Thoracic Outlet Syndrome Flashcards
What does thoracic outlet syndrome include?
Groups of symptoms resulting from compression or obstruction of the following structures:
- subclavian artery
- subclavian vein
- brachial plexus
Possible culprits of compression in TOS
Middle and posterior scalenes
Cervical 1st rib
Pectoralis minor muscle
Clavicle
Symptoms of TOS
Ischemia
Decreased pulse
Pallor
Coolness
Swelling
Pain
Paresthesia
Cyanosis
Possible differential diagnosis for TOS
remember TOS is not a diagnosis, rather symptoms
- cervical disc herniation
- pancoast tumor
- carpal tunnel syndrome
- brain/spinal cord lesions
- somatic dysfunctions of the cervical/thoracic spine, ribs, clavicles, upper extremities
Roos test tests for what?
General TOS
- doesn’t specifically say what is the culprit
Upper limb tension test tests for what?
General TOS
- doesn’t specifically say what is the culprit
Wrights test tests for what?
Pec minor entrapment
Adsons test tests for what?
Middle and posterior scalene entrapment
Halstead test tests for what?
Cervical/ 1st rib entrapment
Double crush syndrome
Compression of nerves/vasculature along their pathway at two or more different locations
Can be synergistic or separate affects
Factors that predispose to TOS
Cervical ribs and fractures
Unusual sleeping positions
Ectomorphic body habits
Occupations:
- mechanics
- backpackers
- military
- painters/artists
- construction workers
When to do further work up for TOS
Unresponsive to conservative treatments
Unusual patterns
Loss of motor or nerve functions
Evidence of Muscle wasting
