Patho Exam 1: head and neck disorders

Headaches

- most commonly treated disorder

- interferes with daily living

-can be benign or a warning sign for a serious condition

What are the type of headaches?

cluster, tension, migraine

What are some assessment of headaches?

• Medical and social history

• Neurological exam

• Headache Impact Test (HIT-6)- assess severity on life

• Headache diary- helps identify pattern and triggers

• CT scan- rules out stroke or hemorrhage

• MRI- evaluates chronic stuff

• EEG- helps identify if cause by brain abnormalities or seizures.

tension headache

• Occurring episodically because of stress

• The pain is dull, aching with gradual in onset and presents as a pressure or "bandlike" sensation in the head.

• Pain is often bifrontal or occipitofrontal.

• Often associated with muscular tightness in the neck, shoulders, and occipital area

• Vital signs and neurological examination are normal.

• Nonopioid medications provide relief

Cluster headaches

• A neurovascular disorder characterized by severe, unilateral, periorbital pain.

• Involves the activation of the hypothalamus and the trigeminal nerve

• Commonly occurs in early morning hours or during sleep.

• Pain is described as sharp, stabbing, and unilateral with radiation to the cheek, jaw, occipital region, or neck.

• The hallmark signs include: tearing of the eyes, conjunctival injection, rhinorrhea, eyelid edema, ptosis

• Triggers: Alcohol, tobacco, stress, allergy, and weather changes

• Vital signs and neurological examination are normal.• Nonopioid medications provide relief

FOLLOWS A PATTERN

migraine

• Etiology: genetic, environmental and neurological factors

• 75% of the sufferers being women

• Neurogenic process with secondary changes in cerebral perfusion, causing recurrent headaches

• Low serotonin levels lead to constriction/dilation of blood vessels (WHAT CAUSES THE PAIN)

• Without treatment, a migraine headache can last 4 to 72 hours.

• Unilateral, vascular, throbbing headache

• Associated symptoms of nausea, vomiting, and sensitivity to light and sound.

• Often preceded by an aura, a visual or sensory experience that occurs before the headache.

• Commonly precipitated by stress, hormones, smoking, weather changes, food additives, caffeine, alcohol, or excessive fatigue.

• Treatment of migraine is focused on alleviating pain: Acute headache, Preventative treatment

Traumatic Brain Injury (TBI)

Injury to the brain that causes temporary, short-term or long-term problems with brain function

• Extent and location of injury determine level of disability

why does a TBI happen?

• Accidents involving automobiles, motorcycles, bicycles

• Falling

• Excessive alcohol ingestion

• Abuse of infants and elderly being cared for by caregivers

what are the symptoms of TBI?

• Headache and fatigue

• Blurred vision

• Vomiting

• Confusion

• Memory problems

• Loss of consciousness

• Seizures

• Changes in speech

What blood vessels supply blood to the brain from the heart?

carotid artery and jugular vein

Lymph nodes

serve as centers for proliferation and response of immune cells

• 100's of them throughout the body (neck, groin,chest, axilla)

• Examples: tonsils, adenoids, spleen and thymus

• filter the debris that has been collected through the use of macrophages.

Lymphadenopathy

when lymph nodes become enlarged due to pathogen invading the body

common sin that the body is fighting an infection

multiple myeloma

• Cancer of the lymphatic system

• Arises from B-lymphocytes that are neoplastic and invade bone marrow

• Incurable

• More common in men; African-Americans

• Risk factors: exposure to chemicals, Agent Orange,radiation, genetic factors

What causes multiple myeloma?

-proliferation of malignant plasma cells in bone marrow and osteolytic bone lesions throughout the skeletal system

- lead to Overproduction of monoclonal antibody

• Disrupts normal antibody production

• Weakens immune system

How does multiple myeloma manifest?

• Severe bone pain

• Pathologic fractures

• Hypercalcemia (high bloodcalcium levels)

• Anemia

• Recurrent infection

• Weight loss

• Fatigue

• Renal insufficiency

How to diagnose myeloma?

- bone marrow biopsy

- x rays

-CBC (decreased RBC, WBC, and platelets

-urine- bence jones proteins

How to treat myeloma?

steroids

chemotherapy

stem cell transplant

What are some complications of myeloma?

fractures

leads to bone destruction, bone marrow failure, renal failure, and neurological complications

What is the function of the thyroid?

metabolisms, growth and repairmen of the human body and cells, affects temperature, and affects HR

What two hormones as secreted by the thyroid?

trioodothronine (T3) and thyroxine (T4)

Hyperthyroidism

excessive activity of the thyroid gland

Hypothyroidism

underactivity of the thyroid gland

How do you assess and diagnose thyroid disorders?

palpate thyroid gland

check T3/T4/TSH levels

what are some symptoms of hyperthyroidism?

• Sudden weight loss, without changes in appetite

• Tachycardia, irregular heartbeat or palpitations

• Nervousness, anxiety, and irritability

• Tremor in the hands and fingers

• Sweating

• Changes in bowel patterns, more frequent bowel movements

• Fatigue, insomnia, muscle weakness

what are some symptoms of hypothyroidism?

• Increased sensitivity to cold

• Unintentional weight gain

• Pale, dry skin

• Thin, brittle hair or nails

• Constipation

• Depression

• Fatigue

• Weakness