Steemit Learning Challenge-S22W6; Thoracic Outlet Syndrome" by @rossnenye

Hello everyone, good evening to you all and welcome back to my blog.

What's a thoracic outlet syndrome? Write in your own words after getting knowledge from the lesson post.

Thoracic Outlet Syndrome (TOS) Is a type of Medical Condition that occurs when there is compression of the nerves or Vascular structures that passes through or over the superior rim of the Thoracic cage. It can also be referred to other names based on the site Involvement or Neurovascular compression like Cervical Rib, First Thoracic Rib, Hyper abduction syndromes and Costco clavicular.

Causes of Thoracic Outlet Syndrome (TOS)

• Occupational activities
  Constant occupational activities like carrying heavy loads that involves repetition of arm movements.

• Acute Trauma/Injury
  Injuries like Whiplash Injury that occurs in road Accidents and occurs in hyperflexion or hyperextension of the cervical region.

• Compression
  Compression of any structure in the neck and shoulder area.

• History of such Injury in the past and result again.

• Sports
  It can also occur as a result of sports activities like swimming, baseball, volleyball.

• Poor posture
  It can also occur as a result of bad posture like sleeping with arm elevated overhead.

Symptoms of Thoracic Outlet Syndrome (TOS)

TOS Is characterised by Vascular and Neuropathic signs and symptoms and they includes the following.

Vascular

• Appearance of bluish hand
  This is as a result of abnormal blood flow to the hand or arm especially in overhead activities.

• Cold and heaviness in arm and hands
  Coldness and heaviness which occurs in the hand and arm while performing exercises as a result of poor blood.

• Puffiness or swelling
  Swelling or puffiness occurs sometimes in the axilla, clavicle, arm or hand region.

• Fatigue
  The patient also feels weakness and tiredness.

Neuropathic

• The patient feels pain in the Ulnar nerve distribution patter.

• There is Muscle wasting or atrophy in hand, and there is difficulty in doing the fine motor activities.

• There is also tingling and numbness sensation in the Medial side or Ulnar nerve.

Types of Thoracic Outlet Syndrome (TOS)

They're three types of TOS based on structures involvement and they includes the following.

• Vascular TOS
  This type of Vascular structures has to do with the subclavian artery and vein which comprises the blood supply to the neck, arm and hand.

• Neurogenic TOS
  In this type, Nerves of Brachial plexus especially Ulnar nerve and others that results to tingling, numbness sensation in the shoulder, axilla arm and hand.

• Mixed TOS
  In this type, the Neurovascular structures involves both the Nerves and blood vessels. Or it can be referred to as the combination of Vascular and Neurogenic type of TOS.

How would you diagnose a thoracic outlet syndrome? Any clinical investigation or assessment tests?

Thoracic Outlet Syndrome diagnosis involves lots of procedures and some of them includes the following.

• Patient History
  The patient would be asked when he started noticing this pain and for how long. He would also be asked the part of the Shoulder and Neck his feeling the pain. He would also be asked if he has been engaging in repetitive use of the arm, especially the shoulder or overhead activities like constant carrying of heavy loads that can trigger this Medical Condition. He would also be asked if he had any previous Injury or Trauma, surgery that can trigger this Medical Condition.

The patient will also be asked about his occupation, family and past medical history.

• Physical examination
  Physical examination will be conducted by the Therapist or Doctor on the Patient inorder to help find out any symptoms that would trigger TOS.

• EMG and NCS will also be performed inorder to
  assess nerve damage and muscle strength.

Imaging test

The following imaging test can be conducted to diagnose TOS.

• X-ray
  This test makes use of electromagnetic radiation to create pictures of the inner body, inorder to show structural abnormalities like
  arthritis, tendon ruptures, muscle damage, and
  narrowed thoracic Outlet that can cause TOS.

• MRI(Magnetic Resonance Imaging)
  This test makes use of radio and magnetic field to show images of the soft tissues inorder to find out any irregularities like arthritis, tendon ruptures, and muscle damage,
  that can cause TOS.

• Ultrasound
  This test makes use of sound waves to show images of the inner body, inorder to identify any abnormalities like arthritis, tendon ruptures, and muscle damage, that can cause TOS.

Special Tests

• Adson Maneuver
  
  This is the test performed by patient in sitting position, arm at his/her side, face forward, measure the BP before performing test, the patient is asked to turn his head/neck, head and neck are in extended position. Ask patient to deep breath or hold the breath of symptoms reproduce then test is positive.

• Halstead Maneuver
  
  This is the test performed by patient in sitting position, measure the radial pulse before test, making the above test position just rotates head to opposite side, the therapist applies a downward and traction force site involved. Assess the radial pulse if there is change in rhythm then vascular TOS is positive.

• Allen or Weight Test
  
  This test is performed on patient in sitting position, hyperabduction at shoulder joint. Observe the changes in skin color, temperate, also radial pulse to see any changes in rhythm.
  Physical Therapy Intervention for Thoracic.

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.

Before performing this exercises, I first of all applied a soft tissue mobilization using a soft tower moisturized with warm water to massage my shoulder region inorder to relax my shoulder Tendon and muscle and to avoid pain.

• Shoulder Shrugs
  https://youtube.com/shorts/2yVwYTz0mQA?si=7ic1pCGyXua4UQ_-
  Shoulder shrugging, this exercise is necessary to improve the posture, relieve tension of shoulder, strengthen the trapezoius muscles, and improve scapula mobility. It is advisable to perform this exercise when you feel weakness or heaviness in the shoulder region.

• Shoulder External Rotation
  https://youtube.com/shorts/AEWxapQ6FZ8?si=vEmBBVgB5WFwOitf
  Whenever there is shoulder and neck muscles involvement, there is limited ROM of shoulder and neck. External Rotation is necessary in completion of ADL's and to strengthen the muscles around axillary region.

• Straight Arm Shoulder Extension
  https://youtube.com/shorts/E8btpTok9d0?si=5hXBGzsafvQXej5x
  Most of the times in thoracic outlet syndrome, shoulder ROM reduce extension especially due to muscle weakness or vascular involvement. So, to improve shoulder extension, ROM exercise is perform either band or fabric for better extension & muscle stretch.

Share your review after performing these exercises either on yourself, a healthy individual or a patient.

As a healthy person who does not have any issues, I didn't feel pain while performing the exercises because I first of applied a soft tissue mobilization. After performing the following exercises, I felt my Shoulder, Neck and Arm muscles stretched and overall I love how the feeling it gave me.

Thanks for reading my post, I invite @adachukwu, @vudeme and @ukpono to participate in this contest.
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@ashkhan