Presentation on
Thoracic Outlet Syndrome
by
Dr James Stoxen DC
Dr James Stoxen's bio
Presented at the
12th Annual World Congress on Anti-aging Medicine
Mandalay Bay Hotel and Casino, Las Vegas Nevada
December 4, 2004
A presentation of the most effective diagnosis, treatment and prevention of
Thoracic Outlet Syndrome (TOS)
Chapter II of IX
Anatomy of Thoracic Outlet Syndrome
Three Areas of Compression
Thoracic Outlet Syndrome – Three Potential Areas of Compression
Thoracic outlet syndrome is the often misdiagnosed cause of neck, shoulder pain and arm disability. It is thought to be neurovascular compression seen at the thoracic outlet, which is something that anatomists can’t agree on. The actual name doesn’t properly describe the condition. It consists of 3 areas of potential regions of compression consisting of:
- The Intrascalene Triangle
- The Costoclavicular Space
- The Intrapectoral Space
The Intrascalene Triangle
This is bordered by the anterior and middle scalenes. The supraclavicular bundle consisting of the subclavian vein, the subclavian artery and the brachial plexus emanate from this triangle and it’s an area where any one of these structures can become compressed and cause symptomatology.
The Costoclavicular Space
The area below the clavicle and above the first rib represents the costoclavicular space. Few patients and doctors understand that the ribs actually go up this high at the face of the neck.
The Intrapectoral Space
The last space is the intrapectoral space and that is in the area of pectoralis minor and that area can be an area of compression.
Arteries, Veins and Nerves pass through the Thoracic Outlet
Doctors have to be aware of these multiple areas of compression and have an understanding of what symptoms can be related to each one of these areas so they can better treat the patient. The three neurovascular structures that pass through the thoracic outlet area are the brachial plexus consisting of cervical nerves C5, C6, C7, C8 and T1. The subclavian artery is the artery that supplies the arm with blood, oxygen and nutrients. The subclavian vein drains the blood away from the arm and back to the heart.
Table of Contents Return...
Chapter I Dr Stoxen's Introduction Read it here...
Chapter II Anatomy of Thoracic Outlet Syndrome Read it here...
Chapter III Thoracic Outlet Syndrome Controversy Read it here...
Chapter IV History or Patient Presentation Read it here...
Chapter V Physical Examination Findings Read it here...
Chapter VI Diagnostic Tests for TOS Read it here...
Chapter VII Treatment of Thoracic Outlet Syndrome Read it here...
Chapter IX Case Histories of Patients with TOS
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