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level: Slides 98-105 (Anterior scalene syndrome)

Questions and Answers List

level questions: Slides 98-105 (Anterior scalene syndrome)

Question	Answer
What is the main job of the scalene muscles?	Tilting the head.
What 3 anatomical features make up the Anterior Scalene Triangle?	Scalenus medius, scalenus anterior and the 1st rib.
Which feature is a typical problematic area of Thoracic Outlet Syndrome, but less often part Anterior Scalene Syndrome?	The Subclavian Vein. The subclavian vein is not restricted by the Anterior Scalene Triangle, as it exists medially to the triangle. For the vein to be affected, the costoclavicular ligament would likely have to be inflamed as well, or the clavicle itself could be restricted/displaced.
The ______ cord of the plexus (inner part of the triangle) is most vulnerable to compression. ______ nerve symptoms are experienced as C8 & T1 make up this cord.	Medial, Ulnar.
Scalene trigger points will refer pain to the lateral shoulder, lower lateral neck and arm. These trigger points are activated by what?	Carrying/listing (leaning) and over use of respiratory muscles (paradoxical breathing or extreme coughing from bronchitis, pneumonia, asthma & emphysema).
Costoclavicular syndrome and Anterior Scalene Syndrome differ in what way?	Costoclavicular syndrome differs from anterior scalene syndrome in that, vascular compression plays a larger role.
Is Anterior Scalene Syndrome more often related to nervous or vascular issues?	Nervous. This typically presents with ulnar pain.
The space varies and narrows on abduction of the arm, retraction of the scapular & elevation of first rib on inhalation. A h____tonic subclavius muscle can also contribute to the narrowing of this space.	(h)yper(tonic). A more active person would be more likely to have muscle hypertonicity.
Venous insufficiency can cause numbness, similar to a pinched nerve, which is why numbness in which two fingers is often found in both Costoclavicular Syndrome and Anterior Scalene Syndrome?	Fourth and fifth (ring fingers and pinkies).
Thoracic Outlet Syndrome can be caused by crutches pushing on the armpit (where the neurovascular issues happen). Do crutches impact the pectoralis muscles in Pectoralis Minor Syndrome?	The pectoralis minor inserts on the humerus, in the area of the rotator cuff, and originates on the clavicle, directly over the Thoracic Outlet... therefore the answer is YES.
While Thoracic Outlet Syndrome, Anterior Scalene Syndrome and Costoclavicular Syndrome are all often caused by lifting, Pectoralis Minor Syndrome is caused by...	Holding the arm (biceps) up, particularly overhead. I.e. Painting, sleeping or playing an instrument – violin or flute. Or passively held when sleeping
Which is this true for? With a neuronal compression parathesia & hyperparathesia such as numbness & tingling are primarily on the ulnar side of the hand, especially in the fingers and possibly the forearm (C8-T1 nerves mainly affected). Costoclavicular Syndrome, Anterior Scalene Syndrome, Pectoralis Minor Syndrome, or a combination of which of the 3?	Correct answer is all 3.
Can trigger points in the scalene be related to Pectoralis Minor Syndrome OR are they only limited to Anterior Scalene Syndrome?	Yes, they are common in Pectoralis Minor Syndrome (but are almost always part of Anterior SS).
Is this true of Pectoralis Minor Syndrome? Read carefully. Diffuse aching or throbbing pain is often experienced in the upper limb, predominantly the shoulder, and in the forearm and hand. Less frequently pain may occur in the neck or chest, or as a headache on the side of the head.	Yes.
What is this area properly called?	Brachial Plexus.
True or False: In Pectoralis Minor Syndrome, trigger points are usually present and refer down the arm form the scalenes, pec minor and subclavius. This referral will overlap with brachial plexus symptoms.	True
Pectoralis Minor Syndrome is primarily (vascular OR nervous) in nature.	Vascular.
Which generally causes more "coldness" in a limb? Nervous or vascular compromise?	Vascular
If Pectoralis Minor Syndrome is vascular in nature, in that blood flow is restricted, can swelling appear in the hands?	Yes. In fact, it's a known symptom.
True or False: In extreme cases of Pectoralis Minor Syndrome, it may result in painful emboli or gangrene in the tips of the toes as well as trophic changes in the nails & skin	False, as Pectoralis Minor Syndrome does NOT affect the TOES. This statement WOULD be true, were it about the fingers.