Steemit Learning Challenge-S22W6; Thoracic Outlet Syndrome

Hello friends, welcome to my blog! I'm happy to have followed these lessons from week one to the end. I will be making an entry on the week's topic "Thoracic Outlet Syndrome (TOS)".

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What's a thoracic outlet syndrome? Write in your own words after getting knowledge from the lesson post. (Note: don't add special tests or investigations and detailed treatment in this question. Write the answer precisely).

Thoracic Outlet Syndrome is a medical condition that affects the human upper body, especially between the collarbone and the first rib. How this affects the region is simple: there is an observed compression of nerves or blood vessels carrying blood toward this region. Therefore, this is a condition that entails a compression of nerves and blood vessels within the thoracic.

While noting this condition, it could be named based on the range or part of compression. It could be called the First Thoracic Rib, Cervical Rib, Costoclavicular, or Hyperabduction. Sometimes, we may observe situations that have their origin from anatomical abnormalities. A case whereby there is an extra rib and an unusual presence of tightened fibrous tissues.

Types:

However, we should note the following occurrences; we could find Thoracic Outlet Syndrome as either being Neurogenic when compression happens at the Brachial Plexus nerves. It is being Venous when its compression happens on the veins, or Arterial Thoracic Outlet Syndrome when compression happens on the arteries. We may also observe Mixed Thoracic Outlet Syndrome when we have compression affecting but Neurogenic and Venous paths.

Symptoms:

Symptoms in a Thoracic Outlet Syndrome patient are categorized into Vascular & Neuropathic paths.

This is often characterized by pains within the region of the neck, shoulder, and arm, with discomfort observed depending on the range/duration of occurrence.

In extension, we could also observe numbness and tingling within the hand or finger region.

We could also see other symptoms like weakness within the arm or hand region, which makes it difficult to grip or raise objects with the affected arm.

However, there may be issues of circulation within the region, which brings about coldness and discoloration. Remember that we talked about the compression of nerves and/or blood supply vessels. Hence, these are condit ways of allowing effective communication.

We may also observe puffiness and swelling within the arm or hand region, which may also induce fatigue or weakness in the area.

Causes:

1. As I mentioned before, Thoracic Outlet Syndrome could be caused by anatomical abnormalities, which caused the presence of an extra rib in the region.

2. Type of job activities one does over. Most overhead occupational activities that entail moving the arm or hand over the head make one susceptible to this condition. This is primarily due to its repetitive nature.

3. Trauma and injury from both indoor and outdoor accidents.

4. Poor sleeping positions and poor posture are likely causes of Thoracic Outlet Syndrome.

5. Aside from our occupational activities, this condition could also be seen in some of the hobbies we indulged in. Sporty activities like swimming, volleyball, and the like.

Question 2: How would you diagnose a thoracic outlet syndrome? Any clinical investigation or assessment tests? ( Don't add treatment to this question)

Diagnosing ThoracicOutletSyndrome

Taking of Medical History:

This is an initial procedure that is required during diagnosis. We have to take background records of patients to enable us to have pre-information on what to anticipate. Discussing the type of activities this patient does in his or her ADLs (activities of daily living), especially overhead activities, would give us a direction. Activities that deal with repetitive use of the arm, especially the shoulder and first rib region, are likely to make him susceptible to this condition.

Also, discussing past medical conditions like injuries from accidents or trauma within the region may be vital. Lastly, a physical examination of the suspected region should be done to have first-hand knowledge of symptoms.

Diagnosis Through Physical Examination:

Physical examination enables us to have a closer look at the patient. This is essential for better clarity of symptoms or diagnosis within the affected region. With physical examination, we should be able to easily detect symptoms like swelling, discoloration, and other symptoms.

Through this medium, detecting patients' poor posture that contributes to thoracic outlet syndrome is easier. The patient is assessed for vascular and neurological to ascertain if these are in full function.

Through Imaging Tests:

The use of the imaging test type is an advanced method,, especially for conditions that are not physically determined. Therefore, we achieve some range of certainty when the use of X-ray, Ultrasound, and MRI. For proper precision of diagnosis, imaging test type is considered.

The use of electrodiagnostic tests like EMG and NCS diagnosis method has been vital in ascertaining the extent of nerve damage and strength of muscle within the arm region.

Through Special Tests:

Adson's Maneuver Tests

During this, the patient is asked to be in a sitting position while extending their neck with their head turning towards the expected affected region with a deep breath. If this position is taken and a deep breath or hold breath test, there's a reduced radial pulse, then the patient has Thoracic Outlet Syndrome. Note that the patient's BP should be checked before starting the test.

Allen or Wright Test

This is another special test done in a sitting position with hyperabduction observed at the shoulder region. This would enable us to see if there is discoloration or reduced radial pulse for the presence of thoracic outlet syndrome.

Roos Test

This is a situation whereby the patient will rise. Up two of his arms with the fist close or sometimes opened. This should be done between 3 to 5 minutes, and if there's pain and numbness within the arm region, then it is Thoracic Outlet Syndrome.

Through Physical Interventions:

The essence of why we still use physical interventions is usually for corrective measures or modifications which tend to reverse some of the observed symptoms. These are likened to solutions or therapeutic treatments. However, this is considered a treatment procedure, which shouldn't be discussed in the question under review.

Try to practice at least 3 exercises that you have learned from the lesson. Share images, gifs, or videos while practicing, preferably gifs or videos.

Shoulder Shrugs

This is an exercise that help us relieve tension around the shoulder region. It helps to improve the posture and scapula mobility. While doing this, we don3need to hang our backs but rather sit upright and raise our shoulders upwards.