Clinical Assessment - TOS / Neural Tension Flashcards
Adson’s Maneuver
Positive is diminished Radial Pulse and reproduced SS
palpate pulse, extend shoulder and apply downward traction, patient takes deep breath while actively extending and ipsilaterally rotating the neck
Travell’s Variation/Halstead Maneuver
Positive is diminished Radial Pulse and reproduced SS
palpate pulse, extend shoulder and apply downward traction, patient takes deep breath while actively extending and contralaterally rotating the neck
Costoclavicular Syndrome Test
Positive is diminished Radial Pulse and reproduced SS
palpate pulse, patient stands with shoulders down and back in exaggerated military stance, takes deep breath
Wright’s Hyperabduction Test
Positive is diminished Radial Pulse and reproduced SS
palpate pulse, patient takes deep breath and holds it, passively fully abduct patients arm (no elevation!!)
Roo’s Test/ Elevated arm stress test
Positive if unable to hold position, ischemic pain, numbness, heaviness of arm
Seated/Standing - arms 90 at shoulder abduction and ex. rotation 90 flexion of elbow, slowely opens and closes hands for 3 min.
Allen’s Test for the shoulder
Positive is diminished Radial Pulse and reproduced SS
patient shoulder and elbow at 90 degrees, therapist checks radial pulse and patient contralaterally rotates their head.
ULT1 - Median Nerve
supine - abduct arm, ext. rotate everything - SLIGHT ext. rotation of shoulder, shoulder girdle depression, hand supinated and out, apply abduction
ULTT2 - Median Nerve, Musculocutaneous Nerve, Axillary Nerve
supine - abduct arm, ext. rotate everything - FULL ext. rotation of shoulder, shoulder girdle depression, hand supinated and out, apply abduction
ULTT3 - Radial Nerve
Supine -Extend arm, INTERNALLY rotation of shoulder, shoulder girdle depression, hand pronated, wrist ulnar deviation, contralaterally rotate neck
ULNT4 - Ulnar Nerve
Supine - wrist extension, forearm supination, elbow flexion, shoulder girdle depression, lateral rotation, and abduction, flex contralateral rotation neck
LLNT1- Sciatic Nerve
Supine Ankle dorsiflexion, hip adduction, internal rotation, cervical flexion
LLNT2 - Femoral Nerve
Prone - knee flexion, hip extension
Where does Brachial Plexus original from and travel through?
C5 - T1, between ant and middle scalene, under clavicle, over 1st rib. under coracoid process posterior to pec minor.
Cause of Brachial Plexus
cervical rib, reduced scalene triangle, decreased costoclaciular / costocoracoid space, shoulder droop, clavical fracture leading to callous
Rule outs for TOS
cervical spine, shoulder, thoracic spine, elbow
