The area between these two bones serves as a passage way for the subclavian artery, the subclavian vein, and the neurovascular bundle made of the brachial plexus and some smaller nerves (Surg 28). The cause of the compression varies and can include: anatomical defects, these defects are inherited defects that are present at birth may include an extra rib located above the first rib or an abnormally tight fibrous band connecting your spine to your rib. Another cause is poor postures which consist of drooping your shoulders or holding your head in a forward position can cause compression in the thoracic outlet area. Thirdly, a traumatic event, such as a car accident, can cause internal changes that then compress the nerves in the thoracic outlet. The onset of symptoms related to a traumatic accident often is delayed. And lastly, repetitive activities, over time, wear on your body’s tissue. Several occupations have been associated with TOS such as dry wall hanger or plasterer, welder, beautician, assembly line inspector, dental hygienist and a host of …show more content…
The most common type of thoracic outlet is neurogenic TOS where the brachial plexus is compressed. Some estimates 95% of all TOS are neurological in nature (Surg 28). Many of the symptoms of neurogenic TOS are similar to other nerve related repetitive stress injuries where swelling or inflammation presses on the nerve. This can send shooting pains or radiate aching throughout the affected area. When nerves are compressed, signs and symptoms of neurological thoracic outlet syndrome include; Wasting in the fleshy base of your thumb (Gilliatt- Sumer Hands); Numbness or tingling in your arm or fingers; pain or aches in your neck, shoulder or hand; and a weakening grip (Surg 29).
In Vascular TOS where either the subclavian artery or the subclavian vein are compressed symptoms are consistent with reduced blood flow such as, throbbing lump near collarbone, a blood clot under your collarbone, or a weak pulse in your arm (Watson 6). Restriction of the subclavian vein on the return side can lead to a buildup of oxygen depleted blood resulting in a blush discoloration. It can also show itself in the form of pain and swelling, as blood pressure increases from a normal supply and a reduced ability to return it to the heart causing a backup of blood in the