Sɔntɛnde yu kin fil wan strenj pen ɔ swɛt we kin kɔmɔt na yu nɛk ɛn sholda dɔŋ yu an? I tan lɛk se dis pen de wɔs we yu es yu an ɔp? Bɔrku pipul kin tink se dis na nɔrmal tin, ɔr na jɔs wan smɔl vein na yu nɛk we dɛn de swɛt, bɔt de kɔz kin kɔmplikt smɔl pas aw yu tink. Tide wi go tɔk bɔt wan sik wae kin mek yu gɛt dis kayn sik, bɔt bɔrku pipul nɔr dɔn yɛri bɔt am. Dat na di sik we dɛn kɔl Thoracic Outlet Syndrome (TOS).
Fɔ tɔk am simpul wan, wetin na di Thoracic Outlet Syndrome (TOS)?
Dis nem kin tan lɛk se i kɔmplikt smɔl. Bɔt lɛ wi kip am simpul. Imajin se wan smɔl ples de we tan lɛk tanɛl bitwin wi nɛk ɛn wi chɛst. fכ bi prεsis, di spεs we de dכn di kכlabon εn oba di fכs rib. dis spεs na wetin wi kכl di ‘thoracic outlet’ insay mεdisin.
dis tכnel rili imכtant biכs wan big bכndεl fכ nεv dεm we de gi sεns εn muvmεnt to wi an (dεn kכl am brachial plexus ), εn di men at we de gi bכdi to di an ( di sabklavian atεri ), εn wan big vein we de kכri bכdi frכm di an bak to di at ( di sabklavian vein ) de pas tru dis sכmכl spεs.
Nɔmal wan, dɛn nɛv ɛn blɔd vesel ya kin travul tru dis spɛs we nɔ gɛt ɛnitin fɔ ambɔg am. Bɔt wetin go apin if dis tanɛl blok fɔ sɔm rizin? Dat min se wetin kin apin if di mכsul dεm, bon dεm, εn כda tin dεm we de rawnd dεn kכmprεs dεn nεv dεm כ blכd vεsεl dεm? Na dat wi kin kɔl Thoracic Outlet Syndrome (TOS) . Dis kɔmpreshɔn na in kin mek bɔku sayn dɛm lɛk pen, swɛlin, ɛn swel na di an.
Men kayn TOS de?
Yes, dεn sheb TOS to tri men tכp dεm dipכnt pan wetin de mek dis prεshכn de kכz. Fɔ no dis gud gud wan rili impɔtant fɔ tritmɛnt.
| TOS tayp | Wetin na prɛs ɛn diskrɔpshɔn |
|---|---|
| Nyurojɛnik Tɔraks Ɔutlet Sindrom (nɛv kɔmpreshɔn) . | Dis na di kayn we we kɔmɔn pas ɔl (lɛk 95% pan di wan dɛn we gɛt TOS). i involv di kכmpreshכn fכ di nεv bכndεl we de rכn frכm di an to di sכlda (brachial plexus). Bɔku tɛm, i kin apin to atlet dɛn we de muv ripit ɔ pan pipul dɛn we dɔn gɛt injury na dɛn nɛk wantɛm wantɛm (lɛk we pɔsin kin wiplash frɔm motoka aksidɛnt). |
| Venous Thoracic Outlet Syndrome (Venɔs Trɔt Sindrɔm) . | dis na di say we di men vein we de gi bak bכdi frכm di an (di sabklavian vein) de blok. Dis kin mek blɔd gɛda na di an, ɛn dis kin mek i swel wantɛm wantɛm ɛn tɔn blu . dis kin bכku pan yכng man dεm, spεshal wan na di an we dεn de yuz mכst (di an we de dominant). |
| Arterial Thoracic Outlet Syndrome (Atεrial Trɔt Trot) . | Dis na di kayn we we nɔ kin bɔku (lɛk 1% pan di TOS pasɛnt dɛn). na ya, di men at we de kכri bכdi go na di an (di sabklavian at) de sכmtεm sכmtεm. Dis kin mek di blɔd nɔ go na di an, ɛn i kin mek i kol, i kin mek i fil lɛk se i nɔ de fil fayn, ɛn i kin mek i fil pen. Sɔntɛnde, blɔd kin klɔt insay dis at. dis kin kכz fכ sכmtin lεk εkstra rib we dεn bכn wit sεvikal rib. |
כl tu di venכs εn atεrial tכp dεm dεn kכl dεm kכl Vascular Thoracic Outlet Syndrome . Bɔku tɛm, dɛn tu kayn ya kin nid ɔpreshɔn. Bɔt di mɔ kɔmɔn Nyurojɛnik tayp kin ansa fayn to fizik tritmɛnt.
Wetin na di sayn dɛm fɔ TOS?
Di sayn dɛm dipen pan if di nerve ɔ di blɔd vesel dɔn kɔmprɛs. Dɛn kin si dɛn sayn ya na wan say (nɛk, ɔp chɛst, sholda, an, ɔ an).
Di sayn dɛm we dɛn kin si bɔku tɛm:
- Pen: Dis pen kin bɔku we yu es yu an ɔp. Sɔm pipul dɛn kin fil dis lɛk smɔl pen.
- Numbness: Na "pins and needles" sensation, we fiba di filin we yu an de numb.
- Numbness: Yu nɔ de fil fayn na sɔm say dɛn na di an.
- Wiknɛs: Di trɛnk we de na di an ɔ di finga dɛn nɔ de go, i nɔ izi fɔ ol di tin dɛn.
- Swel ɔ ebi: Di an kin swel ɛn fil ebi, mɔ we di vein dɔn kɔnstrikt.
- Skin in kɔlɔ kin chenj: Di an kin bi pale ɔ blu.
- Kol an: We di at de smɔl ɛn di blɔd nɔ de flɔ, di an kin kol pas di ɔda an.
- Di wund dɛn na di finga dɛn we de wɛl: Dis kin bi bikɔs di blɔd nɔ de go fayn.
Tink bɔt dis we: di nɛv dɛn tan lɛk ilɛktrik waya na wi bɔdi. We dɛn kin kɔmprɛs, sɔm sayn dɛm lɛk pen ɛn nɔr kin fil fayn kin kam. Blɔd vesel dɛn tan lɛk wata paip. If di tiub we de kɛr blɔd (ati) blok, di an kin kol ɛn nɔ gɛt blɔd. If di tiub (vein) we de kam bak na di blɔd dɔn blok, di an kin swel ɛn ful-ɔp wit blɔd. Wae yu tink bɔt dis kayn wae, e kin izi fɔ ɔndastand de sayn dɛm.
Yu tink se dis pen kin gɛt fɔ du wit at atɔk?
Dis na kwɛstyɔn we rili impɔtant. Bikɔs TOS kin mek yu gɛt pen na di ɔpa chɛst, sɔm kin fred se dis na at atak ɔ angina. Bɔt, klia difrɛns de bitwin dɛn tu.
- TOS pen: Bɔku tɛm i kin wɔs we yu es di an we gɛt di sik . Dis pen nɔ kin wɔs we yu de waka ɔr ɛksesaiz.
- Angina pen: Dis na pen wae de kam wae yu nɔr de gɛt inof blɔd na yu at. Bɔku tɛm, i kin wɔs we yu de tray tranga wan, lɛk we yu de waka ɔ klaym stej . I kin bɛtɛ we yu rɛst. I kin kam wit sɔm sayn dɛm bak lɛk fɔ blo shɔt ɛn fɔ swet.
Semweso, we pɔsin wik na wan say na di bɔdi, dat kin bi sayn fɔ lɛ pɔsin gɛt strok. Bɔt, strok kin mek yu gɛt sɔm sayn dɛn bak lɛk we yu mɔt de drɔp na wan say, i nɔ kin izi fɔ tɔk, ɛn yu kin chenj di we aw yu de si.
I rili impɔtant: If yu gɛt pen na yu chɛst wantɛm wantɛm, yu nɔ de blo fayn, yu de swet, yu wik na wan say na yu bɔdi, ɔ yu nɔ ebul fɔ tɔk, nɔ tink se na TOS ɛn go na ɔspitul imejensi rum (ETU) wantɛm wantɛm. Dɛn tin ya kin bi sayn dɛm fɔ hat atak ɔ strok, we nid fɔ gɛt tritmɛnt kwik kwik wan.
Wetin kin mek pɔsin gɛt TOS?
Dɔktɔ dɛn kin sheb di tin dɛn we kin mek pɔsin gɛt TOS to tri men grup dɛn.
| Rizin kategori | Diskripshɔn ɛn ɛgzampul dɛn |
|---|---|
| Na we dɛn bɔn am | Dis na strɔkchɔral chenj dɛm we dɛn bɔn yu wit. fכ egzampl, sכm pipul kin gεt εkstra rib na dεn nεk (sεvikal rib). dis ekstra rib kin ridyus di spes na di tכraks כltεt εn mek prεshכn pan di nεv dεm כ di bכdi vεsul dεm. |
| Aksidɛnt (Traumatik) . | Dis sik kin kam bikɔs yu gɛt injury na yu nɛk ɔ di ɔpa chɛst. Di ɛgzampul we bɔku pipul dɛn kin du na whiplash , we kin apin we pɔsin in nɛk kin jɔk wantɛm wantɛm we motoka aksidɛnt apin. I kin kam bak bikɔs ɔf sɔntin lɛk we kɔlabɔn brok. |
| Fɔ wok | Dis kin apin bikɔs dɛn kin ripit di sem muvmɛnt dɛn ɔltɛm, mɔ di tin dɛn we dɛn kin du we dɛn kin es di an dɛn ɔp.
|
Sɔntɛnde, ivin if risk de we pɔsin bɔn wit (e.g., ɛkstra rib), di sayn dɛn nɔ kin apin te aksidɛnt ɔ du tin we nɔ fayn fɔ lɔng tɛm.
Yu tink se dis na siriɔs sik? Wetin go apin if dɛn nɔ trit am?
Yes, TOS kin mek siriɔs prɔblɛm dɛn if dɛn nɔ trit am, mɔ we di blɔd vesel dɛn kin kɔnstrikt.
- Trombosis: di bכdi kin f כm na di an bikoz di vein dεm kin sכmtεm sכmtεm. If dis blɔd klɔt brok ɛn lod na di lɔng, i kin mek pɔsin gɛt siriɔs sik we kin mek pɔsin in layf de pan denja we dɛn kɔl pulmonary embolism .
- Swel ɛn pen we nɔ de dɔn: Swel ɛn pen we de kɔntinyu fɔ de na di an.
- di tisu dεm we de day (Gangrene): If wan atεri blok εn di bכdi fכ fכlכ to di an kכmplit, di tisu dεm na di finga dεm kin day.
- Wund dɛn we nɔ de wɛl: Wund dɛn na di finga dɛn nɔ kin wɛl bikɔs di blɔd nɔ de go fayn.
- di nerv dεm we de pwεl pwεl pεrmanεnt: If yu kכmpεsh di nerv dεm fכ lכng tεm, i kin mek di nεv dεm dεm de pwεl fכ tεm.
So, if yu gɛt dɛn sik ya, i rili impɔtant fɔ rili go to yu dɔktɔ ɛn aks fɔ advays, pas fɔ jɔs tink se "dis go jɔs go."
Aw dɔktɔ kin no se i gɛt TOS?
Sɔntɛnde, fɔ no bɔt TOS kin tranga smɔl bikɔs di sayn dɛm kin tan lɛk bɔrku ɔda sik dɛm. Yu dɔktɔ go aks yu fɔs bɔt yu sik dɛn ɛn chɛk yu.
We dɛn de du dis ɛgzam fɔ yu bɔdi, di dɔktɔ go aks yu fɔ du sɔm muvmɛnt dɛn. Fɔ ɛgzampul:
- Rayt yu an dɛn ɔp ɛn aks dɛn fɔ fleks ɛn ɛkstɛnd dɛn an dɛn (Elevated Arm Stress Test).
- Dɛn kin aks yu fɔ tɔn yu nɛk difrɛn say dɛn.
Di dɔktɔ kin gɛt aidia bɔt dis bay we i de wach if yu de gɛt sɔm sayn dɛm lɛk pen ɔr nɔr de fil fayn we yu de du dɛn muvmɛnt ya, ɛn aw dɛn kin apin.
Apat frɔm dat, dɛn kin ɔda fɔ du dɛn tɛst ya fɔ kɔnfirm di diagnosis ɛn fɔ pul ɔda kɔndishɔn dɛn:
- Chεst X-ray: Chεk fכ εkstra rib (sεvikal rib).
- CT skan ɔ MRI skan: Fɔ si di rayt say we di strɔkchɔ dɛn na di nɛk ɛn chɛst dɔn kɔmprɛs, ɛn bak di nɛv ɛn blɔd vesel dɛn.
- Ilektromayografi (EMG) / Nεv Kכndukshכn Stɔdi: I de chεk di nεv fכ wok εn di damej.
- Angiography (MRA ɔ CT Angiography): Fɔ chɛk aw blɔd de flɔ na di blɔd vesel ɛn if ɛnitin de we dɔn blok ɔ we blɔd dɔn klɔt.
Wetin na di tritmɛnt dɛm fɔ TOS?
Di tritmɛnt dipen pan di kayn TOS we yu gɛt, aw yu gɛt di sik, ɛn di tin we kin mek yu gɛt dis sik.
1. Fizikal Tɛrapi: Dis na di fɔs ɛn impɔtant tritmɛnt fɔ Nyurojɛnik TOS. Wan dɔktɔ we de mɛn yu bɔdi go tich yu sɔm patikyula ɛksesaiz dɛn fɔ mek di mɔsul dɛn na yu nɛk ɛn yu sholda strɔng, fɔ mek yu ebul fɔ chenj, ɛn ɛp yu fɔ tinap fayn. Fɔ bɔrku pipul dɛm, dis tritmɛnt kin ridyus di sik wae de kam pan pɔrsin wae gɛt dis sik bad bad wan.
2. Mɛrɛsin dɛn:
- Di mɛrɛsin dɛn we de mek pɔsin fil pen: Yu dɔktɔ kin tɛl yu fɔ yuz mɛrɛsin fɔ mɛn pen lɛk NSAID fɔ kɔntrol di pen.
- Anticoagulants: If blɔd klɔt dɔn fɔm na di blɔd vesel ɔ i de pan denja fɔ fɔm, dɛn kin gi am mɛrɛsin fɔ mek blɔd tan. Sɔntɛnde, dɛn kin gi spɛshal injɛkshɔn (thrombolytic therapy) fɔ sɔlv di klot.
3. Ɔpreshɔn:
- di atεrial εn venus TOS (tayp dεm we di bכdi kin kכnstrikt) bכku tεm kin nid כpεrayshכn biכs di risk fכ siriכs kכmplikεshכn dεm.
- Dɛn kin tink bak bɔt ɔpreshɔn fɔ di wan dɛn we gɛt Nyurojɛnik TOS we nɔ de ansa to di tritmɛnt dɛn we dɛn kin gi fɔ di bɔdi.
- Ɔpreshɔn kin min fɔ pul di tin we mek di nerv ɔ blɔd vesel dɛn kɔmprɛs. Fɔ ɛgzampul, fɔ pul ɛkstra rib ɔ kɔt tayt mɔsul (dikɔmpreshɔn ɔpreshɔn).
Yu dɔktɔ go ɛksplen to yu ditayli if yu nid ɔpreshɔn, wetin i min fɔ du, ɛn wetin de apin to yu.
Mɛsej we dɛn kin kɛr go na os
- If yu gɛt pen ɔltɛm, yu nɔ de fil fayn, ɔ yu wik na yu nɛk, yu sholda, ɔ yu an, nɔ ignore am.
- Dɛn simptom ya kin bi bikɔs ɔf di Thoracic Outlet Syndrome (TOS), we kin kam we di nerv ɔ blɔd vesel dɛn we de na di spes bitwin di nɛk ɛn di chɛst kɔmprɛs.
- If yu nɔ pe atɛnshɔn to di sayn dɛm, mɔ we yu gɛt TOS we gɛt fɔ du wit di blɔd vesel dɛm, i kin mek yu gɛt siriɔs prɔblɛm lɛk we blɔd kin klɔt.
- Mek shɔ se yu go to dɔktɔ fɔ no di rayt we fɔ no if yu gɛt di sik ɛn fɔ mek i gɛt di tritmɛnt.
- Bɔrku pipul kin ebul fɔ kɔntrol dɛn sik wit fizik tritmɛnt, ɛn sɔm tɛm, dɛn kin nid fɔ du ɔpreshɔn.
- If yu gɛt sɔm sayn dɛn lɛk we yu chɛst de pen wantɛm wantɛm ɔ we yu wik na wan say na yu bɔdi, go na imejensi rum (ETU) wantɛm wantɛm.
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