Test 1-Head/neck

Question 1

Primary headaches

Answer 1

●No identifiable underlying cause
●Bilateral
●Steady, pressing or tightening, nonthrobbing, mild to moderate

Question 2

Secondary headaches

Answer 2

Arises from other conditions
Rule out other conditions first
Look for “red flags”

Question 3

Headache red flags

Answer 3

●Recent onset
●Acute onset like “thunderclap”
●Markedly elevated blood pressure
●Presence of rash or signs of infection
●Presence of cancer, HIV, or pregnancy
●Vomiting (projectile)
●Recent head trauma

Question 4

Tension headaches

Answer 4

oEpisodic
oTend to peak after several hours
oOften arise in temporal area
oConsider medication overuse

Question 5

Migraine

Answer 5

oEpisodic
oTend to peak over several hours
oUnilateral
oProdromal onset and/or aura
oNausea and vomiting
oPositive family history

Question 6

OLD CART

Answer 6

Onset- When did you notice the headache?

Location- Where do you feel the headache? Can you point to the area(s)?

Duration- How long has this been going on? Begin suddenly or gradually? Temporary or constant? How long does it last?

Characteristic symptoms-What does it feel like? Describe the pain using scale of 1 to 10

Associated manifestation- Do you notice any other symptoms? What happened just before the headache? Any history of overuse of analgesics, ergotamine or triptans?

Relieving factor-What have you tried to make the headache go away? What has worked the best?

Treatment- Has anyone treated you for headaches over the past year? What type of headache was diagnosed? Have you used any medication?

Question 7

Lymph node order

Answer 7

1-preauricular
2-Posterior auricular
3-occipital
4-tonsillar
5-submandibular
6-submental
7-superficial cervical
8-posterior cervical
9-deep cervical
10-supraclavicular