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T3 Clinical Assessment > 3 TOS & Neural Tension > Flashcards

3 TOS & Neural Tension Flashcards

1
Q

What’s Thoracic Outlet Syndrome (TOS)?

A

Complex of S/S that result from compression of the neurovascular bundle (NB).

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2
Q

What’s the Neurovascular Bundle (NB)?

A
  • brachial plexus
  • subclavian vein
  • subclavian artery
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3
Q

Where does the Brachial Plexus originate and travel?

A
  • originates C5-T1
  • enters between anterior and middle scalene
  • under the clavicle
  • over the 1st rib
  • under the coracoid process posterior to (under) pec minor
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4
Q

What are some possible causes of TOS?

A
  • cervical rib (juts out from C7 – not everyone has one)
  • reduced interscalene triangle (ant. scalene syndrome)
  • decreased costoclavicular space (costoclavicular syndrome)
  • decreased spaced caused by shoulder drop
  • callus formation resulting from a clavicular fracture
  • also consider nerve root compression
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5
Q

Are ruleouts for frozen shoulder conducted uni or bilaterally?

A

unilateral (all ruleouts are unilateral except for spine)

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6
Q

What ruleouts are conducted for TOS?

A
  • cervical spine
  • shoulder
  • thoracic spine (same as lumbar with overpressure)
  • elbow
  • TMJ
  • maybe wrist (flx, ext, uln and rad dev)
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7
Q

How is Adson’s maneuver conducted?

What’s a positive sign?

What’s tested?

A

What’s tested: NB exit through ant and mid scalenes

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8
Q

How is Travell’s Variation/Halstead Maneuver conducted?

What’s a positive sign?

What’s tested?

A

What’s tested: NB exit between ant and mid scalene, but this one focuses more on mid scalene

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9
Q

How is Costoclavicular Syndrome Test/Military Stance conducted?

What’s a positive sign?

What’s tested?

A
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10
Q

How is Wright’s Hyperabduction Test conducted?

What’s a positive sign?

What’s tested?

A
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11
Q

How is Roos Test/Elevated Arm Stress Test conducted?

What’s a positive sign?

What’s tested?

A
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12
Q

How is Allen’s Test for the should conducted?

What’s a positive sign?

What’s tested?

A
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13
Q

What’s the aka for Neural Tension Testing?

A

aka flossing

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14
Q

What are some indications to perform Neural Tension Testing (aka flossing)?

A
  • presence of adhesive scar tissue around the nerves
  • increased pressure on surrounding tissues or nerves (e.g. from increased muscle tone, swelling)
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15
Q

What are some contraindications for Neural Tension Testing (aka flossing)?

A
  • acute inflammatory or unstable neurological signs
  • spinal cord injuries
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16
Q

How are Neural Tension Testing (aka flossing) Testing Maneuvers conducted?

A
17
Q

How are Neural Tension Testing (aka flossing) Treatment Maneuvers conducted?

A
18
Q

When should Neural Tension Testing (aka flossing) maneuvers be stopped?

A

If px experiences burning or shooting pain, the nerve can be considered irritable and all maneuvers should stop!

19
Q

What should I do if the nerve has become irritable?

A

apply cool hydro, light massage and/or fluid techs

20
Q

How is Upper Limb Neural Tension Test 1 (ULNT1) conducted?

A
21
Q

How is Upper Limb Neural Tension 2 (ULNT2) conducted?

A
22
Q

What does ULNT1 test?

A

median nerve

23
Q

What does ULNT2 test?

A
  • median nerve
  • musculocutaneous nerve
  • axillary nerve
24
Q

How is Upper Limb Neural Tension 3 (ULNT3) conducted?

A
25
Q

How is Upper Limb Neural Tension 4 (ULNT4) conducted?

A
26
Q

How is Lower Limb Neural Tension Test (LLNT) for the Sciatic Nerve conducted? What are the variations for the tibial tract, sural tract, and common peroneal tract?

A
27
Q

How is Lower Limb Neural Tension Test (LLNT) for the Femoral Nerve conducted?

A
28
Q

What’s the aka for Roos Test?

A

Elevated Arm Stress Test

29
Q

What’s the aka for Travell’s Variation?

A

Halstead Maneuver

30
Q

What’s the aka for Military Stance Test?

A

Costoclavicular Syndrome Test

31
Q

When testing radial/ulnar deviation, should the palm be pronated or supinated?

A

supinated

32
Q

What are the TOS tests?

A
  • Adson’s Maneuver
  • Halstead Maneuver
  • Military Stance
  • Wright’s Hyperabduction
  • Roos
  • Allen’s
  • Myotome/Dermatome/DTR
  • Muscle Tests
33
Q

What are the Neural Tension tests for the Brachial Plexus?

A
  • Median Nerve/ULNT1
  • Median Nerve/ULNT2
  • Radial Nerve/ULNT3
  • Ulnar Nerve/ULNT4

T3 Clinical Assessment (12 decks)

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