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Anatomical variations that lead to TOS - 3
- Cervical rib
- Narrowing between clavicle & 1st rib
- Hypertrophy of anterior scalene
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TOS - compression of neurovascular bundle in thoracic outlet in what areas? - 3
- Scalene triangle
- Between clavicle & 1st rib
- Between pectorals minor & thoracic wall
 
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TOS - neuromuscular bundle consists of what? - 4
- Brachial plexus
- Subclavian artery & vein
- Vagus nn
- Phrenic nn
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Thoracic Outlet Syndrome (TOS) - Chief complaint - 6
- Parasthesias and hyperesthesias in medial arm
- Pain
- Swelling (venous)
- Cyanosis (venous)
- Cold limb (arterial)
- Weakness in C8, T1 muscles
- Rounded, sagging shoulder posture
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TOS - PT - strengthen openers mms - name - 4
- Rhomboids
- Middle trap
- Deep cervical flexors
- Thoracic extensors
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TOS - PT - stretch closers - name - 5
- Pecs
- Scalenes
- Levator snap
- Short sub occipitals
- Ant portion of intercostals
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Tests for Thoracic Outlet Syndrome - 4
- Adson’s
- Costoclavicular
- Wright
- Roos
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Adson's - describe
Head to tested side - extend arm & ER while extending head
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Costoclavicular - describe
- Narrowing between clavicle & 1st rib
- Move shoulder down and back
-
Wright - describe
- Max shoulder ABD/ER + rotate head to opposite side
- Take a deep breath & rotate head to opposite side = accentuates symptoms
-
Roos - describe
- Full ER, 90 ABD, slight horizontal ABD, elbows at 90
- Open and close hands for 3 minutes
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Name test
Compression of neurovascular bundle by what in this position?
- Adson's test
- Compresson of neurovascular bundle between anterior & middle scalene
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Name test
Compression of neurovascular bundle by what in this position?
- Costoclavicular (military brace) test
- Compression by clavicle
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Name test
Compression of neurovascular bundle by what in this position?
- Wright (HyperABD) test
- Compression of neurovascular bundle by pec minor or coracoid process
-
-
Name test
- Roos Test
- Most sensitive test for TOS
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