Headache and Stiff Neck Symptoms Quiz

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Questions and Answers

What are some common associated symptoms of headaches?

Photophobia (correct)

Joint pain

Increased appetite

Skin rash

Which factor is noted to potentially exacerbate headaches?

Adequate hydration

Regular sleep schedule

Physical exercise

Prolonged fasting (correct)

In which areas might pain from a stiff neck be radiated?

Knees and ankles

Forehead and temples

Hands, shoulders, and down the back (correct)

Ears and jaw

Which treatment option is suggested for stiff necks?

Heat therapy Signup and view all the answers

What characterizes the pain associated with headaches?

Throbbing, pounding, or constant pressure Signup and view all the answers

What could be a physical sign of thyroid dysfunction?

Swelling in the neck Signup and view all the answers

Which emotional changes may indicate a thyroid issue?

Increased lethargy and disinterest Signup and view all the answers

What symptom might suggest hyperthyroidism regarding eye appearance?

Puffiness in periorbital area Signup and view all the answers

Which medical history detail could be relevant for thyroid issues?

Surgery for tumor in neck region Signup and view all the answers

What change in menstrual flow may reflect thyroid dysfunction?

Very heavy or irregular periods Signup and view all the answers

Which examination step is essential when assessing the head?

Inspecting the head position and facial features Signup and view all the answers

How should the skull be palpated during a physical examination?

In a gentle rotary movement Signup and view all the answers

What might be a potential environmental risk according to personal and social history?

Exposure to toxins or chemicals Signup and view all the answers

What characteristics should the hair exhibit upon palpation?

It should be smooth and symmetrically distributed. Signup and view all the answers

During the neck examination, which muscle symmetry should be evaluated?

Sternocleidomastoid and trapezius. Signup and view all the answers

What should you check for upon palpating the lymph nodes in the neck?

Nodules, tenderness, or enlargement. Signup and view all the answers

When should percussion be performed during the examination?

Only if sinusitis is suspected. Signup and view all the answers

What should be observed when inspecting the neck?

Unusual shortness, webbing, or masses. Signup and view all the answers

What should be checked when palpating the thyroid gland?

For symmetry and presence of nodules. Signup and view all the answers

Which technique is used to assess the trachea during palpation?

Evaluating its midline position. Signup and view all the answers

What aspect of the temporal arteries should be noted during palpation?

Their course and condition. Signup and view all the answers

Which cranial nerve is primarily responsible for facial sensation and motor control of the muscles of mastication?

Cranial Nerve V Signup and view all the answers

What is the anatomical location of the parotid salivary gland?

Anterior to ear, above mandible Signup and view all the answers

Which structure is NOT part of the facial skull's bony structure?

Occipital bone Signup and view all the answers

Which area is defined as the anterior triangle of the neck?

Medial border of the sternocleidomastoid muscles, the mandible, and the midline Signup and view all the answers

Which symptom is commonly associated with head injury as part of the initial assessment?

Altered level of consciousness Signup and view all the answers

In the context of headaches, which factor is important for assessing the pattern of symptoms?

Duration and character of the headache Signup and view all the answers

The common carotid artery is primarily located in which region of the neck?

Anterior triangle Signup and view all the answers

Which component is included in the history of present illness for head injuries?

Predisposing factors Signup and view all the answers

Study Notes

Physical Examination of Head and Neck

Objectives:
- Review anatomy and physiology of the head and neck
- Review patient history (present, past, family, and social)
- Outline examination techniques (inspection, auscultation, palpation, percussion)

Anatomy & Physiology

Skull: Composed of 7 bones (2 frontal, 2 parietal, 2 temporal, 1 occipital)
Facial Skull Cavities: Eyes, nose, mouth
Facial Bones: Frontal, nasal, zygomatic, ethmoid, lacrimal, sphenoid, maxillary bones, mandible
Cranial Nerves: V and VII
Major Artery: Temporal artery
Salivary Glands: Parotid (anterior to ear, above mandible), submandibular (medial to mandible), sublingual (anterior, floor of mouth)

Neck

Structure: Cervical vertebrae, ligaments, sternocleidomastoid and trapezius muscles
Posterior Triangle: Formed by trapezius, sternocleidomastoid muscle, clavicle, and posterior cervical lymph nodes
Anterior Triangle: Formed by medial border of sternocleidomastoid muscles, mandible, and midline
Additional Structures: Hyoid bone, cricoid cartilage, trachea, thyroid, anterior cervical lymph nodes, common carotid artery, internal jugular vein

Neck - Anatomical Review

Includes various muscles and nerves (images included)

Neck - Lymphatic Glands

(Diagram included showing location and types of lymphatic glands)

History of Present Illness

Head Injury: Independent observer's account of the event, state of consciousness immediately and 5 minutes after, duration of unconsciousness(combative, confused, alert, or dazed), underlying predisposing factors (seizure disorder, hypoglycemia, poor vision, lightheadedness)
Associated Symptoms: Head or neck pain, laceration, altered LOC, changed breathing pattern, blurred or double vision, discharge from ear/nose, nausea/vomiting (N/V), ability to move extremities
Medications: Prescriptions, over-the-counter

Headache

Onset: Early morning, daytime, nighttime; gradual or abrupt
Duration: Minutes, hours, days, weeks, relieved by medication or sleep, spontaneous resolution
Location: Entire head, unilateral, specific site (neck, sinus, behind eyes)
Character: Throbbing, pounding, boring, dull, constant pressure
Severity: Graded 1-10, same or different with each event
Visual Prodrome: Scotoma, hemianopia, distortion of size, shape, or location
Other Features: Pattern - worse morning/evening, gradual or abrupt, episodes closer together or worsening, lasting longer, change in level of consciousness as pain increases associated symptoms, nausea, vomiting, diarrhea, photophobia, increase lacrimation, precipitating factors (fever, fatigue, stress, food additives, prolonged fasting), efforts to treat (sleep, pain meds, anticonvulsants, beta-blockers, anti-depressants)

Stiff Neck

Causes: Neck injury/strain, head injury, swelling of neck, fever, bacterial/viral infection.
Symptoms: Movement limitation, pain in movement, continuous/cramping pain, radiation pattern (arms, shoulders, hands, down the back).
Predisposing Factors: Unilateral vision/hearing loss
Treatment: Heat, pain medication, physical therapy, prescription/nonprescription/alternative or complementary medicine

Thyroid Problem

Symptoms: Change in temperature preference (clothing relative to family), swelling in neck (interference with swallowing), redness/pain with touch, swallowing or hyperextension of the neck, difficulty buttoning shirts, change in texture of hair, skin, or nails, increased pigmentation of skin at pressure points.
Other Symptoms: Change in emotional stability (increased energy/irritability, nervousness or increased lethargy/disinterest), increase prominence/puffiness in periorbital area, blurred or double vision, tachycardia/palpitations, change in menstrual flow.
Treatment: Medications: thyroid preparations, prescriptions, non-prescriptions, alternative or complementary

Past Medical History

Conditions: Head trauma, subdural hematoma, recent lumbar puncture, therapy around the head/neck, headaches (migraine, vascular), surgery, thyroid dysfunction, thyroid surgery.

Family History

Conditions: Headaches (types, character, similarity to patient's), thyroid dysfunction

Employment: Risk of heat injury, use of helmets, exposure to toxins/chemicals
Stress: Tension, demands at homework or school
Potential Injury Risk: Participation in sports, handrails available, unsafe environment
Nutrition: Recent weight gain/loss, food intolerances, eating habits.
Substance Use: Alcohol, street drugs

Examination of the Head - Inspection

Posture/Facial Features: Upright posture and still position, should be inspected for shape and symmetry with rest, movement, expression. Note asymmetry if present (affect entire face or just a portion); any change in shape, edema, or puffiness; check head size, shape, and symmetry
Scalp: Check systematically for lesions, scabs, and tenderness.

Palpation (Head/Neck)

Skull: Palpated in gentle rotary movement progressing systematically (front to back). Check for symmetry, smoothness, and absence of tenderness, swelling, or depression.
Hair: Palpate texture, color and distribution. Check for smooth symmetry, absent split/cracked ends.
Temporal Arteries: Palpate and note course.
Temporomandibular Joint (TMJ): Check space bilaterally.
Salivary Glands: Check symmetry and any enlargement.
Percussion: Only performed if sinusitis is suspected
Auscultation: Only performed if a vascular anomaly is suspected.

Examination of the Neck - Inspection

Neck: Usual position, slight hyperextension, while swallowing; look for symmetry of sternocleidomastoid/trapezius muscles, trachea alignment, landmarks of triangles, subtle fullness of base of the neck. Note masses, webbing, excess folding, unusual shortness, or asymmetry
Jugular Vein/Carotid Arteries: Note any distention
Range of Motion (ROM): Check head and neck movement; smooth and painless ROM.

Palpation (Neck)

Trachea: Palpate for midline position, compare left vs right space between trachea and sternocleidomastoid muscle.
Cartilages (hyoid, cricoid, thyroid): Palpate for smoothness, non-tenderness, and motion during swallowing.
Lymphatic Nodes: Inspect and palpate all nodes in the neck
Thyroid Gland: Inspect, palpate, and auscultate for symmetry, size, shape, configuration, consistency, tenderness, and nodules.

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Description

Test your knowledge on the common symptoms associated with headaches and stiff necks. This quiz explores how factors can exacerbate headache pain and where neck pain might radiate. Additionally, it highlights suggested treatment options for stiff necks.