College of Massage Therapists of British Columbia (CMTBC) Practice Exam

What symptom would most commonly be present in a patient diagnosed with thoracic outlet syndrome (TOS)?

1. Shoulder weakness and vague pain

2. Extreme fatigue in the legs

3. Inability to move arms

4. Palpitations and chest discomfort

The correct answer is: Shoulder weakness and vague pain

In a patient diagnosed with thoracic outlet syndrome (TOS), shoulder weakness and vague pain are common symptoms due to the compression of nerves and blood vessels in the thoracic outlet area, which is located between the collarbone and the first rib. This condition affects the brachial plexus, which supplies nerves to the arm, as well as the subclavian vessels that supply blood. As a result, individuals may experience weakness in the shoulder muscles, pain that can radiate into the neck, shoulder, and even down the arm, and sensory changes, which can all be categorized under vague pain. The other symptoms listed pertain to different medical conditions. Extreme fatigue in the legs could be associated with circulatory issues or neurological disorders, but it does not typically relate to TOS. Inability to move the arms suggests a more significant injury or neurological problem that would likely manifest in more dramatic symptoms than those seen in TOS. Palpitations and chest discomfort are symptoms associated with cardiovascular conditions, not the specific compromise of the thoracic outlet. Thus, shoulder weakness and vague pain encapsulate the hallmark manifestations of thoracic outlet syndrome, aligning closely with the anatomical and physiological implications of the disorder.