Thoracic Syndromes (2) Flashcards
What is thoracic outlet syndrome?
Compression of the nerves, artery, or vein resulting in symptoms in the arm
What are the different types of TOS?
Neurogenic
Venous
Arterial
What are the different types of neurogenic diagnosis in TOS?
True
Disputed
What is true neurogenic TOS?
Hard neurological signs (myotomal weakness, dermatomal numbness, reflex losses)
What is disputed neurogenic TOS?
Symptoms such as hand falling asleep but neurological exam is normal
What is the most common type of TOS?
Disputed neurogenic (95%)
What percentage of TOS are venous?
5-10%
What percentage of TOS are arterial?
1-5%
What should you do if someone has arterial TOS?
Refer out
What are signs of arterial TOS?
Raynaud’s phenomenon (cold arm)
Peripheral embolisation (poor capillary refill)
BP different in arms
What are signs of venous TOS?
Upper limb swelling
Cyanosis
What are signs of neurogenic TOS?
Weakness, atrophy, or sensory disturbance of C5-C7 and C8-T1 (C8-T1 more common)
Where are the 3 areas where TOS originates due to compression?
Between anterior and middle scalene (cannot be venous)
Between clavicle and 1st rib
Behind pec minor
Who is most likely to develop TOS?
Trauma to the neck or shoulder
Repetitive overhead athletes (most common)
Anatomical variants
What are the 3 tests used to rule in or out TOS?
Adsons
Roos
Wrights
