Term
| Numbness associated with Thoracic Outlet Syndrome is typically in the ______ distribution of the arm and hand. |
|
Definition
|
|
Term
| Thoracic Outlet Syndrome definition |
|
Definition
| A condition that results in compression of the neurovascular bundle as it courses through the neck and shoulder. (Neurovascular bundle = subclavian a., subclavian v., brachial plexus) |
|
|
Term
| T/F Thoracic Outlet Syndrome is always congenitally caused. |
|
Definition
| F. You expect a congenital cause in a young pt. TOS may be slowly developed due to poor posture and repetitive movements; more acute in onset TOS is due to neck/should injury. |
|
|
Term
| T/F TOS is more prevalent in males. |
|
Definition
| F. Female to male ratio 9:1. |
|
|
Term
| Name the three regions of impingement that could lead to TOS. |
|
Definition
Middle/Anterior scalene.
Clavicle/First rib.
Pectoralis minor. |
|
|
Term
| What does the thoracic inlet consist of? |
|
Definition
|
|
Term
| What does the thoracic outlet consist of? |
|
Definition
| Everything that goes through the inlet. |
|
|
Term
| T/F thoracic outlet pain is limited to the hand. |
|
Definition
| F. Pain may be in the hand or radiate up the arm too. |
|
|
Term
| Hyperextension injury to the neck causes TOS due to compression in which of the three entrapment locations? |
|
Definition
Anterior/Middle Scalene.
Poor posture with head forward, fatigue of respiratory assist m., and exhaled first/second ribs are also associated with anterior/middle scalene entrapment. |
|
|
Term
| What are three mechanisms of dysfunction for entrapment in the costoclavicular region? |
|
Definition
| Inhaled first/second rib, Inferior sternoclavicular head dysfunction, Abnormal clavical (previous fx) |
|
|
Term
| What are the four mechanisms of entrapment involving the pectoralis minor? |
|
Definition
| Hyperextension injury of the shoulder, overuse or fatigue of the m., exhaled rib somatic dysfunction (stretch pec minor more tightly into neurovascular structures), abnormal positioning of the coracoid process (weird attachment of pec minor) |
|
|
Term
| If the pelvic diaphragm is restricted what else is restricted? |
|
Definition
| The other three diaphragms (four total). Abdominal diaphragm, tentorium ceribelli, thoracic inlet. |
|
|
Term
| Adson's test tests for TOS due to impingement at what location? |
|
Definition
|
|
Term
| How is the Adson's test performed? |
|
Definition
| Arm is extended posteriorly with head turned away from the affected side while monitoring the radial pulse. Then monitor with the head turned toward the affected side. A positive result is deminished radial pulse or reproduction of neurologic symptom. |
|
|
Term
| When performing the Adson's test and looking toward the affected side, which scalene are you testing? |
|
Definition
|
|
Term
| When performing the Adson's test and looking away from the affected side, which scalene are you testing? |
|
Definition
|
|
Term
| Treatment for hypertonic anterior/middle scalenes? |
|
Definition
|
|
Term
| The Military Posture Test tests for impingment in which of the three TOS locations? |
|
Definition
|
|
Term
| What does a positive test with the Miliary Test indicate? |
|
Definition
| Indicates inhaled 1st rib or inferior clavicle. |
|
|
Term
| Describe how to perform the hyperabduction/hyperextension test. |
|
Definition
| Arm is extended behind and raised up to 180 degrees. |
|
|
Term
| What does a positive Hyperabduction/hyperextension test indicate? |
|
Definition
| Indicates a hypertonic pectoralis minor and attachment to the humerus |
|
|
Term
| Treatment of hypertonic pectoralis minor? |
|
Definition
| Adduct arm diagonally across the chest in the plane of the m. |
|
|
Term
|
Definition
| Both arms placed at right angles to the shoulder and the forearms at right angles to the upper arms. Hands are opened and closed as fast as possible to see if symptoms occur. Symptoms of fatigue don't count; neurological symptoms do occur. |
|
|
Term
| Axial compression test is used to assess what? |
|
Definition
| Spinal nerve impingement from degenerative disc, spinal stenosis/other boney pathology. |
|
|
