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15 Cards in this Set
- Front
- Back
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what is thoracic outlet syndrome
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compression of neurovascular bundle
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what are the contents of the neurovascular bundle
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1) brachial plexus (C8-T1)
2) subclavian artery and vein |
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what are the borders of the thoracic outlet
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anterior: ant. scalenes
inferior: first rib posterior: middle scalenes |
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what is the most common population to hgave thoracic outlet
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90% women with protracted shoulders
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where are the 3 sites of compression for TOS
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1) between mid/ant scalene
2) pec minor and 1st rib 3) clavicle and 1st rib |
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what are the symptoms related to neurological compression
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UE pain/parestesia in ULNAR NERVE distribution
arm fatigue/weakness |
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what are the symptoms related to vascular compression
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claudication related to arm position and use (usually worse AFTER arm used and at night)
coolness, edema, numbness diffuse pain definite aggravation with elevation of upper extremity |
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what are the signs of TOS
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1) may/maynot be able to mreasure/observe coolness or poor coloration of hand
2) most likely no measureable loss of sensation or decrease strength 3) posotive tests (adisons, allens, costoclavicular, ROOS) |
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what is a POSITIVE test for TOS
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REPRODUCTION OF SYMPTOMS
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Adsons test compresses
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between the scalenes
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Allens test compresses between
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mec minor and ribs
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costoclavicular (military position) tests
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compression between first rib and clavicle
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Roos tests
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no specific site of compression
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what are the bony abnormaliites that may lead to TOS
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1) presence of cervical rib
2) abnormallyu shaped clavicle and/or excessively long C7 TP |
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what is the tx of TOS
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1) correction of posture
2) stretching scalines, pec major, pec minor 3) avoid overhead activities 4) avoid carrying objects in involved hand 5) avoid sleeping prone (places neck in rotation and extension) 6) sit with arm supported 7) home ex prog. posture, breathing, stretching 8) teach use of diaphragmatic breathing ansd stress full expiration with thoracic breathing 9) mob ACJ (AP direction) SCJ (cranio-caudal) scap and first rib 10) soft tissue mob mec major/minor, scalenes |
