Đang chuẩn bị liên kết để tải về tài liệu:
Peripheral Vascular Ultrasound - part 7

Cánh tay cũng có thể được nâng lên hoặc hạ xuống trong thời gian thử nghiệm này (3 và 4) và người đứng đầu xoay để hai bên (5 và 6). B: Costoclavicular cơ động. Trong cảm hứng sâu (1) lồng ngực được đẩy về phía trước (2) và quay trở lại cánh tay (3 | DUPLEX ASSESSMENT OF UPPER EXTREMITY ARTERIAL DISEASE 141 Figure 10.10 Provocation maneuvers used for the assessment of TOS. A Hyperabduction test. The arm is abducted 1 and the arm externally rotated 2 . The arm can also be raised or lowered during this test 3 and 4 and the head rotated to either side 5 and 6 . B Costoclavicular maneuver. During deep inspiration 1 the chest is pushed forward 2 and the arms backwa 1 3 . The headis Ournedfrom sideto side 4 . possible compression between the scalene muscles or the presence of a cervical rib. Finally the patient should also be asked to place the arm inanypositionthatprovokes symptoms such as rai.ni nyionbovcelis heoO. Any change to or loss of the Dopiplcssipni l Ourmgthesemaneuvees suggests nompression of ths SA. Tina patient should altoSitskedso indicate anonosnp tomsthas occur duh spg irnmD aoo i c i soanetmalDopoltr signal in to ptntenae of opmpsoms may InOicate o nonvasculnstaese Soroliycomalaiiit. Duplex att sment of osso To perform a duplex scan for TOS the patient should liesupine onthe exammation table with the arms resting by the sides. Sometimes it may be necessary to imnon sCt asteries with se patient in so sitting position so that certain provocation tests can be performed. The SA is initially imaged from the supraclavicular and infraclavicular positions. Thoflow veSaoitina ase 1 saPs dcsd and ails abnotma.-ities suchasOorOuocityoranenrosmal dilatlons natod. Tlin SA con then te massed uuino any of die orovocationmooeeoest shy acoaro Souod sareauce oroblitessoy tire nadial astory tignal with poncll Doppler. One scry useful mrnenveo iuvokas scorning oftheSAfromthoinfradavicolcouotisiun wlile the aam fisUo snOucted Fis- to.si . TOe iinnh can bo drawn tnword ohe boyO ohtho paoient s head and evensuallyu Sace no ehõiOsSo S c adtlStettusc is then gontlo nyolientothe ermtt pnshisback-ward. AnyfUangerlnrSloflowdasaemoraraasof significann s els t ito mcreaht aSind one dA onions provocatipnseslssOautdbe rsouade .