Thoracic Outlet Syndrome
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| What is Thoracic Outlet Syndrome? | A condition that involves the compression of the Brachial Plexus and accomanying vasculature.
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| What are some causes of Thoracic Outlet Syndrome (T.O.S)? | - Internal or external compression- Prolonged Poor Positioning- Poor Posture- Trauma
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| Where are the places TOS occurs? | Subclavius, Pec Minor, Anterior Scalenes.
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| Will myotome and dermatome tests be positive or negative in TOS? | Negative due to it being a peripheral nerve compression and not a nerve root compression.
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| What are some symptoms of vascular compression? | - Comp. circulation- Pain- Paller- Possible cyanosis- Edema
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| What are some symptoms of neurological compression? | - Numbness- Tingling
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| What are observations seen with TOS? | - Hyperkyphosis- Edema- Pallor- Internal Humaral rotation, droopy shoulder, head forward, hyperkyphosis, arms medially rotated, dorsal surface of hands forward.
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| Is there a reduction in the ROM? If so, which movements? | AF & PR reveal decreased rotation, flexion, and lateral flexion in c-spine.
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| What special tests are used to confirm TOS? | Adson's test is + for anterior scalene compression.
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| What special tests are used to differenciate? | Phalen's test to rule out carpal tunnel.
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| What are treatment goals for TOS? | - decrease SNS firing- decrease compression of neurovascular bundle- decrease pain- decrease inflammation- decrease Hypertonicity
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| Which muscles require stretching for TOS? | - Pec Minor, SCM, Scalenes
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| What type of hydrotherapy is used for TOS? | - Heat to shoulder, neck and pec minor.
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| What is an AHA moment for TOS? | Whole arm, not just hand. Feels congested, maybe nerve pain.
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| What does the palpation for TOS feel like? | neck, shoulder, arm, expect H/T and TPs, ischemia, bogginess/congestion.
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| What is the treatment plan for TOS? | decrease compression of brachial plexus. Treat neck, pecs, shoulder girdle. Be sure to mention scalenes, subclavius and pec minor. Use heat to pecs and back of neck.
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