Thoracic Outlet Syndrome

Posted by e-Medical PPT Sunday, November 7, 2010
Thoracic outlet syndrome (TOS) is a syndrome involving compression at the superior thoracic outlet involving compression of a neurovascular bundle passing between the anterior scalene and middle scalene.It can affect the brachial plexus , and/or the subclavian artery or vein.The compression may be positional (caused by movement of the clavicle (collarbone) and shoulder girdle on arm movement) or static (caused by abnormalities or enlargement of the various muscles surrounding the arteries, veins, and brachial plexus).
It is also possible to classify TOS by the location of the obstruction:
* Scalenus anticus syndrome (compression on brachial plexus and/or subclavian artery caused by muscle growth) – diagnosed by using Adson's sign with patient's head turned outward.
* Cervical rib syndrome (compression on brachial plexus and/or subclavian artery caused by bone growth) – diagnosed by using Adson's sign with patient's head turned inward.
* Costoclavicular syndrome (narrowing between the clavicle and the first rib) – diagnosed with the costoclavicular maneuver.

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