Thoracic Outlet Syndrome

Question 1

What are the “tunnels” that the brachial plexus, subclavian artery, and subclavian vein travel through?

Answer 1

Between anterior and posterior scalenes (not vein)
Between clavicle and first rib
Under pec minor

Question 2

Actions of the scalenes

Answer 2

Elevates ribs 1 and 2 of a patient in sternal breathing

Flexes head and neck

Question 3

How is TOS symptoms typically aggravated?

Answer 3

Arm elevation or end range movements of the head and neck

Question 4

What do patients with TOS typically complain of?

Answer 4

Vague, heavy, cold, weak, numbness, and tingling in the arm

Question 5

What is the most classified source of TOS? What percentage?

Answer 5

Neurogenic (90%)

Question 6

What can cause pressure on the brachial plexus as they exit the neck and travel to the arm?

Answer 6

Structural (an extra rib), muscular tightness, joint tightness/restriction, postural and motor control problems

Question 7

How can the scalenes affect TOS?

Answer 7

Tightness or chest breathing can pull the first rib closer to the clavicle

Question 8

How can pec minor affect TOS?

Answer 8

Tightness and put pressure on neurovascular tissue

Question 9

Examples of how posture can cause narrowing tunnels

Answer 9

Scapular protraction/depression/anterior tipping
Thoracic kyphosis
Forward head, increased cervical lordosis

Question 10

Individual TOS tests lack…

Answer 10

solid diagnostic accuracy

Question 11

It is not uncommon for non-pathological non-symptomatic people to have…

Answer 11

postitive special test findings