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11 Cards in this Set
- Front
- Back
Define thoracic outlet syndrome...
Main symptoms? |
is a syndrome involving compression of nerves blood vessels or both... more of a neurological presentation
- pain upper extremities toward ulnar side - raising arms, arms moving neck pain |
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What are some muscle machine tests to rule out nerve problem and results?
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EMG/NCS:
to rule out: 1. radiculopathy- inflammation of nerve so patterns follow dermatome 2. Carpal tunnel syndrome 3. Nerve injury |
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What are the main etiologies of TOS?
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1. Osseous- first rib injury, callus formation in process of healing
2. Soft Tissue- scalene and/or pectoral muscle contraction due to posture or structure change (i.e. trauma, Pancoast's tumor) 3. Vascular 4. Neurogenic- Depends on cause |
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Describe the following types of tests...
a. Adson's maneuver- b. Wright's hyperabduction |
a. checking radial pulse, while patient is looking away and ABducted 90 degrees if Radial pulse goes away after deep breath... positive for TOS
b. |
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What is the order of the physical exam used to diagnose TOS?
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1. History
2. Neurological of upper extremities 3. Vascular 4. Provocative tests 5. Osteopathic evaluation |
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What are the provocative physical exams to diagnose TOS?
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a. Adson's maneuver- scalenes
b. Wrights hyperabduction- pectoralis minor c. costoclavicular maneuver d. east test or hands up test- cervical nerve root problem e. spurling's test |
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Describe the following types of tests
a. costoclavicular maneuver b. east test |
a. ABduct and extend arm back... if pain or shooting = positive for nerve
b. hand above head 90' opening and closing hands, if pain or numbness = positive for nerve |
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Describe the following types of test
a. Wrights |
feel radial pulse and then have patient puts thenar side of hand on head... if pulse diminishes= positive
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What are procedures that could use for TOS diagnosis?
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a. X-rays- if apical lung tumor, cervical rib
b. CT c. MRI- radicular, nerve problems d. angiography e. venography f. EMG- 2-4 weeks before pathology shows (plexopathy) g. doppler flow studies |
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What are nerve suggestive of TOS?
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low amplitude median motor, ulnar motor, ulnar sensory responses
- normal median sensory conduction |
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What are treatments of TOS?
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Medicine-
a. analgesics b. NSAIDs/Steroids c. Muscle relaxants 2. PT 3. Self stretching- key to success 4. OMT- myofascial release, muscle energy 5. Surgery- (last resort)- - first rib taken out -"trans axillary" - sclenectomy |