Friday, February 27, 2009

Thoracic outlet syndrome: a syndrome of many words

interscalene triangle/scalene fissue
scaleotracheal fossa
costoclavicular triangle
subcoracoid triangle deep to the tendon of pectoralis minor

Scalenus anticus syndrome
hyperabduction syndrome
cervical rib syndrome
costoclavicular syndrome

adson's test
costoclavicular maneouvre

Paget Schroetter disease (venous TOS)
Gilliat Sumner hands (neurogenic TOS)
- atrophy of abductor pollicis brevis, hypothenar eminences and hypothenar
- sensory deficits of the ulnar nerve distribution
- expected as ulnar nerve originate from lower levels of the brachial plexi

Adson's maneuvre
Wrights test
Roo's test
Costoclavicular maneuvre

Side notes on anatomy:

Thenar muscles: 3 muscles: abductor pollicis brevis, opponens pollicis, flexor pollicis brevis, all mediam nerve
Adductor pollicis is innervated by the ulnar nerve

Hypothenar muscles: 3 muscles: flexor digiti minimi, abductor digiti minimi, opponens digiti minimi

Anatomical snuff box: extensor pollicis longus, extensor pollicis brevis, abductor pollicis longus, radial artery, scaphoid bone, radial styloid

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