What composes the TO?
Composed of a bony part (5 ribs, clavicle, and scapula), and a muscular part (scalenes, pectoralis minor)
What are the contents of the TO?
Contents : Brachial Plexus & branches, Subclavian artery, vein, & branches
What tests are performed for TOS?
Adson's test - scalene triangle - Extend & rotate neck toward tested side. Shoulder extended.
Military Brace - costoclavicular space - depression, retraction of scap and passivley extend the GH joint
Wright - retropectoral space - 90 d. of abduction and some horizontal abduction
What are the 2 categories of TOS?
Vascular - surgery indication
- Arterial ( 1%, Sanders et al)
- Venous (3-5%)
- Difficult to treat conservatively
Neurogenic (> 95%) - 2 Types:
- True Neurogenic - surgery for hard signs - Confirmed with valid, standard diagnostic testing.
- Disputed Neurogenic - surgery if all else fails - No confirmation from standard diagnostic testing.
What test is used to rule out distal arterial occlusion?
Allen's Vascular Occlusion Test
Upper vs. lower plexus irritation
Upper - radial aspect
Lower - ulnar
(T/F) Compressors often have worse symptoms at night
compressors worse with overhead movements