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    The Thoracic Outlet Syndrome, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    The Thoracic Outlet Syndrome, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    The Thoracic Outlet Syndrome, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Ebook151 pages1 hour

    The Thoracic Outlet Syndrome, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

    By Kenneth Kee

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    About this ebook

    This book describes The Thoracic Outlet Syndrome, Diagnosis and Treatment and Related Diseases

    Thoracic outlet syndrome (TOS) is a complex medical disorder featured by different neurovascular signs and symptoms of the upper limb due to injury in the cervicothoracobrachial region.

    “Thoracic outlet syndrome (TOS)” is the term applied to depict a group of disorders that happen when there is compression, injury, or irritation of the nerves and blood vessels (arteries and veins) in the lower neck and upper chest area as they exit through the thoracic outlet.

    TOS is an umbrella term that comprises 3 related syndromes that involve compression of the nerves, arteries, and veins in the thoracic outlet and cause pain in the arm, shoulder, and neck.

    There are 3 types of thoracic outlet syndrome:

    1. Neurogenic: Affects nerves leading from the spinal cord to the neck to the arm.
    Majority of thoracic outlet syndrome cases involve nerves.

    2. Venous: Affects veins

    3. Arterial: Affects arteries

    About 95% of thoracic outlet syndrome cases affect the brachial nerves.

    It is infrequent but more serious when it involves a vein or an artery.

    It is 3-4 times as frequent in woman as in men between the age of 20 and 50 years.

    Females have a lesser amount of developed muscles, a higher likelihood for drooping shoulders due to extra breast tissue, a narrowed thoracic outlet and a structural lower sternum

    These factors alter the angle between the scalene muscles and consequently cause a higher incidence in women.

    There are many causes of thoracic outlet syndrome such as physical trauma, structural defects, tumors that compress nerves, poor posture that induces nerve compression, pregnancy, and repetitive arm and shoulder movements and activity, such as from playing certain sports.

    The symptoms are:
    1. Pain in the neck, shoulder, or arm
    2. Numbness and tingling
    3. Swelling
    4. Weakness
    5. Discoloration -- blue, red, or pale
    6. Cold hands

    The TOS related disorders are:
    1. Carpal tunnel syndrome
    2. Peripheral neuropathies (like ulnar nerve entrapment at the elbow, shoulder tendinitis and impingement syndrome)
    3. Fibromyalgia of the shoulder and neck muscles
    4. Cervical disc disease (like cervical spondylosis and herniated cervical disk)

    The diagnosis of TOS is essentially based on the medical history, physical examination, provocative tests, and ultrasound, radiological evaluation and electrodiagnostic evaluation.

    The disorder can occasionally be diagnosed in a physical examination by tenderness in the supra-clavicular area, weakness and a "pins and needles" sensation when raising the hands, weakness in the fifth finger, and paleness in the palm of one or both hands when the person raises them above the shoulders, with the fingers pointing to the ceiling.

    Doctors normally advise nerve conduction studies, electromyography, or imaging studies to confirm or exclude a diagnosis of TOS.

    The treatment starts with exercise programs and the physical therapy to strengthen chest muscles, restore normal posture, and alleviate compression by raising the space of the area the nerve passes through.

    Doctors will often give non-steroidal anti-inflammatory drugs (naproxen or ibuprofen) for pain.

    Other medicines are thromobolytics to break up blood clots and anticoagulants to stop clots.

    If this does not relieve pain, a doctor may advise thoracic outlet decompression surgery to release or eliminate the structures causing compression of the nerve or artery.

    Thrombolytic medicines are given to dissolve blood clots before surgery.

    The majority of persons with TOS will improve with exercise and physical therapy

    TABLE OF CONTENT
    Introduction
    Chapter 1 Thoracic Outlet Syndrome
    Chapter 2 Causes
    Chapter 3 Symptoms
    Chapter 4 Diagnosis
    Chapter 5 Treatment
    Chapter 6

    LanguageEnglish
    PublisherKenneth Kee
    Release dateDec 28, 2019
    ISBN9780463359181
    The Thoracic Outlet Syndrome, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Author

    Kenneth Kee

    Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

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      Book preview

      The Thoracic Outlet Syndrome, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions - Kenneth Kee

      The Thoracic Outlet Syndrome,

      A

      Simple

      Guide

      To

      The Condition,

      Diagnosis,

      Treatment

      And

      Related Conditions

      By

      Dr Kenneth Kee

      M.B.,B.S. (Singapore)

      Ph.D (Healthcare Administration)

      Copyright Kenneth Kee 2019 Smashwords edition

      Published by Kenneth Kee at Smashwords.com

      Dedication

      This book is dedicated

      To my wife Dorothy

      And my children

      Carolyn, Grace

      And Kelvin

      This book describes the Thoracic Outlet Syndrome, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

      (What You Need to Treat the Thoracic Outlet Syndrome)

      This e-Book is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

      If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

      Thank you for respecting the hard work of this author.

      Introduction

      I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

      My purpose in writing these simple guides was for the health education of my patients.

      Health Education was also my dissertation for my Ph.D (Healthcare Administration).

      I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.

      This autobiography account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

      From which many free articles from the blog was taken and put together into 800 eBooks.

      Some people have complained that the simple guides are too simple.

      For their information they are made simple in order to educate the patients.

      The later books go into more details of medical disorders.

      The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

      Since 2013, I have tried to improve my spelling and writing.

      As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

      Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

      I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

      I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

      I apologize if these repetitions are irritating to some readers.

      Chapter 1

      The Thoracic outlet syndrome

      What is the thoracic outlet syndrome?

      Thoracic outlet syndrome (TOS) is a complex medical disorder featured by different neurovascular signs and symptoms of the upper limb due to injury in the cervicothoracobrachial region.

      Thoracic outlet syndrome (TOS) is the term applied to depict a group of disorders that happen when there is compression, injury, or irritation of the nerves and blood vessels (arteries and veins) in the lower neck and upper chest area as they exit through the thoracic outlet.

      TOS is an umbrella term that comprises 3 related syndromes that involve compression of the nerves, arteries, and veins in the thoracic outlet and cause pain in the arm, shoulder, and neck.

      There are 3 types of thoracic outlet syndrome:

      1. Neurogenic: Affects nerves leading from the spinal cord to the neck to the arm.

      Majority of thoracic outlet syndrome cases involve nerves.

      2. Venous: Affects veins

      3. Arterial: Affects arteries

      About 95% of thoracic outlet syndrome cases affect the brachial nerves.

      It is infrequent but more serious when it involves a vein or an artery.

      Incidence

      TOS affects about 8% of the population

      It is 3-4 times as frequent in woman as in men between the age of 20 and 50 years.

      Females have a lesser amount of developed muscles, a higher likelihood for drooping shoulders due to extra breast tissue, a narrowed thoracic outlet and a structural lower sternum

      These factors alter the angle between the scalene muscles and consequently cause a higher incidence in women.

      The start of symptoms normally happens between 20 and 50 years of age.

      The mean age of people affected with TOS is 30s-40s

      It is rarely seen in children.

      But it can involve anyone.

      Almost all cases of TOS (95-98%) involve the brachial plexus; the other 2-5% involving the vascular structures such as the sub-clavian artery and vein.

      It is also often observed in athletes and workers who make repeated arm motions.

      What is the Causes of Thoracic outlet syndrome?

      Causes

      There are many causes of thoracic outlet syndrome such as physical trauma, structural defects, tumors that compress nerves, poor posture that induces nerve compression, pregnancy, and repetitive arm and shoulder movements and activity, such as from playing certain sports.

      The main causes are:

      1. Trauma:

      Whiplash, a broken collarbone, or other trauma can leave scar tissue and inflammation.

      2. Poor posture:

      When the shoulders slump, the collarbones can move out of place and press on the nerves.

      Weak shoulder muscles can cause bad posture.

      3. Repetitive stress:

      It can affect people who move their arms in a certain way, like swimmers, volleyball players, and baseball pitchers.

      4. Physical defects:

      Some people are born with an extra cervical rib or a thoracic outlet that is

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