什麼是胸廓出口症候群? 簡單的來說，供應上肢的神經與血管都必須經過胸廓(thoracic outlet)部位才會進入上肢。一但這部位受到壓迫就會連帶引起神經與血管的類似症狀。最常見的抱怨包括手臂酸、麻、痛、手部冰冷、感覺沉重…等等。患者可能會描述：“我覺得我的手在睡覺，感覺似乎不是我自己的手。老是得常常甩甩手來叫醒它！”少部分有嚴重壓迫血管的患者可能會有上肢顏色變化(變白或變紫)。
臨床上最常發生胸廓出口症候群的人包括車禍患者、經常需要舉手工作的人(畫家、老師、修車技工、油漆工…等)、經常需要抬手過頭運動的運動員(如：棒球、游泳、排球、網球選手…等)或經常久坐辦公桌的電腦族。這些族群因為急性受傷或慢性重複性傷害的關係，大多有著頸肩部位肌肉過於僵硬的問題。另外骨架較為瘦小的女性由於天生鎖骨與肋骨之間的空間較小，更容易因為肩頸肌肉稍微緊繃而產生症狀。
Thoracic outlet syndrome (TOS) can be defined as a compression of the neurovascular bundle as it passes between the neck and axilla. Common compression points are between the anterior and middle scalene, between the first rib and clavicle, underneath the pectoralis minor, or potentially the presence of an extra cervical rib. Patients with thoracic outlet syndrome typically present with forward, rounded shoulders and a history of repetitive overhead motion.
Both the neural and vascular structures can become compromised, but >95% of all cases are neurogenic.*
If you are suspecting a patient with neurogenic TOS cluster your TOS tests results with other neuro-dynamic tests.
Thoracic Outlet Syndrome Tests
Adson's Test
Costoclavicular Brace Test
Hyperabduction Test
Roos Test
Thoracic Outlet Tests - The Student Physical Therapist - http://bit.ly/1ww2S75
我的手在睡覺-談胸廓出口症候群 - 台灣凱羅健康協會 - http://goo.gl/1M7snr
