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Thoracic Outlet Syndrome Anatomy
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Thoracic Outlet Syndrome Anatomy

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Questions and Answers

Which specific muscle is targeted when laterally flexing and extending the head?

  • Anterior scalene (correct)
  • Levator scapulae
  • Pectoralis major
  • Trapezius

    • What type of training is recommended for cervical and thoracic extensors?

  • Resistance training (correct)
  • Balance training
  • Aerobic training
  • Flexibility training

    • Which of the following is NOT listed as a component of conservative management?

  • Stretching of pectoralis muscles
  • Postural education
  • Activity modifications
  • Stretching of quadriceps muscles (correct)

    • What is the purpose of postural education/training in conservative management?

    <p>To correct and maintain proper posture</p> Signup and view all the answers

    Which method is used to stretch the anterior scalene muscles?

    <p>Lateral flexion and extension of the head</p> Signup and view all the answers

    Which structure is located immediately superior to the first rib in the thoracic outlet?

    <p>Clavicle bone</p> Signup and view all the answers

    What is the primary muscle involved in the thoracic outlet region?

    <p>Subclavius muscle</p> Signup and view all the answers

    Which vascular structure is the most anterior in the thoracic outlet region?

    <p>Subclavian vein</p> Signup and view all the answers

    Which structure passes directly posterior to the clavicle bone in the thoracic outlet?

    <p>Subclavian artery</p> Signup and view all the answers

    Which of the following structures is NOT likely to be compressed in Thoracic Outlet Syndrome?

    <p>First rib</p> Signup and view all the answers

    What anatomical structure is directly involved in thoracic outlet syndrome?

    <p>Subclavian artery</p> Signup and view all the answers

    Which muscle is commonly associated with contributing to thoracic outlet syndrome?

    <p>Scalenes</p> Signup and view all the answers

    Thoracic outlet syndrome involves compression of which of the following structures?

    <p>Subclavian artery and brachial plexus</p> Signup and view all the answers

    Which posture is a contributing factor to thoracic outlet syndrome?

    <p>Impaired cervical posture (forward head)</p> Signup and view all the answers

    What anatomical anomaly is considered a contributing factor to thoracic outlet syndrome?

    <p>Abnormal 1st rib anatomy</p> Signup and view all the answers

    Which structure is NOT part of the neurovascular bundle compressed in the shoulder?

    <p>Axillary vein</p> Signup and view all the answers

    Which muscle is involved in the compression of the neurovascular bundle according to the diagram?

    <p>Scalene muscles</p> Signup and view all the answers

    What clinical test is used to assess the presence of neurovascular compression in the shoulder?

    <p>Roos test</p> Signup and view all the answers

    Which of the following symptoms is NOT typically associated with neurovascular compression in the affected limb?

    <p>Swelling</p> Signup and view all the answers

    Impaired sensation and motor function due to neurovascular compression in the UE can lead to difficulty with which activity?

    <p>Grasping</p> Signup and view all the answers

    Which condition is NOT a cause of spinal canal encroachment?

    <p>Increased disc height</p> Signup and view all the answers

    What is a direct result of the narrowing of the spinal canal?

    <p>Decreased space for the spinal cord</p> Signup and view all the answers

    Which of the following can occur due to localized trauma?

    <p>Narrowing of the spinal canal</p> Signup and view all the answers

    Where can narrowing of the spinal canal occur?

    <p>Anywhere in the spinal canal</p> Signup and view all the answers

    Which of the following is an example of pathologic encroachment?

    <p>Tumors</p> Signup and view all the answers

    What anatomical feature is directly causing the spinal cord compression in cervical stenosis?

    <p>Degenerative disc</p> Signup and view all the answers

    Aside from degenerative discs, what other structure is contributing to spinal cord compression in cervical stenosis?

    <p>Bony spurs</p> Signup and view all the answers

    Which part of the spine is specifically affected in cervical stenosis?

    <p>Cervical spine</p> Signup and view all the answers

    In cervical stenosis, what term describes the abnormal bony growths contributing to spinal cord compression?

    <p>Osteophytes</p> Signup and view all the answers

    What might be a consequence if cervical stenosis is left untreated?

    <p>Chronic pain and neurological deficits</p> Signup and view all the answers

    Which symptom alleviation is commonly reported in patients with spinal cord impairments?

    <p>Forward flexion</p> Signup and view all the answers

    Which condition is NOT a commonly reported impairment in individuals with spinal cord issues?

    <p>Enhanced trunk extension ROM</p> Signup and view all the answers

    What might patients with spinal cord impairment experience during extension movements?

    <p>Intolerable pain</p> Signup and view all the answers

    Which of the following is a potential outcome if the spinal cord is affected?

    <p>Difficulty with ADL’s, clumsiness, and impaired balance</p> Signup and view all the answers

    Which statement accurately describes a possible issue in the presence of spinal cord impairment?

    <p>Forward flexion can help alleviate symptoms</p> Signup and view all the answers

    Which structure is specifically altered in both laminectomy and laminoplasty?

    <p>Lamina</p> Signup and view all the answers

    What is the primary visual difference in the spine before and after a laminectomy as shown in the illustration?

    <p>Presence of bone spurs</p> Signup and view all the answers

    In the 'After (view from behind)' image, what distinctive feature emphasizes the change post-surgery?

    <p>Clear view of the spinal canal</p> Signup and view all the answers

    Which direction is the surgical removal or modification conducted during a laminectomy?

    <p>Posterior</p> Signup and view all the answers

    Which spinal component remains untouched after the laminectomy procedure shown?

    <p>Transverse processes</p> Signup and view all the answers

    Which surgical procedure involves the fusion of two spinal segments?

    <p>Spinal fusion</p> Signup and view all the answers

    What is the main purpose of a laminectomy?

    <p>To remove the lamina</p> Signup and view all the answers

    Which of the following procedures is specifically designed to remove a part of a damaged or herniated disc?

    <p>Discectomy</p> Signup and view all the answers

    Which surgical procedure primarily aims to relieve pressure on the spinal cord or nerves?

    <p>Decompressive surgery</p> Signup and view all the answers

    What distinguishes a spinal fusion procedure from a discectomy?

    <p>Spinal fusion involves fusing two segments; discectomy removes part of a disc.</p> Signup and view all the answers

    Which component of conservative management involves exercises that emphasize spinal bending to reduce symptoms?

    <p>Flexion biased therapeutic exercise</p> Signup and view all the answers

    What is a key benefit of postural education/training in conservative management?

    <p>Improving patient self-awareness and habits to reduce strain</p> Signup and view all the answers

    Which conservative management technique primarily aims to alleviate symptoms by addressing underlying muscle imbalances and improving movement patterns?

    <p>Postural education/training</p> Signup and view all the answers

    What is the main focus of patient education in conservative management?

    <p>Teaching patients about their condition and how to manage it independently</p> Signup and view all the answers

    Which technique is depicted in the bottom image where a person is holding their chin to their chest?

    <p>Flexion biased therapeutic exercise</p> Signup and view all the answers

    Study Notes

    Thoracic Outlet Syndrome

    • The thoracic outlet is a region where the subclavian artery, subclavian vein, and brachial plexus pass through.
    • Compression of these structures can occur inferior to the clavicle and superior to the 1st rib.
    • Contributing factors include:
      • Impaired cervical posture (forward head) and thoracic spine posture (kyphosis)
      • Tight scalenes
      • Shortened pec minor
      • Abnormal 1st rib anatomy

    Conservative Management

    • Stretching focused on the anterior scalene by laterally flexing and extending the head
    • Stretching of pectoralis muscles
    • Resistance training of cervical and thoracic extensors
    • Postural education/training
    • Activity/work modifications

    Clinical Presentation

    • Pain, numbness, tingling, weakness, skin and temperature changes in affected limb (ipsilateral side of neurovascular compression)
    • Impaired sensation and motor function of affected UE
    • Ex: impaired grasping, difficulty with movements
    • PT special tests: Roos, Adson, Upper Limb Tension Tests

    Cervical Stenosis

    • Narrowing of spinal canal
    • Decreased space for spinal cord in canal
    • Can occur anywhere in the spinal canal
    • Encroachment of spinal canal due to:
      • Osteophyte formation
      • Loss of disc height and/or disc disease/pathology
      • Localized trauma
      • Pathologic encroachment (e.g., tumors, cysts)

    Clinical Presentation

    • Depends on area of spinal cord affected and how much of spinal cord affected
    • May complain of pain, impaired motor function, impaired sensation in upper extremity
    • Can be asymptomatic and pain not primary complaint
    • Forward flexion tends to alleviate symptoms
    • Patients will not tolerate extension due to pain
    • Limited trunk extension ROM
    • If spinal cord affected: difficulty with ADL's, clumsiness of hands/lower limbs, impaired gait and balance

    Medical Management

    • Surgical procedures:
      • Decompressive surgery
      • Spinal fusion: two spinal segments fused together
      • Laminectomy: removal of lamina
      • Discectomy: section of damaged or herniated disc is removed
    • Conservative management:
      • Pain management
      • Patient education
      • Postural education/training
      • Flexion biased therapeutic exercise
      • Stretching

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    Description

    Identify the labeled structures in the Thoracic Outlet, which can be compressed and contribute to Thoracic Outlet Syndrome. This anatomy quiz covers the Clavicle bone, Subclavian artery, Subclavius muscle, First rib, Subclavian vein, and Brachial plexus.

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