Term
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Definition
| tunnels made up of bones and mm. A compromise of the nerves AND blood vessels within or or more tunnels is referred to as TOS |
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Term
| TOS may be identified by specific sites of copromise of the neuroascular structure such as (5) |
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Definition
scalene anticus syndrome
costoclavicular syndrome
pectoralis minor syndrome
humeral head syndrome
first rib syndrome |
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Term
| 9 tunnels of the upper quarter |
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Definition
vertebral canal
IV foramina
Scalenes (ant/mid)
Infraclavicular
Pectoralis region
Cubital tunnel
Carpal tunnel
Tunnel of guyon |
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Term
| TOS: Which parts of the brachial plexus have the most involvement |
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Definition
| lower trunk and medial cord |
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Term
| TOS: symptoms are found at what nn distribution |
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Definition
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Term
| TOS: Mechanisms of Neurovascular Compromise: (2) |
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Definition
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Term
| TOS: Mechanisms of Neurovascular Compromise: which is the more common mechanism |
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Definition
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Term
| TOS: Mechanisms of Neurovascular Compromise: describe the developmental mechanism |
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Definition
| during normal growth the scapulae descend on the thorax and an associated strain of the scapualr suspensory mm during development is known to be associated with TOS |
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Term
| TOS: Mechanisms of Neurovascular Compromise: describe the traumatic MOI (2) |
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Definition
| macrotrauma or repetive use of UE overhead |
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Term
| TOS: Mechanisms of Neurovascular Compromise: desribes what happens as a result of the traumatic mechanism (2) |
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Definition
post traumtic scarring alogn the deep cervical fascia which blends with the axillary sheath encompassing the neurovascular bundle
shortening of mm d/t poor posture or traumatic scarring |
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Term
| TOS: Other causes of neurovascular compromise: cardiopulm related |
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Definition
| abnormal breathing pattern causing over development of scalenes and pec minor which narrows tunnel |
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Term
| TOS: Other causes of neurovascular compromise: developmentally related |
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Definition
| wide distal attachment of scalenes, accessory cervical rib, anomalous fibrous bands of tissues |
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Term
| TOS: Other causes of neurovascular compromise: neuro/cardiopulm related |
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Definition
| dysfunction of C3,C4 which affects tone of the diaphragm, leading to decreased abdominal breathing and high costal breathing |
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Term
| TOS: Other causes of neurovascular compromise: bony thorax related (2) |
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Definition
elevation of the 1st rib causing increasing compression and irritation of the neurovascular structures.
decreased mobility of the clavicle |
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Term
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Definition
numbness (whole arm)
weakness (heaviness)
coldness
blanching
discoloration
pain (ischemic)
decreased radial pulse |
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Term
| TOS: Neurological s/s (4) |
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Definition
numbness (segmental)
weakness (myotomal)
pins and needles (release phenomena)
pain |
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Term
| TOS: Exam findings: pain locaiton (5) |
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Definition
lateral aspect of neck
supraclavicular area
shoulder area
hypothenar region
fourth and fifth digits |
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Term
| TOS: Exam findings: symptoms aggravated by |
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Definition
dependency of the arm
any use of the arm in lifting, pushing, pulling reaching overhead, or reptitive activity such as writing |
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Term
| TOS: Exam findings: hx (2) |
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Definition
trauma both acute and insidious
acute trauma is often secondary to MVA |
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Term
| TOS: Exam findings: insidious onset is often associated with what |
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Definition
| occupations requiring sustained hand activity under high cognitive demands in conjunctino with poor ergonomics |
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Term
| TOS: Exam findings: positive special tests precaution |
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Definition
| reliability and validity of test's is controversial. Must reproduce pt's symptoms |
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Term
| TOS: Exam findings: observations/palpation (5) |
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Definition
decreased posture common
Significant ULTT
Tenderness over the scalane/mm bellies, subclavius region, carpal tunnel
Paradoxical breathing pattern
Double crush injury |
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Term
| TOS: Dx: assessment should include scapulothoracic openers and closers. What are the openers (3) and clsoers (3) |
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Definition
openers: levator, SCM, UT
closers, Pec mj and mn, scalenes |
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Term
| TOS: Dx: specific bony and neurological testing (6) |
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Definition
first rib position
clavicle position (hx of fx)
scapualr position
AC jt mobility
SC jt mobility
neuromeningeal tests |
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Term
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Definition
nerve root impingement C8,T1
pancoast tumor
cubital tunnel syndrome
CRPS
raynaud's syndrome
breast cancer |
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Term
| TOS: differential dx: nerve root compression refers to what (3) |
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Definition
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Term
| TOS interventions: intervention precaution |
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Definition
| aggressive PT should be avoided d/t symptoms exacerbating |
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Term
| TOS interventions: the 3 obvious ones |
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Definition
posture correction
mm relaxation
relief of inflammation |
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Term
| TOS interventions: 5 more specific TOS interventions |
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Definition
Stretch shortened mm
Strengthen scapular stabilizers
Mob entire shoulder complex
1st and 2nd rib mobs
neuromobilizaiton techniques |
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Term
| TOS interventions: stretching shortened mm refers to what mm (2) |
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Definition
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Term
| TOS interventions: mobilization of entire shoulder complex refers to what (4) |
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Definition
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Term
| TOS interventions: sign to be expected when stretching a shortened mm |
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Definition
| provocation of symptoms because shortened tissue is being stretched and may result in further compression of the tissue with the stretch |
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Term
| TOS interventions: HEP and education (5) |
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Definition
shoulder retractions
neck rectraction
scapular strengthening
ADL modification
Ergonomic education |
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