Term
| What are the key things to look for on physical examination of someone presenting w/headache? |
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Definition
| CN/neuro exam, mental status, vitals, OMM structural exam, muscle stiffness,e tc. |
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Term
| Focal neurologic symptoms other than typical visual or sensory aura should raise suspicion for what? |
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Definition
| mass lesion, arteriovenous malformation, or collagen vascular disease |
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Term
| When would imaging studies (CT or MRI) be appropriate for pts. presenting w/headache? |
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Definition
-Recent significant change in the pattern, frequency or severity of headaches
-Progressive worsening of headache despite appropriate therapy
-Focal neurologic signs or symptoms
-Onset of headache with exertion, cough, or sexual activity
-Orbital bruit
-Onset of headache after age 40 years |
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Term
| What are the 2 most common primary headaches? |
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Definition
| tension then migraine (cluster less common) |
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Term
| A bandlike headache is what? |
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Definition
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Term
| A unilateral or bilateral headache ass. w/photosensitivity or light sounds is what? |
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Definition
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Term
| A headache w/pain behind the eye and tearing/lacrimation is what? |
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Definition
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Term
| How can OMM help headaches? |
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Definition
| May reduce pain input into the trigeminal nucleus caudalis, favorably altering neuromuscularautonomic regulatory mechanisms to reduce pain |
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Term
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Definition
| pressure or tightness around head that waxes/wanes in intensity - head pain devoid of typical migrainous featuers |
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Term
| What structurs in the head and neck are pain sensitive and can contribute to headaches? |
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Definition
| meninges, blood vessels, etc. |
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Term
| Somatic dysfunction of what areas should be osteopathic considerations of headache? |
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Definition
| suboccipital muscles, OA, C2 and C3 are frequent sources of headache |
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Term
| What are some secondary causes of headache you must rule out for every headache prsentation? |
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Definition
| bleed, tumor, contusion w/edema, CSF bleed/increase in pressure, hypoglycemia |
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Term
| What are some "RED FLAGS" that a pt might present with that would warrant an immediate evaluation and/or treatment? |
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Definition
-New or sudden onset
-Change in pattern
-Effort-induced pain
-Positional pain
-Onset in middle age or later
-Recent head trauma
-Setting of chronic illness (ie cancer, AIDS)
-Fever
-Any neck stiffness
-Change in personality or behavior
-Neurologic findings on examination |
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Term
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Definition
usually the result of skull fractures
typical story is a head injury that causes a concussion w/loss of consciousness and a skull fracture. Return of consciousness is followed by sudden development of coma caused by an expanding hematoma |
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Term
| This vascular disorder presents w/chronic headaches, a change in personality, and weakness of the extremities. |
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Definition
subdural hematoma
**typically occur in elderly individuals after a fall or other head trauma |
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Term
| The work-up of pts w/a suspected subarachnoid hemorrhage beins w/what? |
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Definition
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Term
| The rapid onset of headache with strenuous exercise, especially when minor trauma has occurred, raises the possibility of what? |
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Definition
| carotid artery dissection or intracranial hemorrhage |
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Term
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Definition
head pain spreading into lower neck
neck stiffness
rash - palpable and non-blanching
Brudzinski/Kernig Signs |
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Term
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Definition
| closes jaw - elevates and retracts mandible |
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Term
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Definition
| closes jaw - elevates and protracts mandible |
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Term
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Definition
| closes jaw, elevates and protracts the mandible if contracted b/l, unilaterally it causes mandible to glide to the opposite side |
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Term
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Definition
| opens jaw, depresses and protracts the mandible if contracted b/l, unilaterally it causes mandible to glide to the opposite side |
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Term
| This is characterized by chronic or acute musculoskeletal pain with dysfunction of the masticatory system |
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Definition
| temporomandibular joint dysfunction syndrome (TMJ dysfunction syndrome) |
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Term
| How do you check for TMJ dysfunction? |
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Definition
| check for malocclusion, teeth grinding, muscular imbalance |
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Term
| The temporal bone will tend to be oriented in what direction in TMJ? |
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Definition
| externally rotated on side of jaw deviation |
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Term
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Definition
| chronic nasal stuffiness or chronic respiratory infection |
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Term
| sympathetic innervation of sinuses |
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Definition
| T1-T4 and pass through cervical ganglia |
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Term
| parasympathetic innervation sinuses |
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Definition
| arise from sphenopalatine ganglion |
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Term
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Definition
check for tenderness under points to see if pt has sinusitis
-On the superior edge of the 2nd rib 3.5” from the sternum
-Midway between the spinous process and the transverse process C2 |
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Term
| Conclusion of study of antibiotics and topical nasal steroids for Tx of sinusitis |
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Definition
Neither an antibiotic nor a topical steroid alone or in combination was effective as a treatment for acute sinusitis in the primary care setting
**OMT will make it feel a little worse at first, but will help resolve actual problem |
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Term
| Why are ear infections more common in children? |
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Definition
| shorter eustacian tube that's more horizontal |
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Term
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Definition
Assists in the opening of the Eustachian tube to allow for
improved lymphatic drainage
**lift anterior and inferior a bit to try and open area |
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Term
| Otitis Media Chapman points (2 each side) |
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Definition
1. superior edge of clavicle where crosses 1st rib
2. superior edge of posterior aspect of C1 transverse process |
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