Term
| define thoracic outlet syndrome |
|
Definition
| symptom complex characterized by pain, parasthesia, weakness, and discomfort in arm aggravated by elevation of the arms or exaggerated head and neck movements |
|
|
Term
| at what age is TOS most common |
|
Definition
|
|
Term
| do TOS cases usually have neurological involvement |
|
Definition
|
|
Term
| do TOS cases usually have vascular involvement |
|
Definition
|
|
Term
|
Definition
| brachial plexus injury documented by nerve conduction or EMG |
|
|
Term
|
Definition
| subclavian artery/vein dysfunction documented by imaging |
|
|
Term
| what is nonspecific or disputed TOS |
|
Definition
| patients have symptoms, but no tests document a lesion. Very common |
|
|
Term
| 3 sites of TOS compression |
|
Definition
| scalene triangle, costoclavicular space, coracopectoral space |
|
|
Term
| borders of the scalene triangle |
|
Definition
| anterior scalene, middle scalene, first rib |
|
|
Term
| what are the contents of the scalene triangle |
|
Definition
| trunks of brachial plexus, subclavian artery |
|
|
Term
| what are the borders of the costoclavicular space |
|
Definition
|
|
Term
| what are the contents of the costoclavicular space |
|
Definition
| trunks of brachial plexus, subclavian artery and vein |
|
|
Term
|
Definition
| tight scalenes or elevated 1st rib |
|
|
Term
|
Definition
| palpate 1st rib and look for elevation |
|
|
Term
| borders of coracopectoral space |
|
Definition
| coracoid process, pec minor, ribs 2-4 |
|
|
Term
| contents of coracopectoral space |
|
Definition
| cords of brachial plexus, axillary artery and vein |
|
|
Term
|
Definition
| congenital abnormality, trauma, functionally acquired |
|
|
Term
| what are congenital abnormalities that cause TOS |
|
Definition
| cervical rib (long TP at C7), fibrous/muscular anomaly such as nerves going through scalene |
|
|
Term
| what traumas can cause TOS |
|
Definition
| fractured clavicle, whiplash |
|
|
Term
| what things cause functionally acquired TOS |
|
Definition
| hypertrophic muscles from ADLs, training, breathing and bad posture |
|
|
Term
| how will posture change with TOS |
|
Definition
| shoulder protraction shortens SCM, scalenes, pec minor |
|
|
Term
| are TOS vascular symptoms common |
|
Definition
|
|
Term
| what are venous TOS symptoms |
|
Definition
|
|
Term
| what are arterial TOS symptoms |
|
Definition
| ischemia with effort, Raynaud's, cold limb |
|
|
Term
| are neurological TOS problems easily reproduced with nerve testing |
|
Definition
|
|
Term
| what are neurologic symptoms of TOS |
|
Definition
| thenar, hypothenar, interosseous weakness and atrophy; ulnar and medial antebrachial cutaneous numbness; paraesthesia and weakness that is undefined; fatigue in UE; aggs = raise arms, heavy load |
|
|
Term
| what to ask in TOS history |
|
Definition
| Onset of symptoms (when, how, where); History of trauma/stress; occupation with overhead; aggs/eases; PMHx |
|
|
Term
| how is TOS a diagnosis of exclusion |
|
Definition
| not very common, so check it out when you can't figure out what's wrong |
|
|
Term
| what's the exam sequence for TOS |
|
Definition
| UQ screen, assess shoulder, special tests |
|
|
Term
| what TOS test is for scalene involvement |
|
Definition
|
|
Term
| what TOS test is for clavicular involvement |
|
Definition
|
|
Term
| what TOS tests are for pec minor |
|
Definition
| hyperabduction/Wright's test; Allen's test |
|
|
Term
| what TOS test is for general TOS |
|
Definition
|
|
Term
| what else can be used for TOS testing |
|
Definition
| upper limb tension testin |
|
|
Term
|
Definition
| ergonomics, behavioral changes. Address posture |
|
|
Term
| how to address posture in TOS |
|
Definition
| posterior muscle lengthening. Anterior/superior muscle shortening. Downward rotation of scapula |
|
|
Term
| how long will it take to see improvements from exercise in TOS |
|
Definition
|
|
Term
| what specific postural exercises are good for TOS |
|
Definition
| scapular pinches, shoulder circles, chin tuck, slump sit to upright sit |
|
|
Term
| what to stretch in TOS treatment |
|
Definition
| scalenes, pec minor, upper traps |
|
|
Term
| what to strengthen in TOS treatment |
|
Definition
| middle/lower traps, serratus, LB extensors, triceps, lats |
|
|
Term
| what to mobilize in TOS treatmetn |
|
Definition
| cavicle, C-spine, 1st rib, scapula |
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