Steemit Learning Challenge-S22W6; Thoracic Outlet Syndrome"

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Now, suppose you are holding this extremely thick hose of water and everything is good and merely okay, where the water simply goes through it and running out very well. If you somehow bent or stepped on it, then there is a huge chance that this water flow will become slow or just stop at that moment. Why on earth would the water stop!? Because the pressure will build up, after which the hose cannot function freely, or simply properly. Let's see how this will make "Thoracic Outlet Syndrome" understandable ,with the below questions brought to us by @ashkan.....

So let us now return to thoracic outlet syndrome. Think of that space between the collarbone and the first rib as that hose. This so called space- thoracic outlet-.. transmits "blood" same as the hose transmit water. However in this case when nerves or blood vessels is blocked or squeeze-thus stopping it from carrying essential pathways from our chest to our arms; it's like stepping on the hose particularly if these very nerves or blood vessels we talking about get pinched or squeezed, however they won't be able to function well anymore,and that squeezing or pinching is what we called or known as,"Thoracic Outlet Syndrome."

In another words, Thoracic Outlet Syndrome is that very condition involving compression of the blood vessels or nerves in the thoracic outlet. It is described as the passageway between our collarbone and our first rib. This is an important area because it serves as a passageway for nerves and blood vessels that travel from the neck into the arm. Compression of these structures leads to a variety of symptoms which can really impact our everyday life, ruining our day and putting the happiness we had into a stops on enjoying life.

Well, as we know, anything syndrome or sickness has causes. So, there are a number of causes for TOS, and I would more than be willing to categorize them into three types of causes: anatomical, traumatic, and postural.

1. Anatomical Causes: Some people have anatomical characteristics that predispose them to developing TOS. For instance, an extra rib (cervical rib) or an excessively tight fibrous band may be compressing nerves and blood vessels of the thoracic outlet.

2. Traumatic causes: Severe neck and shoulder injuries may also be the cause of TOS. A car injury or a serious sports injury could cause swelling or make structural changes, which may push or compress the thoracic outlet.

3. Postural Causes: This is where people are seated for too long or slouching. The posture causes tightness of the muscles, shoulder or neck misalignment, and the compression of nerves and blood vessels.

Now we know what has caused it. What about the types?. TOS is normally differentiated into three primary categories based on the compressed structures:.

1. Neurogenic TOS: However,it is the most common type of; compression of the network of nerves, or called the brachial plexus, through which signals from the spine go to the shoulder, arm, and hand. It can has symptoms including pain, numbness, and weakness in the arm and hand.

2. Vascular TOS: The subclavian vein is compressed. This causes swelling in the arm and partial discoloration. In extreme cases, one may experience blood clot formation due to an obstruction that causes something to be sticky to the blood.

3. Arterial TOS: The rarest of all-the subclavian artery in it is compressed. Some of the symptoms include coldness in the arm, pains, and a weak pulse.

Symptoms of TOS vary between the two subtypes and levels of severity but most frequently appear as:

• Pain or ache: It felt in the neck, shoulder, or arm: it could be sharp, throbbing, aching.
• Numbness or tingling: It felt both, in the fingers or hand which can sometimes ache and may create some kind of concern for the ones experiencing them-they may certainly interfere with everyday lifestyle and even daily activities.

• Weakness: Weak grip, without being able to lift.
• Swelling: In vascular TOS, there is swelling of the arm; this is usually accompanied by heaviness.
• Coldness: In arterial TOS, the affected limb may be cooler as compared to the opposite one, with pale or bluish discoloration of the skin.

However, I should say that Understanding TOS is very important, because it will help us to know and recognize its symptoms and seek appropriate help._{There is a free book that talk much deep about TOS, click here to get your copy.}

Diagnosis of thoracic outlet syndrome usually occurs after an extensive clinical examination. In the case that a specific test or imaging studies have been applied, the final diagnosis is determined upon history and physical examination. Thus, I'd love to diagnose TOS in four ways:.

1. Patient History: Ask about the symptoms, their onset, and severity, as well as any activities that exacerbate them. Inquire about past traumatic injuries or previous medical conditions that may be contributing to TOS.

2. Physical Examination: I will perform an examination of his or her posture, neck, shoulder, and arm range of motion and strength. This will also confirm possible signs of nerve compression, which include numbness or weakness in the arm.

3. Provocation Symptoms: There are some positions or movements which may provoke symptoms, and with that, I can ask the patient to perform certain actions to see if she would reproduce it symptoms. It can help in determining what kind of TOS.

4. Symptom Observance: There should be an assessment for any swelling, discoloration, or temperature change in the affected arm, as these are sure signs of venous or arterial involvement.

While some imaging studies are generally performed-a normal X-ray of the cervical region, MRI, or ultrasound-as needed to assist in making a diagnosis for associated anatomical defects,of TOS.

_{Note:proper diagnosis by your physician is needed to devise treatment:.}

There are three particular test that can be brought to practice to detect Tos. Here are the three test:-Adson Maneuver, Halstead Maneuver and Allen or Weight Test.

Adson Maneuver

Patient has to sit with the arm at the side and the hand facing anteriorly. First thing is to Check their blood pressure. Then ask the patient to flex the neck to one side and hold it there. They are to take a deep breath and hold it. If their symptoms return, then the test is positive.

Halstead Maneuver

Sit patient down. He or she shall take radial pulse first and should then turn neck towards the other side compared with Adson test. I shall then now pull affected side of patient by the downward path. Once more, pulse needs to be rechecked and then if there exists an alteration within the movement it shall result into a positive of vascular TOS.

Allen or Wright Test

For the Allen or Wright test, the patient is instructed to sit down and elevate the arm overhead, and any alteration in color, temperature, and pulse of the wrist. These changes examine if there has been any compression on the thoracic outlet.

Some specific exercises even reduce the expressions of Thoracic Outlet Syndrome by making postures better, improving flexibility of the thoracic and strengthening muscles around the thoracic. Below are the three I learned.

1.Shoulder Shrugs

How to Do It:
Stand or sit with your arms at your sides.

• Raise your shoulders towards your ears as high as possible.
• Hold for a moment then relax and slowly return your shoulders to the original position.
• Do 10 to 15 repetitions.