Thoracic outlet syndrome

Question 1

Adson maneuver

Answer 1

TOS
Pte extends arm, examiner feels radial pulse, Pte looks above the examiner and hold breath.
Decreased intensity of pulse
TOS

Question 2

Halstead maneuver

Answer 2

TOS
Pte sits on side of table, with arm relax down. Examiner feels radial pulse, and use the other arm to hold the two epicondyle of humerus, then pull down.
Decrease intensity of pulse
TOS

Question 3

Allen maneuver

Answer 3

TOS
Pte flex elbow at 90 degree (like preparing a punch). Examiner feel radial pulse. Pte looks away.
Decrease intensity of pulse
TOS

Question 4

Roo’s test

Answer 4

TOS
Pte hold up arm and makes twinkle twinkle little stars for 3 mins
Pte unable to keep arms in starting position for 3 mins
TOS

Question 5

Wright maneuver

Answer 5

TOS
Pte sits and hands down. Examiner feels pte’s radial pulse, then lift pte’s arm up (hyper-abduct the arm)
Decrease intensity of pulse
TOS

Question 6

Costoclavicular syndrome

Answer 6

TOS
Pte seated, hands held back. Examiner grabs wrist and feels radial pulse. Pte brings shoulder down and back.
Decrease intensity of pulse
TOS

Question 7

Allen’s test

Answer 7

TOS
Pte open/closes hand 5 times, then hold close. Examiner presses radial and ulnar artery. Pte hand open. Examiner then release one hand at a time
Regain normal color > 10 s
Radial or ulnar artery occlusion

Question 8

Adam’s position / skyline view

Answer 8

Thoracic
Pte bends over forward, observe from behind if hump on one side
Unilateral hump scoliosis
Scoliosis

Question 9

Passive scapular approximation

Answer 9

TOS
Pte lays faces down. Examiner lifts the shoulders up
Pain in scapular
T1 or T2 nerve root lesion

Question 10

Slump test

Answer 10

TOS
(1) Pte seated. Examiner holds head (on head and chin), pte then slouches forward so shoulders sag forward (2) chin touches chest. (2) examiner extends pte’s knee (3) examiner dorsiflex foot of extended leg
Sciatica
Impingement of dura and spinal cord