im sure this has been posted but
http://www.tosinfo.com/
The terms neurogenic and neurovascular are misconceptions. They are clinical terms. Nerves DO have a blood supply! (arteries, veins, and lymphatics)1 Image the artery and you image the nerve that binds to the artery for its nutrient blood supply. Research shows, compressing a nerve also compresses the blood supply.
Laxity of the sling/erector muscles of the shoulder girdle causes costoclavicular compression2. Costoclavicular compression is compression of the bicuspid valves within the draining veins of the neck, supraclavicular fossa with lymphatics, that diminishes the blood supply to and from the brachial plexus and the rest of the circulatory system. Any decrease in venous return diverts venous and lymphatic flow expanding soft tissues that increases intrathoracic, intracranial, and intraabdominal pressure that triggers TOS complaints3,4......................
Thoracic Outlet Syndrome patients display forward rotated shoulders that increases the slope of the first ribs, backwardly displacing the manubrium, posterior right and/or left that crimps the great vessels (like a water hose)7. Crimping diminishes nutrient arterial, venous, and lymphatic circulation to the five senses (hearing, sight, smell, taste, touch) that triggers patient's complaints.
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474.4
Backwards displacement of the manubrium causes crimping of the great vessels in patients with thoracic outlet syndrome (TOS): MRI/MRA/MRV
James D. Collins1, Ernestina H. Saxton2, Samuel S. Ahn3, Hugh Gelabert3 and Alfred Carnes1
1 Radiological Sciences
2 Neurology
3 Vascular Surgery, UCLA, Los Angeles, CA
ABSTRACT
Rounding of the shoulders increases the slope of the first ribs and asymmetrically displaces the manubrium posteriorly. This compresses the retrosternal fat with the involuted thymus gland and the left brachiocephalic vein against the brachiocephalic trunk. This displaces the aorta posteriorly and crimps (like a water hose) the great vessels: right brachiocephalic vein with the superior vena cava, common carotid arteries, subclavian arteries with binding nerve roots and vertebral arteries. Bilateral MRI/MRA/MRV displays costoclavicular compression and crimping of the great vessels that trigger complaints of TOS: facial, back and upper and lower extremity pain; numbness, tingling and edema; visual blurring and "floaters"; syncope and headache (FASEB 2003; 17:A784). Monitored multiplanar images with abduction external rotation, 2D Time of Flight MRA/MRV without contrast, were acquired on a 1.5 Tesla GE Signa LX unit, 44 cm field of view, 521 x 256 matrix and saline water bags to enhance signal to noise ratio. Two patients were selected, one following acute trauma, the other with repetitive strain injury. The second patient was misdiagnosed and underwent acromioclavicular joint surgery with a resultant unstable joint. Both patients developed laxity of the sling/erector muscles and round shoulders. Both displayed crimping of the great vessels and costoclavicular compression with TOS symptoms.
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"Cyriax release test" & more -PDF - good PT info pages
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