anti-emetics serotonin agonists IV/IM NSAID's Narcotics Steroids
Cluster HA gen char
Def: a series of HA over a period of 2-3 maths
- occur every 1-2 yrs
M>W
Cause:
dilation of retro-orbital blood vessels and inflammation of trigeminal nerve branches
Cluster HA clin
SS: unilateral excrutiating penetrating pain trigeminal nerve distribution lacrimation conjunctival injection nasal congestion/rhinorrhea ptosis miosis
Txt:
Oxygen
similar to migraine but no BB
Tension HA gen char
Def: MC HA
30 min - 7 days
Cause:
Tension HA clin
SS: pressing/tightness/band-like mild-moderate intensity unaffected by physical activity possible photo/phonophobia
Txt:
Mild analgesics
stress reduction
relaxation techniques
Sinusitis summary
Def: acute or chronic infection of sinus cavities SS: stabbing or aching - worse bending forward and coughing Eval: percuss over sinus area
Acute glaucoma summary
Def: orbital pain
SS: N/V cornea edematous conjunctiva injected decreased vision
Eval:
tonometry device to get intra-ocular pressure
Temporal arteritis summary
Def: vasculitis involving branches of external carotid artery (temporal artery)
SS: >50 yrs W>M jabbing, excruciating pains over temple unilateral but can be bi visual loss systemic sx (fever, malaise) temporal artery tender to palpation
Eval:
ESR elevated
biopsy
Txt:
Steroids
TMJ summary
Def: spasms of muscles around TMJ
Cause:
overbite
dental work
grinding teeth
SS:
unilateral or bilateral pain
tender palpation
clicking in joint
Txt:
NSAIDs and dental referral
Trigeminal neuralgia summary
Def: brief, severe attacks in distribution of branch or branches of trigeminal nerve
Cause:
demyelinization of trigeminal nerve (compression)
triggered by eating, talking, washing face
SS: pain lancinating (electric shock)
Txt:
analgesics
anti-seizure
surgery
