TOS/Miscellaneous disorders Flashcards
symptoms of TOS are MC associated with?
elevation of the arm/repetitive motion
what will patient typically present with if they have TOS?
diffuse arm symptoms
numbness and tingling
symptoms often worse with overhead activity
what are common compression sites for TOS?
elongated C7 TVP cervical rib scalene muscles costoclavicular area subcoracoid area
3 common sites of compression
scalene triangle
costoclavicular space
subpectoral space
scalene triangle
between scalenus anterior and scalenus medius
costoclavicular space
between clavicle and 1st rib
subpectoral space
between pec minor and coracoid process
which is more common? compression of subclavian vessels or compression of the brachial plexus?
brachial plexus
what does brachial plexus comression result in?
pain
paresthesia
numbness of the upper limb
what does subclavian vessel compression result in?
ischemia coolness pallor claudication paresthesia decreased upper limb pulses
associated conditions with TOS
cervical rib scalenus anticus or medius costoclavicular syndrome pectoralis minor grip strength reduced relfexes normal paresthesia generally proceed persistent pain
what are the provocative tests of TOS
Adson’s test (scalene muscles)
pec minor (wright’s)
functional rest (roo’s)
neurological evaluation to differentiate TOS from lower brachail plexus, nerve root or peripheral entrapment
clinical consequences of insulin resistance
coronary heart disease hypertension atherosclerosis obesity stroke
diabetic complications
macrovascular, microvascular disease atherosclerosis related death 2/3 of adult pts w/ DM have HTN blindness renal failure neuropathy gangrene of the feet diabetic nephropathy
history/risk factors
older than 45 obesity family history history of diabetes s/s polyphagia, polyuria, polydipsia history of high cholesterol or triglyceride levels physically active or not history of gestational diabetes or delivered a baby more than 9 pounds
