Blood vessels and nerves exiting the thorax at the axilla may be compressed, resulting in a thoracic outlet syndrome.


NOTE: The term "thoracic outlet syndrome" is also used for structures entering or leaving the thorax at the neck.


Causes of the compression:

(1) congenital cervical rib

(2) trauma

(3) tumor


Clinical features:

(1) pain (see below)

(2) paresthesias

(3) fatigability in the arm

(4) vascular changes (coldness, color change, Raynaud's syndrome), especially when caused by a change in arm position

(5) brachial plexus tenderness to palpation

(6) sensory and/or motor deficits in the upper extremity


Location of Pain and Paresthesias

Nerve Roots

Site of Compression

shoulder, neck and radial aspect of arm and forearm

C5 and C6

upper brachial plexus

ulnar aspect of arm and forearm

C8 and T1

lower brachial plexus


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