Thoracic Outlet Syndrome Questions

The distal section of the cervicoaxillary canal is the more critical for compression syndromes.

The brachial plexus and subclavian artery are located in the anteromedial compartment of the costoclavicular space.

The borders of the scalene triangle are the scalenus anticus, scalenus medius, and first rib.

Inspiration tilts the coracoid process inferiorly, placing tension on the neurovascular bundle.

Bony abnormalities are present in the majority of patients.

Question 2: Which of the following statements is true regarding symptoms of thoracic outlet syndrome?

Vascular signs are more common than neurologic signs.

Pain and paresthesias are present in over 90% of patients.

Neurogenic symptoms most commonly occur along the median nerve distribution.

The onset of symptoms is characteristically sudden and occurs after trauma.

Raynaud's phenomenon presents as bilateral, symmetric blanching of fingers followed by cyanosis and rubor.

Question 3: Which of the following statements is true regarding the diagnosis of thoracic outlet syndrome?

The Adson test is positive when the radial pulse is diminished after arm hyperabduction.

A cervical rib is best identified using cervical CT scanning.

A nerve conduction velocity above 60 m/sec is normal.

Decreased velocity across the elbow indicates ulnar nerve entrapment rather than thoracic outlet syndrome.

Peripheral angiography should be performed in all cases to exclude subclavian artery stenosis.

Question 4: Which of the following statements is true regarding treatment of thoracic outlet syndrome?

Patients with a conduction velocity greater than 60 m/sec generally improve with conservative management.

Both insertions of the scalenus anticus and scalenus medius should be divided during transaxillary rib resection.

A short posterior segment of the first rib should be retained to maintain stability of the triangle.

Recurrent thoracic outlet syndrome is uncommon and usually occurs more than one year after operation.

Reoperation should be performed through a transaxillary approach in order to prevent brachial plexus injury.