TOS

Question 1

pt c/o heaviness and pain in UE and chest and edema. pt also c/o numbness & tingling in the hand with cyanosis and distended veins and worsening of symptoms with activity.

type of TOS?

Answer 1

Venous TOS

Question 2

pt presents with pain, numbness in a non-radicular pattern, pallor, cramping (claudication) in the hands and c/o symptoms worsening in the cold. the skin is also cold to touch during exam.

Type of TOS?

Answer 2

Arterial TOS

Question 3

pt presents with FH posture and complains of pain, numbness, and paresthesia in the arm and hand during the day and symptoms are aggravated with prolonged sitting at desk.

Upon exam the pt does present with strength deficits and sensory deficits
type of TOS

Answer 3

True Neurogenic (compressors)

Question 4

pt presents with FH posture and complains of pain, numbness, and paresthesia in the arm during the night that he doesn’t really notice bother him during the day and symptoms are relieved with position changes during sleep.

upon exam there are no strength or sensory deficits and pain is not easily reproduced.

type of TOS?

Answer 4

Disputed neurogenic TOS
(releasers)

Question 5

complaints of numbness & weakness = worse prognosis and axons are affected

vs

just parasthesis = neural irritation

Question 6

surgery recommended if NCV Is <60 m/sec
normal - 85m/sec