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CABS - Neuro > Headaches > Flashcards

Headaches Flashcards

1
Q

what is included within the limbic system

A

hypothalamus
mammillary bodies
hippocampus
amygdala
arcuate nucleus

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2
Q

what does the limbic system do

A

help with regulation of emotions, hunger clues, learning/memory
tracts help with memory pathways

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3
Q

what is the function of the thalamus

A

memory, emotion, behavior

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4
Q

what is the function of the mamillary bodies

A

part of the hypothalamus
memory consolidation
olfactory reflexes including smell memory

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5
Q

what is the function of the hippocampus

A

memory processing

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6
Q

what is the function of the amygdala

A

fear, agression, emotions and olfaction

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7
Q

what is the function of arcuate nucleus

A

receives signals, helps with feeding ques

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8
Q

what is CN1 for

A

olfactory - smell

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9
Q

what is CN2

A

optic - vision

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10
Q

what is CN3 for

A

oculomotor
eye motion and eye lid movement

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11
Q

what is CN4

A

Trochlear
superior oblique extra-ocular movement - down and out

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12
Q

what is CN5

A

Trigeminal
from pons to the face and cranial dura
sensory - helps with 3 regions of sensation
Motor - helps with moving mouth, chewing.

cause for migraines

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13
Q

What is CN6

A

Abducens
lateral rectus muscle and sensory for proprioception - helps with lateral muscle

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14
Q

what is CN7

A

facial
Motor: expressions, lacrimal and salivary glands
Sensory: taste buds, anterior tongue

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15
Q

what is CN8

A

vestibulocochlear
balance and hearing

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16
Q

what is CN9

A

glossopharyngeal
motor: salivary glands, pharynx and tongue - helps with speech and cough
sensory: to pharynx, posterior tongue and carotid bulb receptor

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17
Q

what is CN10

A

Vagus
sensory to pharynx
primary efferent parasympathetic nerve that acts on viscer - parasympathetic response

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18
Q

vasovagal syncope

A

may be triggered by high emotions (such as fear or anxiety, pain

trigger occurs causing the afferent limb of the ANS to be engaged

afferent limb will react - parasympathetic response firing causing decrease HR and BP

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19
Q

what is CN11

A

accessory nerve
sensation and motor to sternocleidomastoid
muscle of pharynx and larynx

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20
Q

what is CN12

A

Hypoglossal
motor to tongue and sensory to brain

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21
Q

what are the different types of pain

A

somatic/cutaneous pain
deep somatic pain
visceral pain
psychogenic pain

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22
Q

what is somatic or cutaneous pain

A

arises from nociceptive receptors in the skin and mucous membranes
superficial pain
feels like sharp, burning, pricking and is constant
fast or slow onset

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23
Q

what is deep somatic pain

A

stems from tendons, muscles, joints, periosteum and blood vessels

24
Q

what is visceral pain

A

originates from internal organs: pelvis, abdomen, chest and intestines
activates nociceptor of the viscera
poorly localized and is an achy and dull sensation
visceral structures are highly sensitive to stretching, ischemia and inflammation but insensitive to other stimuli that normally provoke pain

25
Q

what is psychogenic pain

A

individuals “feel” pain but cause is emotional rather than physical

26
Q

what is pain associated within the head

A

traction
inflammation
pressure/displacement of arteries
meningeal irritation
sinus pain
muscle spasms

27
Q

what is nucal regidity

A

neck stiffness - meningitis

bend their head down and is causes visceral response

28
Q

why do headaches occur

A

due to nociceptive neurons within the trigeminal, vagus or glossopharyngeal cranial nerves within the upper cervical roots becoming depolarized

29
Q

what are cluster headaches characterized by

A

deep pain that is burning, stabbing or lancinating pain
pain can be excruciating: patients may even consider suicide

30
Q

what is the common patient population for cluster headaches

A

Males > females
autosomal dominant inheritance pattern
1st degree relative cluster headache increases risk by 5-18x

31
Q

what are risk factors of cluster headaches

A

tobacco use, family history of headache, head injury, shift work

32
Q

what are triggers for cluster headaches

A

sleep apnea, food containing nitrates, nail varnish, petroleum, vasodilators (nitroglycerin, alcohol, histamine)

33
Q

what is the pathophysiology of cluster headaches

A

not completely understood but leads to trigeminal activation

functional MRI suggests that hypothalamus involved - opioid system involved and parasympathetic involvement

34
Q

what are the typical signs of clusterheadaches

A

lacrimation, ipsilateral forehead or facial flushing or sweating, ipsilateral nasal discharge, affected eye red with dilated conjunctival injection; restlessness and or packing/rocking head in hands

35
Q

Migraines

A

lasts 4-72 hours
may or may not have aura
vascular edema

36
Q

what is scotomata

A

visual scintillations - transient, fully reversible, colorful flashing lights or dark spots

37
Q

what is the location of a migrane

A

unilateral 50% of the time, but can be frontal

38
Q

what are the characteristics of migraines

A

pulsating, throbbing headache or dull, ache-type headache

39
Q

what are provaocative meausures for migraines

A

physical activity - walking/climbing stairs

40
Q

what are the positive effects of caffeine

A

increase attention and alterness, decreased fatigue
lower risk of cardiovascular disease
lower risk of diabetes
increased metabolic rate

41
Q

what are the negative effects of caffeine

A

anxiety
increased vasoconstriction and blood pressure
reduced control of fine motor movements
stimulation of urination

42
Q

what is a tension headache

A

Aka TTH (tension-type headache)
band headache often associated with neck pain
often associated with muscle spasms

43
Q

what is a sinus headache

A

mucosal inflammation of paranasal sinuses and nasal mucosa - typically co-inflamed
sinus ostia irritation and edema

44
Q

how is the maxillary sinus connected

A

via hiatus semilunaris at the roof of the sinus

45
Q

what is sinusitis pathophysiology

A

most commonly associated with viral URI
edema/inflammation
mucus production
obstruction of sinus outflow tract
stagnant fluid and overgrowth of bacteria

46
Q

what are the symptoms of sinus headaches

A

sinus “aching” pain or pressure, increases wtih bending forward, mastication and with bending forwards; purulent discharge or green nasal discharge

47
Q

what is the most common cause of sinus headache

A

viral infection - rhinovirus is the msto common

rarely bacterial - 2 weeks of symptoms

48
Q

what is an exertional headache

A

brought on by exercise - need to ensure no other underlying pathology
i.e. TBI, CAH, mass, Chiari malformation, pheochromocytoma

49
Q

what is chiari malformation

A

congenital deformation condition in which brain tissue extends into the spinal canal. It occurs when part of the skull is misshapen or smaller than is typical, pressing on the brain and forcing it downward

50
Q

what is a phenochyromocytoma

A

adrenal tumor - elevates BP due to hormonal changes

51
Q

what is the pathophysiology of exertional headache

A

not completely known
1. release of neuroinflammatory chemicals
2. dysregulation of vasoactive neurotransmitters that control pain pathways

52
Q

what is the presentation of exertional headache

A

usually unilateral with moderate-to-severe pain that is pulsating in nature - patient may also have N/C=V, scotomas, and photophobia

53
Q

what is a menstraul headache

A

estrogen withdrawal and/or prostaglandin release
change in levels - change in neuronal networks associated with pain
trigeminal vascular system activated - proinflammatory changes

54
Q

what are the symptoms of menstrual headaches

A

onset 2 days prior to menses and will last until final days of menses
may be acoompanied with fatigue, acne, joint pain, decreased urination, constipation and or lack of coordination

55
Q

what is an overuse headache

A

a vicious circle of medication over use - more medications -> more headaches -> more medications -> more headaches

associated with overuse of HA medication - 15+ days per month

56
Q

what is the pathophysiology of overuse headaches

A

genetic predisposition
develop central sensitization
with chronic use of medications, there is bigger change in neurotransmitter receptors (decreased inhibitory pathways and increase perceived discomfort)

CABS - Neuro (15 decks)

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