NMS
7/19/99
TOS
- Is a
neuropathy
- Lower
motor neuron lesion
- Cervical
examination is negative—doesn't reproduce symptoms
- Scalenus
anticus Syndrome
- Entrapment
of neurovascular bundle b/w anterior and medial scalene
- Adson's
test
- Turn
head ipsilateral
- Extend
head
- Take
a deep breath—use accessory muscles
- Take
pulse—see if it diminishes
- Wait
for hand to go numb
- Muscle
stretching
- Cervical
adjusting
- Clavicle
adjusting
- Hyperabduction
test
- Arm
up over head
- Head
turned away
- Take
pulse
- Radiculopathy—relief
of traction
- TOS—no
relief on traction
- Poke
around in the periphery can reproduce the symptoms
- Rule
of thumb—if cervical, c/c is pain and restricted motion—if TOS, limited to
nonexistent pain, more complain of numbness and tingling
- Heaviness=weakness
of muscles
- Numbness
is a layman's term; it does not mean anesthesia
- In TOS
the nerves are not damaged
- Ask pt
what they can do to bring on the symptoms
|
|
Pressure on
|
Pressure off
|
Digital movement
|
|
Peripheral nerve
|
Numbness
|
Paresthetic tingling
|
Increase tingling
|
|
Nerve root
|
Pain
|
Relief
|
No change
|