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Veins are blood vessels in the circulatory system of humans and most other animals that carry blood toward the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are those of the pulmonary and fetal circulations which carry oxygenated blood to the heart. In the systemic circulation arteries carry oxygenated blood away from the heart, and veins return deoxygenated blood to the heart, in the deep veins.
The median nerve is a nerve in humans and other animals in the upper limb. It is one of the five main nerves originating from the brachial plexus.
The long thoracic nerve is a branch of the brachial plexus derived from cervical nerves C5-C7 that innervates the serratus anterior muscle.
In human anatomy, the subclavian arteries are paired major arteries of the upper thorax, below the clavicle. They receive blood from the aortic arch. The left subclavian artery supplies blood to the left arm and the right subclavian artery supplies blood to the right arm, with some branches supplying the head and thorax. On the left side of the body, the subclavian comes directly off the aortic arch, while on the right side it arises from the relatively short brachiocephalic artery when it bifurcates into the subclavian and the right common carotid artery.
The pectoralis major is a thick, fan-shaped or triangular convergent muscle of the human chest. It makes up the bulk of the chest muscles and lies under the breast. Beneath the pectoralis major is the pectoralis minor muscle.
Thoracic outlet syndrome (TOS) is a condition in which there is compression of the nerves, arteries, or veins in the superior thoracic aperture, the passageway from the lower neck to the armpit, also known as the thoracic outlet. There are three main types: neurogenic, venous, and arterial. The neurogenic type is the most common and presents with pain, weakness, paraesthesia, and occasionally loss of muscle at the base of the thumb. The venous type results in swelling, pain, and possibly a bluish coloration of the arm. The arterial type results in pain, coldness, and pallor of the arm.
A Pancoast tumor is a tumor of the apex of the lung. It is a type of lung cancer defined primarily by its location situated at the top end of either the right or left lung. It typically spreads to nearby tissues such as the ribs and vertebrae. Most Pancoast tumors are non-small-cell lung cancers.
Adson's sign is the loss of the radial pulse in the arm by rotating head to the ipsilateral side with extended neck following deep inspiration.
Piriformis syndrome is a condition which is believed to result from compression of the sciatic nerve by the piriformis muscle. The largest and most bulky nerve in the human body is the sciatic nerve. Starting at its origin it is 2 cm wide and 0.5 cm thick. The sciatic nerve forms the roots of L4-S3 segments of the lumbosacral plexus. The nerve will pass inferiorly to the piriformis muscle, in the direction of the lower limb where it divides into common tibial and fibular nerves. Symptoms may include pain and numbness in the buttocks and down the leg. Often symptoms are worsened with sitting or running.
Klumpke's paralysis is a variety of partial palsy of the lower roots of the brachial plexus. The brachial plexus is a network of spinal nerves that originates in the back of the neck, extends through the axilla (armpit), and gives rise to nerves to the upper limb. The paralytic condition is named after Augusta Déjerine-Klumpke.
Paget–Schroetter disease is a form of upper extremity deep vein thrombosis (DVT), a medical condition in which blood clots form in the deep veins of the arms. These DVTs typically occur in the axillary and/or subclavian veins.
A brachial plexus injury (BPI), also known as brachial plexus lesion, is an injury to the brachial plexus, the network of nerves that conducts signals from the spinal cord to the shoulder, arm and hand. These nerves originate in the fifth, sixth, seventh and eighth cervical (C5–C8), and first thoracic (T1) spinal nerves, and innervate the muscles and skin of the chest, shoulder, arm and hand.
The medial pectoral nerve is (typically) a branch of the medial cord of the brachial plexus and is derived from spinal nerve roots C8-T1. It provides motor innervation to the pectoralis minor muscle, and the lower half of the pectoralis major muscle. It runs along the inferior border of the pectoralis minor muscle.
May–Thurner syndrome (MTS), also known as the iliac vein compression syndrome, is a condition in which compression of the common venous outflow tract of the left lower extremity may cause discomfort, swelling, pain or iliofemoral deep vein thrombosis.
Subclavian steal syndrome (SSS), also called subclavian steal steno-occlusive disease, is a constellation of signs and symptoms that arise from retrograde (reversed) blood flow in the vertebral artery or the internal thoracic artery, due to a proximal stenosis (narrowing) and/or occlusion of the subclavian artery. This flow reversal is called the subclavian steal or subclavian steal phenomenon, regardless of signs/symptoms being present. The arm may be supplied by blood flowing in a retrograde direction down the vertebral artery at the expense of the vertebrobasilar circulation. It is more severe than typical vertebrobasilar insufficiency.
The popliteal artery entrapment syndrome (PAES) is an uncommon pathology that occurs when the popliteal artery is compressed by the surrounding popliteal fossa myofascial structures. This results in claudication and chronic leg ischemia. This condition mainly occurs more in young athletes than in the elderlies. Elderlies, who present with similar symptoms, are more likely to be diagnosed with peripheral artery disease with associated atherosclerosis. Patients with PAES mainly present with intermittent feet and calf pain associated with exercises and relieved with rest. PAES can be diagnosed with a combination of medical history, physical examination, and advanced imaging modalities such as duplex ultrasound, computer tomography, or magnetic resonance angiography. Management can range from non-intervention to open surgical decompression with a generally good prognosis. Complications of untreated PAES can include stenotic artery degeneration, complete popliteal artery occlusion, distal arterial thromboembolism, or even formation of an aneurysm.
Ulnar nerve entrapment is a condition where the ulnar nerve becomes physically trapped or pinched, resulting in pain, numbness, or weakness, primarily affecting the little finger and ring finger of the hand. Entrapment may occur at any point from the spine at cervical vertebra C7 to the wrist; the most common point of entrapment is in the elbow. Prevention is mostly through correct posture and avoiding repetitive or constant strain. Treatment is usually conservative, including medication, activity modification, and exercise, but may sometimes include surgery. Prognosis is generally good, with mild to moderate symptoms often resolving spontaneously.
Magnetic resonance neurography (MRN) is the direct imaging of nerves in the body by optimizing selectivity for unique MRI water properties of nerves. It is a modification of magnetic resonance imaging. This technique yields a detailed image of a nerve from the resonance signal that arises from in the nerve itself rather than from surrounding tissues or from fat in the nerve lining. Because of the intraneural source of the image signal, the image provides a medically useful set of information about the internal state of the nerve such as the presence of irritation, nerve swelling (edema), compression, pinch or injury. Standard magnetic resonance images can show the outline of some nerves in portions of their courses but do not show the intrinsic signal from nerve water. Magnetic resonance neurography is used to evaluate major nerve compressions such as those affecting the sciatic nerve (e.g. piriformis syndrome), the brachial plexus nerves (e.g. thoracic outlet syndrome), the pudendal nerve, or virtually any named nerve in the body. A related technique for imaging neural tracts in the brain and spinal cord is called magnetic resonance tractography or diffusion tensor imaging.
Anterior interosseous syndrome is a medical condition in which damage to the anterior interosseous nerve (AIN), a distal motor and sensory branch of the median nerve, classically with severe weakness of the pincer movement of the thumb and index finger, and can cause transient pain in the wrist.
First rib resection is a surgical procedure used in humans to treat thoracic outlet syndrome (TOS) and Paget–Schroetter disease. It involves the surgical removal of a segment of the first rib, which is the rib closest to the head, under the collar bone.
References
- 1 2 3 Sencen, Lisa. "Thoracic Outlet Syndrome". NORD (National Organization for Rare Disorders). Retrieved 25 August 2022.
- 1 2 Howard, Matthew; Jones, Michael; Clarkson, Richard; Donaldson, Oliver (2022). "Pectoralis minor syndrome: diagnosis with Botulinum injection and treatment with tenotomy – a prospective case series". Shoulder & Elbow. 14 (2): 157–161. doi:10.1177/1758573220968454. PMC 8899325 . PMID 35265181.
- ↑ Sanders, Richard J.; Annest, Stephen J. (2014). "Thoracic outlet and pectoralis minor syndromes". Seminars in Vascular Surgery. 27 (2): 86–117. doi:10.1053/j.semvascsurg.2015.02.001. PMID 25868762.
- 1 2 Sanders, Richard J.; Rao, Neal M. (2010). "The Forgotten Pectoralis Minor Syndrome: 100 Operations for Pectoralis Minor Syndrome Alone or Accompanied by Neurogenic Thoracic Outlet Syndrome". Annals of Vascular Surgery. 24 (6): 701–708. doi:10.1016/j.avsg.2010.02.022. PMID 20471786.
- ↑ Pietramaggiori, Giorgio; Scherer, Saja (2020). "Diagnosis and Treatment of Pectoralis Minor Syndrome (Neurogenic Thoracic Outlet)". Minimally Invasive Surgery for Chronic Pain Management: An Evidence-Based Approach. Springer International Publishing. pp. 47–52. ISBN 978-3-030-50188-4.
- ↑ Sanders, Richard J. (2013). "Pectoralis Minor Syndrome". Thoracic Outlet Syndrome. Springer. pp. 93–100. ISBN 978-1-4471-4366-6.
- ↑ Martinez Del Carmen, Dorelly Tanayra; Martí Mestre, Francisco Xavier; Tripodi, Paolo; Macia Vidueira, Ivan; Ramos Izquierdo, Ricard; Romera Villegas, Antonio (2022). "Role of Botulinum Toxin in Pectoralis Minor Syndrome". Annals of Vascular Surgery. 81: 225–231. doi:10.1016/j.avsg.2021.09.032. PMID 34775010. S2CID 244070486.
- ↑ Aktas, Ilknur; Kaya, Ezgi; Akpinar, Pinar; Atici, Arzu; Unlu Ozkan, Feyza; Palamar, Deniz; Akgun, Kenan (2020). "Spasticity-induced Pectoralis minor syndrome: a case-report". Topics in Stroke Rehabilitation. 27 (4): 316–319. doi:10.1080/10749357.2019.1691807. PMID 31774031. S2CID 208319300.
- ↑ Haeni, David; Martinez-Catalan, Natalia; Esper, Ronda N.; Wagner, Eric R.; El Hassan, Bassem T.; Sanchez-Sotelo, Joaquin (2022). "Arthroscopic release of the pectoralis minor tendon from the coracoid for pectoralis minor syndrome". Journal of Experimental Orthopaedics. 9 (1): 57. doi: 10.1186/s40634-022-00491-x . PMC 9206061 . PMID 35713735. S2CID 249713897.
- ↑ Sanders, Richard J.; Rao, Neal M. (2009). "PP30. The Forgotten Pectoralis Minor Syndrome: Report of 100 Operations". Journal of Vascular Surgery. 49 (5): S23. doi: 10.1016/j.jvs.2009.02.060 .