The
Thoracic Outlet Syndrome
The brachial plexus of nerves (C5, 6, 7, and 8 and T1) and
the subclavian artery and vein are closely related to the upper surface of the
1st rib and the clavicle as they enter the upper limb it is here that the
nerves or blood vessels may be compressed between the bones. Most of the
symptoms are caused by pressure on the lower trunk of the plexus producing pain
down the medial side of the forearm and hand and wasting of the small muscles
of the hand. Pressure on the blood vessels may compromise the circulation of
the upper limb.
Movements of the Ribs and Costal Cartilages
The 1st ribs and their costal cartilages are fixed to the
manubrium and are immobile. The raising and lowering of the ribs during
respiration are accompanied by movements in both the joints of the head and the
tubercle, permitting the neck of each rib to rotate around its own axis.
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