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

Which thoracic outlet assessment is appropriate for a student experiencing numbness in their arms from carrying a heavy backpack?

1. Hyperabduction arm test

2. Costoclavicular syndrome test

3. Adson's maneuver

4. Halstead maneuver

The correct answer is: Costoclavicular syndrome test

The costoclavicular syndrome test is appropriate for assessing thoracic outlet syndrome, particularly in cases where symptoms like arm numbness may arise from compression of the neurovascular structures as they pass under the clavicle. In this scenario, the heavy backpack suggests a potential for mechanical compression due to the additional weight and posture alignment changes, which can predispose an individual to thoracic outlet syndrome. The costoclavicular syndrome test involves assessing for changes in blood flow and neurological symptoms while positioning the shoulders and arms in a specific way. If the student experiences numbness during this maneuver, it may indicate that there is compression occurring at the thoracic outlet due to the pressure from the backpack and the resulting position they may adopt while carrying it. Other assessments, while they can help identify thoracic outlet syndrome, have different focuses or may be less relevant given the student's specific situation. For example, the hyperabduction arm test primarily examines for issues related to the brachial plexus under the pectoralis minor, whereas Adson's maneuver focuses on the relationship between the subclavian artery and the scalene muscles. The Halstead maneuver is similar to Adson's but emphasizes a different set of neurological signs. None of these specifically target the potential structural