After taking vitals, palpation, and cervical ROM, which physical examination would you MOST LIKELY perform to assess thoracic outlet syndrome?

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Multiple Choice

After taking vitals, palpation, and cervical ROM, which physical examination would you MOST LIKELY perform to assess thoracic outlet syndrome?

Thoracic outlet syndrome is tested with provocative maneuvers that recreate the space-occupying pressure at the outlet where the neurovascular bundle passes. The Roos test does this by having the arms raised and externally rotated with the elbows flexed at 90 degrees, and then the patient repeatedly opens and closes the fists for several minutes. This position compresses the structures between the clavicle and first rib and through the scalene/pectoralis minor areas, so if neurovascular symptoms such as numbness, weakness, fatigue, or color changes occur, it supports a TOS finding. The other tests target different conditions: Allens test mainly screens arterial patency in the hand, Phalen test is used for carpal tunnel (median nerve at the wrist), and Spurling test assesses cervical nerve-root compression. So the Roos maneuver is the most appropriate exam to assess thoracic outlet syndrome.

Thoracic outlet syndrome is tested with provocative maneuvers that recreate the space-occupying pressure at the outlet where the neurovascular bundle passes. The Roos test does this by having the arms raised and externally rotated with the elbows flexed at 90 degrees, and then the patient repeatedly opens and closes the fists for several minutes. This position compresses the structures between the clavicle and first rib and through the scalene/pectoralis minor areas, so if neurovascular symptoms such as numbness, weakness, fatigue, or color changes occur, it supports a TOS finding.

The other tests target different conditions: Allens test mainly screens arterial patency in the hand, Phalen test is used for carpal tunnel (median nerve at the wrist), and Spurling test assesses cervical nerve-root compression. So the Roos maneuver is the most appropriate exam to assess thoracic outlet syndrome.

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