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NBME 22 Answers

nbme22/Block 1/Question#8

A 16-year-old girl has pain and tingling in her ...

Cervical rib

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submitted by mcl(218),

Homegirl got some cervical outlet syndrome and should probably take some stuff out of her backpack or get one of those lil roller ones.

mcl  Whoops, my bad, THORACIC outlet syndrome +1  
dr.xx  Stretching, occupational and physical therapy are common non-invasive approaches used in the treatment of TOS. The cervical rib can be surgically removed. +  

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submitted by pparalpha(19),

According to BnB:

Cervical rib is an anomalous extra rib from the 7th cervical vertebrae. People with this are at risk for thoracic outlet syndrome (aka compression of nerves and vessels that leave the thorax. This occurs above the first rib and behind the clavicle).

Clinical features include:

1) brachial plexus injury (such as Klumpke palsy, which is a lower plexus injury)

2) Venous compression

3) Arterial compression

*An important anatomical correlate the scalene triangle (anterior scalene, middle scalene, above the first rib)