Headaches Flashcards by Miyuki Numata

Cluster Demographic

Affect only 0.1 % of people

Men 5X more likely

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Cluster symptoms

Unilateral, intense pain
Intermittent pain (every few hours or intense pain several times in an hour)
Often nocturnal

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Cluster etiology

smoking is a risk factor

Association with abnormal hypothalamic function

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Tension symptoms

Bilateral, diffuse, band pain around head
Dull or vice like
Onset later in the day
last 30 min to weeks
Mm stiffness, hypertoned mm, nausea, vertigo and tinnitus

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Tension demographic

86% of women experience them 63% of men experience them
3 % of all people have them
These HA begin in adulthood

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Tension etiology

Stress, poor ergonomics or posture, family history, trigger points in neck or head, cold, hypoglycemia, fatigue

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Migraine symptoms

unilateral, starts as dull ache then becomes intense and pounding over a focal area
last 4-72 hours
may have aura

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Migraine Demographic

25% of women 8% of men

Family history 70%

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Migraine Etiology

Triggers: hunger, stress, allergies, meds, weather, visual/auditory olfactory stimuli, sleep, hormones

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Trauma Symptoms

pain in the head or neck from injury

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Demography of Trauma headache

As a result of trauma - anyone

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Etiology of headache

Trauma to the head, neck or spine, falls on tailbone may create headache due to dural tube and meninges tension

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Sinus sign and symptoms

Pain in forehead, maxilla, between eyes
Nasal drip or congestion
Facial tenderness

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Demographics of sinus headache

Rare, only in 2% of people that get headaches

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Etiology of Sinus headache

Viral, bacterial infections, allergies, history of facial trauma, abscesses in molars

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Sign and symptoms of Rebound headache

Begin in early a.m. when blood levels of drug are lower
Throbbing pain
Bilateral pain

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Demography of rebound headache

Anyone experiencing medication/drug withdrawal

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Etiology of Rebound headache

Removal of caffeine, drugs or medications

Headache may be due to

inflammation
Muscle spasm
Vasodilation/vasoconstriction of blood vessels
Ischemia
Trigger points
Soft tissue and or nerve injury
Trauma
Pain referred from elsewhere (organ, etc)
point involvement (OA, joint compression, cervical subluxation etc)
underlying pathology (tumor, aneurysm, venous swelling)
Chemicals (internal or external)
Others: food, noise, lack of sleep, sugar, hyper tension, dehydration

Primary headaches

Cluster, migraine, tension headaches is the condition itself

Headache is as known as

Cephalalgia

What do you do to test nerve root or facet joint irritation

Cervical compression/distraction
Seated, stand beside the patient
Carefully apply compression downward on the patient’s head

How do you know compression test is positive for nerve root or joint facet

Radiating pain or other neurological signs in affected arm indicates compression of a cervical nerve root

Pain in the neck/shoulder indicates cervical facet joint irritation

how to apply Distraction test

Position seated
Grasp the patient’s head at occiput and temporal (or frontal) area - not on mandible
Apply slow traction, superiorly, maintain traction for at least 30 seconds

How do you know your distraction test is positive

Reduction of pain/signs and symptoms reduce, because of opening of the foramina, reduced pressure on facet joints, relieving muscle spasm

tests for cervical nerve root or facet joint irritation. You can identify one side at a time

Spurling's /quadrant test

How to apply Spurling's test

Unaffected side first Seated, extend, side bend and rotate Carefully apply compression down ward

How do you know Spurling's /quadrant test is posive

Pain radiates down into the arm of that side

Tests for circulation deficiency of the vertebral artery at the trasverse foramen

Vertebral Artery Test (VAT)

How to apply Vertebral Artery Test (VAT)

Patient is spine, therapist seated by guest's head Patient has eyeglasses off (if applicable) asked to keep eyes open Passively fully extend the head and neck, side flexion, then fully rotate to the same side, hold for 30 seconds

How do you know Vertebral Artery test is positive

Vertigo, nausea, nystagmus (rapid involuntary movement of the eyes), Malaise, Nausea, vomiting, Dizziness/vertigo, Unsteadiness in walking, incoordination, visual disturbances, severe headache, weakness in extremities, sensory changes in face or body, dysarthria (speech), dysphagia (swallowing) disorientation, light headedness, hearing difficulties, facial paralysis

How do you find out if the person has meningitis

Kernig's Test/soto hall test

How to do Kernig's/Soto Hall Test

Patient is supine on the table ask the patient to place their hands behind their head and flex their chin to their chest If the patient experiences a sharp pain down the posterior neck and spine this may indicate meningities

The type of vasculitis may coexist with polymylagia rheumatica, which is characterized by sudden onset of pain and stiffness in muscles (pelvis, shoulder) of the body and seen in the elderly (Women 70 years).

Temporal arteritis, inflammatory disease of blood vessels. Can be with RA, SLE. Fever, headache, tenderness and sensitivity on the scalp, reduced visual acuity (blurred vision) acute visual loss. 76% canses invovling the eye. Medical emergency.

PHYSIOLOGICAL EFFECTS OF STRESS

Hypothalamus secretes a cortisol releasing factor, which stimulates pituitary gland to release adrenocorticotrophic hormone (ACTH) this hormone communicates to adrenal glands to release cortisol to adrenal glands to release cortisol and epinephrine.

What does Cortisol do

Glucose level, fat metabolism and influencing vascular flow and breathing

What does Epinephrine do

dilates blood vessels increases cellular metabolism and heart activity

How is reticular activating system activated?

through somatic, visual and auditory, cerebral cortex, hypothalamus and limbic system. Once activated, it activates Sympathetic nervous system. - Hypertonicity

What does diaphragmatic breathing promote

- relaxation by decreasing the effects of the nervous system - relaxation of muscle contractions upon exhalation - pain management - relaxation by stimulating PNS

Hydorotherapy for tention HA

Hot bath or heat application to Trigger point cool cloth to head during HA Foot baths during HA

Vascular headaches hydrotherapy

No local heat as increased blood flow to the head makes worse

Migraine hydrotherapy

Herbal bath on foot, cold towel on neck and forehead Icy foot bath to increase circulation of the foot (afterwards) cold water and hot water wrist baths (when HA is coming on) Hot full immersion baths if client feels cold before HA

Cluster headaches hydrotherapy

Alternating hot and cold showers to improve circulation once a day for 2-3 months. Cold compress relief by soaking a cloth with cold water for a few minutes, wringing it out and putting on the painful area