Thoracic Outlet Syndrome Flashcards
Thoracic Outlet Syndrome
-group of disorders where compression of veins, arteries, or nerves
TOS Anatomical Sites
-Interscalene triangle
-Costoclavicular space
-Subcoracoid space
nTOS
-nerve involvement
-MC
-Brachial plexus entrapment
-radiating pain, chest pain
vTOS
-unilateral s/s
-impingement of subclavian vein
-heaviness, swelling, cyanosis
aTOS
-artery involvement
-LC
-subclavian artery
-diminished pulse
-ischemia
C5-C7 Compression Referred Pain
-rhomboid
-ant clavicle
-deltoid and traps
C8-T1 Compression Referred Pain
-anterior shoulder and down the arm
Thoracic Outlet Syndrome Tests
(+): disappearance of pulse
(+): Reproduction of neuro s/s
Thoracic Outlet Syndrome
-aim of test to dec pulse or reproduce neurologic s/s
-4 tests
Adson’s Vascular Test
-TOS
- Pt seated
- Pt hold arm into 15deg of abduction
- Pt asked to inhale and hold breath
- Then extend head and rotate away
- Check for dimished pulse or increased s/s
Costo-Clavicular Test
-TOS
- Pt seated w/ arms at side
- Pt retracts arms/shoulders and protrudes chest and hold for 60s
- Check for dimished pulse or increased s/s
Hyperabuction Test
-TOS
- Pt seated
- Pt asked to turn away from tesing side
- Pt asked to raise arm into hyperabd/ext for 1-2min
- Check for diminished pulse or increased s/s
Roo’s Test
-TOS
- Pt seated w/ both arms in 90/90
- Asked to open and close fingers for 3 min
- Check for diminished pulse or inc s/s
stop test if s/s present
