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os Fall Midterm II > OS approach to Cervicogenic Headache > Flashcards

OS approach to Cervicogenic Headache Flashcards

1
Q

What is Cervicogenic Cephalgia (CHA)?

A

Pain from Cervical SD referred to head

Unilateral!

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2
Q

CHA can be associated with? (3)

A

Tendonitic of Cerv-M.

Tender points

Cervical joint inflammation

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3
Q

Females or males more?

A

Females

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4
Q

This is common after?

A

Whiplash/neck trauma

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5
Q

Is there a pattern?

A

No, but is episodic/recurrent

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6
Q

Suboccipital Triangle Muscles (3) and action

A
  1. Obliquus Capitis Superior (SB same side)
  2. Obliquus Capitis Inferior (Rt same side)
  3. Rectus Capitis Posterior Major
  • B/L contraction => extension
  • U/L contraction => SB/Rt same side
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7
Q

What is the Myodural Bridge?

A
  1. Direct anatomic link btw msk and dura mater
  2. Form posterior OA membrane and directly fuse w/spinal dura btw C1-2 and C2-3 (could elicit pain in occipital region
  3. Fascia and tendon of rectus capitis post minor
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8
Q

SCM contraction

A

U/L = SB towards and rotate away

B/L = Flexion of H and N

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9
Q

Trap

A

Primary elevator of adductor of UE

Connects shoulder, thoracic spine and H and N

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10
Q

Semispinalis

Splenius Capitic

longissimus capitis

A
  1. Connect T-spine to H and N
  2. B/L contraction = extension
  3. Splen and long U/l = SB/Rt same side
  4. Sem U/L = R away
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11
Q

Rotatores and Multifidi

A

Multifidi (1-3 spinal levels)

Rotatores: connect successive vertebra

U/L = Rt away

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12
Q

Intertransversarii

A

Connect V. TP to TP

B/L = Extension

U/L = SB same

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13
Q

Tectospinal tract coordinates eye and ___ movements?

A

Neck

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14
Q

Vestibular function is linked to?

A

Neck motion

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15
Q

Neck motion is linked to ___ and ____ motion

A

Shoulder and upper back

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16
Q

Trigeminal Nerve descending into the upper cervical spine =?

A

Trigeminal nucleus caudalins (TNC)

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17
Q

How far down does TNC go?

A

To C4

18
Q

What N. innervates SCM and Trap?

A

XI

19
Q

C1-3 converge with what?

A

TNC

20
Q

Do sensory N. Converge with TNC?

A

Yes (V1, V2 and V3)

21
Q

Sympathetics are related to Superior cervical ganglia. What level is it located at?

A

Anterior to C2

22
Q

Where are sympathetic Pre-gang fibers?

A

T1-4

23
Q

Activating sympathetics causes?

A

Pupil dilation and decreased glandular secretions

24
Q

Greater and lesser occipital nerves from what levels?

A

C1-3

Innervate post. Scalp

25
Q

What can cause occipital neuralgia?

A
  1. Trauma

2. Entrapment of occipital nerves, upper cervical zygapophyseal joints and C2

26
Q

C2 neuralgia. Where is pain? anything else?

A
  1. Deep/dull from occiput to rest of head
  2. Paroxysmal sharp pain on top of dull pain
  3. Ipsilateral eye lacrimation and conjunctival injection are common
27
Q

C3 neuralgia is associated with?

A

Whiplash

28
Q

C3 neuralgia, where is the pain?

A

Frontotemporal and periorbital regions

29
Q

What causes CHA?

A

Cervica SD (OA and AA = MC)

-Whiplash pts (C2-3 joint pain)

30
Q

Can V and XI be involved in Cervical SD?

A

Yes via TNC

31
Q

How do upper cervical/suboccipital spasms transmit and cause head pain?

A

Via Myodural bridge

32
Q

C1 and 2 facets produce pain where and via what nerve?

A

Post auricular region

Via greater occipital N.

33
Q

What can treat cervicogenic pain?

A

Trigger point resolution

Bo-tox injections

34
Q

Are cytokines and NO higher in CHA or migraines?

A

CHA

= more pain

35
Q

Is trigeminovascular system activated in CHA?

A

No. No calcitonin seen

36
Q

CC of CHA?

A

Mod-severe deep, non-throbbing/lancinating pain

37
Q

What causes CHA?

A
  1. Neck movement
  2. Sustained head position
  3. Whiplash
38
Q

Location of pain

A

Anywhere but U/L

39
Q

Where does pain radiate?

A
  1. Ipsilateral H and N and shoulder/arm
40
Q

TART changes in CHA?

A

T: tissue tecture OA/AA C2-4

A: H and N position

R: rotation (AA and C1-2)

T: Pain induced by motion/palpation

41
Q

Evidence for OMM?

A

Manipulation/PT relieve pain

42
Q

Are there any complications?

A

None reported

os Fall Midterm II (6 decks)

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