CPA 3 - Thoracic Outlet Syndrome

Question 1

What are 3 components of the Biomechanical model for Thoracic Outlet Syndrome?

Answer 1

ME for rib 1 inhalation dysfunction
SC adduction dysfunction HVLA
ME for SCM

Question 2

What are 3 components of the Respiratory/Circulatory model for Thoracic Outlet Syndrome?

Answer 2

Open thoracic inlet
Effleurage/Petrissage on UE
Pectoral traction

Question 3

What are 3 components of the Neurlogic model for Thoracic Outlet Syndrome?

Answer 3

Sensory area = C5-T1 –> paraspinal inhibition - decrease nerve root compression
ANS area = C5-T1 –> paraspinal inhibition - normalize PNS tone
BOTOX injection into scalene - inhibit excessive contraction

Question 4

What are 2 components of the Metabolic/Energy model for Thoracic Outlet Syndrome?

Answer 4

NSAIDs - reduce pain/inflammation

Muscle relaxer - reduce muscle contraction

Question 5

What are 3 components of the Behavioral model for Thoracic Outlet Syndrome?

Answer 5

Limit overhead arm movement
Use other arm for repetitive movements
Home stretching Rx

Question 6

What is the first area to screen and what are the TART findings?

Answer 6

Thoracic Outlet/Inlet
Tenderness
Clavicular ROM (SC/AC joints)
Erythema, swelling, ecchymosis

Question 7

What is the second area to screen and what are the TART findings?

Answer 7

Rib 1
Tenderness
Rib 1 ROM (50/50)
Erythema, swelling, ecchymosis

Question 8

What is the third area to screen and what are the TART findings?

Answer 8

Shoulder
Tenderness
Shoulder ROM
Erythema, swelling, ecchyomsis

Question 9

What tests would you use to diagnose an SD at the Thoracic outlet?

Answer 9

Spurling’s Maneuver - down, E and down, E/SB toward and down

Adson’s test (look away = scalene, look toward = rib 1)

Question 10

What tests would you use to diagnose an SD at Rib 1?

Answer 10

Monitor pump handle motion

Monitor bucket handle motion

Question 11

What Tx would you use to Tx the Thoracic Outlet SD and is it indirect or direct?

Answer 11

MFR to Thoracic Outlet

Indirect

Question 12

What Tx would yo use to Tx the Rib 1 inhalation and bucket handle SD’s and is it indirect or direct?

Answer 12

ME to both - restore normal movement

Direct

Question 13

What is an OMM ANS Tx for Thoracic Outlet syndrome?

Answer 13

Rib raise - normalize SNS tone

Question 14

What is an OMM Lymphatic Tx for Thoracic Outlet syndrome?

Answer 14

Effleurage/Petrissage

*Open Thoracic inlet first