Thoracic Outlet Syndrome Flashcards
patho
condition in which there is compression of the nerves, arteries, or veins in the passageway from the lower neck to the armpit.
The most common cause is
a congenital cervical rib—an extra rib that arises from the seventh cervical vertebra.
There are 3 main types of TOS
Neurogenic TOS
The venous type
Arterial TOS
Neurogenic TOS is: Frequency, cxfx
the most common type; it presents with pain, weakness, and thenar atrophy.
The venous type results in
swelling, pain, and cyanosis of the arm.
Arterial TOS cxfx
causes pain, coldness, and pallor of the arm.
Adson sign. what is it?
Some patients may have it, the loss of the radial pulse in the arm upon rotating the head to the ipsilateral side, with neck extended, and taking a deep inspiration
The best initial test is
a Doppler ultrasound of the subclavian vessels
The most
accurate test is
a magnetic resonance angiography
Treatment
indicated only for symptomatic patients; incidentally found
asymptomatic cervical ribs should be observed.
Neurogenic TOS tx
should initially be managed with physical therapy.
Thoracic outlet decompression is indicated for
symptomatic patients with:
Vascular symptoms of TOS
Neurologic weakness or disabling pain and paresthesia
