Don't sweat the technique
Mom look at my chest!
Well, there's your problem
TOS Basics
P.S.
100
The preferred surgical approach for neurogenic TOS
What is transaxillary first rib resection?
100
Poland anomaly occurs more commonly on this side
What is the right?
100
The most common anterior chest wall anomaly
What is pectus excavatum?
100
This structure is (almost) always involved in thoracic outlet syndrome
What is the first rib?
100
This is another name for Paget-Schroetter syndrome
What is effort thrombosis?
200
The anterior scalene is divided at this attachment to the first rib
What is the scalene tubercle?
200
A defect in mesodermal growth in the upper quadrant of the fetus
What is Poland syndrome?
200
school aged children, teenagers, and young adults most often seek evaluation of pectus excavatum for this symptom
What is exercise intolerance/endurance issues?
200
The three variants of thoracic outlet syndrome
What are: Neurogenic Venous Arterial
200
Paget-Scroetter syndrome involves thrombosis of this vessel
What is the subclavian (axillary) vein?
300
When dividing the anterior scalene muscle care is taken to avoid injury to this nerve
What is the phrenic nerve?
300
indications for repair of pectus excavatum (name 3)
What are: symptomatic (exercise, endurance) Caliper measurement > 2.5 Haller index > 3 Evidence of heart/lung compromise Below normal or low normal FVC, FEV1, max vent volume Body image issues pain exercise induced asthma Echo - compression of RA, RV
300
maximal transverse diameter of chest/narrowest AP length of the chest
What is the Haller index?
300
The borders of the scalene triangle
What are: Anterior scalene muscle (anterior border) Middle scalene muscle (posterior border) Superior border of the first rib
300
These anatomic structures can contribute to venous compression in Paget-Schroetter syndrome (name 2)
What are: first rib clavicle subclavius muscle costocoracoid ligament Anterior scalene muscle costoclavicular ligament
400
Care must be taken to avoid these nerves when performing a transaxillary first rib resection (name 2)
What are: Thoracodorsal nerve Long thoracic nerve Phrenic nerve intercostalbrachial cutaneous nerve
400
Marked enlargement of the second coastal cartilages with heaping up of these cartilages and the sterno-manubrial joint
What is Pouter chest? (a form of pectus carinatum)
400
cardiac valve abnormality commonly seen in patients with pectus excavatum
What is mitral valve prolapse?
400
The distribution of the 3 variants of thoracic outlet syndrome (percentage)
What are: Neurogenic - 95% Venous - 4-5% Arterial - ~1%
400
The treatment for the acute phase of Paget-Schroetter syndrome usually involves
What is catheter directed thrombolysis?
500
Neurolysis of these nerve roots is included in transaxillary rib resection
What is C7, C8, T1?
500
Pectus excavatum most typically involves
What is the lower sternum and costal cartilages 4-7?
500
Patients with pectus excavatum should also be evaluated for this
What is connective tissue disorder?
500
Urschel's sign
What is a prominent net of dilated collateral subcutaneous veins across the shoulder and upper arm?
500
The appropriate treatment sequence for failed thrombolysis in patients with Paget-Schroetter syndrome
What is open thrombectomy and TOS decompression during the same admission? (versus long term Coumadin if operation not desired)
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