Head, Face and Neck including Regional Lymphatic System Flashcards
What are 2 questions to ask about someones headache?
- Unusually frequent or severe
- Onset: gradual or suddenly
When asking for location of headache, what can we determine from that? (which headaches occur where)
- Tension headaches: occipital or frontal, or bandlike tension
- Migraines: supraorbital, retro-orbital or frontotemporal
- Cluster Headaches: pain around eye, temple, forehead and cheek
When asking patient if pain is localized on one side or all over, what does this tell us?
Unilateral or bilateral pain is a clue to the type of headache (ex. cluster headaches, always all over pain)
What does it mean when we ask about character of headache?
Whether the pain is throbbing or aching
What is the difference between throbbing and aching headache, and what type of headache does it usually mean
Throbbing: Pounding and shooting, migraine/temporal arteritis
Aching: vicelike, constant pressure and dull, tension headache
What type of headaches would you experience ‘excruciating’ pain
Migraine and cluster headaches
How often on average do migraines occur and how long do they last
2 per month, lasting 1-3 days
How often on average do cluster headaches occur and how long do they last
1-2 headaches/day, lasting .5- 2 hours for 1-2 months, but then complete remission for months/years
What can bring on cluster headaches?
Alcohol ingestion and daytime napping
What can bring on migraines?
Alcohol, letdown after stress, menstruation and eating chocolate/cheese
What would be associated factors to headaches?
- Nausea or vomiting, stomach problems
- Vision changes, bright lights
- Neck pain or stiffness
- Fever, weakness, moodiness
What symptoms are associated with migraines?
Nausea, vomiting and visual disturbances
What symptoms are associated with cluster headaches?
Eye reddening, tearing, eyelid drooping, rhinorrhea and nasal congestion
What symptoms are associated with tension headaches?
Stress and anxiety
What symptoms are associated with meningitis or encephalitis?
Nuchal Rigidity (neck resistance to flexion) and fever
Why do we ask about other illnesses patient may have? Give examples
Other illnesses such as hypertension, fever, hypothyroidism and vasculitis can produce headaches
What type of medications can produce headaches?
Oral contraceptives, bronchodilators, alcohol, nitrates and carbon monoxide inhalation
Why do we ask if there is any family history of headaches?
Migraines are associated with family history of migraines
What do people do in effort to treat migraines? Cluster headaches?
Migraines: people lie down to feel better
Cluster Headaches: need to move, even just pacing
What could it mean if someone loses consciousness before they fall?
The head injury may not be caused by the fall, instead they could have a cardiovascular problem
When someone has a head injury, why do we ask if they have had a change in consciousness since the injury
Change in consciousness is important in evaluating for neurological deficit
What is our definition of dizziness?
Lightheaded, swimming sensation or falling feeling
What is vertigo
True spinning feeling caused by neurological disease
What in the brain causes vertigo?
Labyrinthine-vestibular apparatus and vestibular nuclei in brain stem
When vertigo is objective, the patients perception is _______, when it is objective the patients perceptive is _______
the room spins, he or she is spinning
When we ask patient about what caused the onset, what can neck stiffness, headache and fever be symptoms of?
Meningeal inflammation
What is the vicious circle of pain?
Tension increases pain and disability, which produces more tension
When asked if patient has lumps or swelling in neck, what are we looking for?
Tenderness: acute infection
Persistant lump: causes suspicion of malignancy (40+ suspect unless proven otherwise)
History of irradiation (enlargement?) of neck can increase risk of what?
Risk of salivary or thyroid tumours
Dysphagia is______
Difficulty swallowing
Smoking and large alcohol consumption increases____
risk of cancer
What are the 4 questions we ask about head/neck surgery
- Ever had surgery in head or neck
- For what condition
- When did the surgery occur
- How do you feel about the results
What are the two questions we make sure to ask older adults?
- Dizziness and how it affects daily activities
- Pain and how it affects ADL
