OAT Head Pain

Question 1

osteopathic considerations of head pain in the anteiror 2/3 of head would focus you to what nerve

Answer 1

trigeminal n

Question 2

osteopathic considerations of head pain in the posterior 2/3 of head would focus you to what nerve

Answer 2

lesser occipital C1-3, recurrent branche sof IX and X

Question 3

who is affected by tension HA

Answer 3

25-30yo onset
peak prevalence at 30-39
female 5: 4 male
30-78% mean lifetime prevalence

Question 4

risk factors for tension HA

Answer 4

stress, metnal tension, emotional disturbance
possible risk factors include poor self=rated helath
inability to relax after work
sleeping few hours per night

Question 5

associated conditions of tension HA

Answer 5

anxiety and depression

Question 6

omt causes of tension HA

Answer 6

active myofascial trigger poitns in the neck, head and shoulder might refer pain
episodic = peripheral pain
chronic = central pain mechanisms

Question 7

most common abnormal OMT finding of tension HA

Answer 7

pericranial muscle tenderness

tends to be mostly the scalp but absence fo tenderness does not r/o diagnosis

Question 8

risk factors for migraines

Answer 8

analgesic overdoes - daily or almost daily use of analgesics for over one month
MS
oral contraceptives?

Question 9

HA caused by a disorder of the cervical spine and its component bony, joint and or soft tissue elements

Answer 9

cervicogenic HA

Question 10

Cervical nerves C1-3 innervate which portino of the neck

Answer 10

posterior 1/3 of head

Question 11

cervical nerves C4-5 innervate what portino of the neck

Answer 11

behind the ears to the top of the shoulders

Question 12

involvement of the C2-3 facet is the most frequent source of what type of HA

Answer 12

cervicogenic HA

Question 13

Criterion for diagnosing a cervicogenic HA

Answer 13

two of the following

1. developed in temrporal relation to the onset of cervical disorder/lesion
2. significnatly improved or resolved with improvement in or resolution of the cercial disorder/lesion
3. cervical ROM is reduced and HA is made significantly worse by provacotive maneuvers
4. abolished following diagnostic blockade of a cervical structure or its nerve supply

Question 14

differential dx for cervicogenic ha .

Answer 14

migraine
tension
c2 neuralgia 
neck tongue syndrome 
occipital neuralgia

Question 15

paroxysmal sharp or shock-like pain centered in the occpital region, ipsilateral eye lacrimation and conjuctival injection are common

Answer 15

c2 neuralgia

Question 16

rapid head turning causes subluxation of the posterior AA joint and C2 spinal root compression
symptoms include neck pain and occipital pain, may be associated with ipsialteral tongue sensory symptoms
onset typically druing childhood or adolescence

Answer 16

neck-tongue syndrome

Question 17

respiratory/circulatory considerations for cervicogenic HA tx

Answer 17

addres lymphatics first to reduce irritants from inflammatory milieu

Question 18

biomechanical considerations for cervicogenic HA tx

Answer 18

address joint SD with MET, stills, FPR

HVLA may irritate facilitated segments

Question 19

neurologic considerations for cervicogenic HA tx

Answer 19

address CS points anteriorly and posteriorly in the cervicals and upper thoracics, upper ribs and upper extremities
use crnaial to address other conributing SD

Question 20

metabolic considerations for cervicogenic HA tx

Answer 20

improvement d/t other approaches

Question 21

behavioral considerations for cervicogenic HA tx

Answer 21

exercise Rx to support treatment of SDs contributing to symptoms