Case 16 Cervical Rib


Case 16
                                                            Cervical Rib
What Happened ?                                                       How it disturbs you ?
Examination
Introduction ownself
Exposure
Look
            Surgical Scar on Neck
            Atrophy of Muscles on Arm , Forearm , hand
            Wasting of thenar / hypothenar muscles
            Finger tip necrosis or well perfused
Feel
            Palpate tender swelling on supraclavicular region
Neurovascular examination
            Vascular
                        Pulsation – Brachial /Radial / Ulnar
                        Claudication on elevating limb
                        Adson’s test
                        Roos test
                       
            Neurological
                        T 1 Symptoms , T 1 hypoaesthesia , Intrinsic weakness
                        Weakness and clumsiness of hand
                       


Presentation – Vascular / Neural and local symptoms

Local Symptoms
            Tender supraclavicular lump
            Bony hard and fixed
           
Neural Symptoms
            Thenar wasting , atrophy of finger pulps , Ulcers
Vascular Symptoms
            Ulcers , Cold / White or mottled
            Adson test / Roos test +
            Bruit – supraclavicular area with stethescope













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