Thoracic Outlet Syndrome Flashcards

1
Q

What is thoracic outlet syndrome?

A

Compression of 1 or more of the neurovascular structures in the thoracic outlet

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2
Q

What structures are commonly affected?

A

Brachial plexus
Subclavian artery
Subclavian vein

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3
Q

Where is the thoracic outlet

A

Area between the neck/shoulder, top of the thorax and under the clavicle to the axilla

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4
Q

What are common causes of thoracic outlet syndrome?

A

Trauma
Repetitive movements
Cervical rib

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5
Q

What are risk factors for developing TOS?

A
Cervical rib
Trauma 
Poor posture
Repetitive overhead activity 
Obesity 
Female
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6
Q

What are the types of TOS?

A

Neurological TOS

Vascular TOS

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7
Q

What is neurological TOS?

A

Injury of the brachial plexus

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8
Q

What is vascular TOS?

A

Compression of the subclavian vein/artery

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9
Q

What are the symptoms of neurological TOS?

A

Painless hand muscle wasting
Numbness/tingling
Cold hands
Arm swelling

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10
Q

What are the symptoms of vascular TOS?

A

Diffuse arm swelling
Distended veins
Painful arm claudication
Ulceration

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11
Q

What investigations are used in suspected TOS?

A

Cervical spin x-ray
CXR

EMG/nerve conduction study - if neurological is suspected

CT angiography - if arterial suspected

Doppler ultrasonography - if venous is suspected

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12
Q

How is neurological TOS managed?

A

Surgery to manage nerve compression if present

Conservative management

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13
Q

How is arterial TOS managed?

A

Surgery - decompression

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14
Q

How is venous TOS managed?

A

Catheter-directed thrombolysis

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