Tough neck

Introduction The neck activity is limited and this symptom can be seen in the neck rib syndrome. Cervical rib syndrome is a complex clinical syndrome caused by vascular nerve compression in the thoracic exit area. It is also known as cervical thoracic outlet syndrome, anterior scalene syndrome, pectoralis minor muscle syndrome, rib lock syndrome, and excessive abduction. Syndrome, etc., refers to a series of upper extremity blood vessels and neurological symptoms caused by compression of brachial plexus and subclavian arteries and veins for some reason. Clinically, the main manifestations are pain, numbness of the shoulders, arms and hands, and even muscle weakness, weakness of the hands, cold and purple, and weakening of the iliac artery.

Cause

For the cause of stiff rib syndrome, Chinese medicine and Western medicine have their own views:

1. The cause of Western medicine:

(1) Neck ribs: The 7th cervical rib remains or the transverse process is too long.

(2) The triangular space of the scalene muscle is narrowed.

(3) Structural variation of the rib cage channel: malformation of the first rib or clavicle, exostose, and traumatic fracture, dislocation of the humeral head, etc.

(4) The nerves behind the ulnar ligament or the small chest tendon during the abduction of the shoulder, the blood vessels are compressed.

2, Chinese medicine etiology and pathogenesis:

(1) qi and blood stasis: due to the congenital hypertrophy of the anterior scalene muscle, the narrow interstitial space, or the swelling of the anterior scalene muscle caused by trauma, resulting in local tendon veins, meridian pressure, qi stagnation, blood stasis. Qi stagnation and blood stasis are diseases, mutual cause and effect, caused by qi stagnation leading to blood stasis or blood stasis leading to qi stagnation, eventually stagnation obstructs the air machine, or qi stagnation produces blood stasis, making the pain worse.

(2) liver blood deficiency: the disease has not healed for a long time, or the spleen and stomach are weak, and the blood function of the blood is reduced, resulting in liver deficiency. Blood deficiency can not support the tendons, can not go to the glory of the head, then dizziness, eye flowers, blood deficiency and easy to dry and windy, the virtual wind inside, visible skin numbness, restraint, sputum and other performance.

an examination

Related inspection

Cervical test, periosteal reflex, cervical CT, neck test

1. X-ray examination: Conventional X-ray photographs the cervical lateral radiograph and the upper chest radiograph to determine the presence or absence of cervical rib or upper lung tumor, clavicle or first rib deformity.

2, angiography: If the blood circulation disorder is severe, it is feasible to perform subclavian venous venography to understand the vascular compression, occlusion or stenosis and collateral circulation.

3. Electromyography: Check the bioelectrical changes of the muscles during rest and contraction to help determine if the lesion is in the peripheral nerve or in the muscle itself.

Differential diagnosis

1. Cervical spondylosis: Cervical spondylosis is more common in men over 40 years old. This disease is more common in women under 40 years old. Cervical spondylosis is mainly caused by neck and shoulder. This disease is mainly caused by hand numbness; cervical spondylosis is rarely sized. Fish muscle atrophy, no signs of vascular compression; X-ray film of the cervical spine and cervical MRI can help to confirm the diagnosis.

2, syringomyelia: the age of the disease is 20 to 30 years old, more common in men, the ratio of male to female is 3:1; the sensory disorder is separated (pain disappearance, tactile presence) is serious; when the cavity is enlarged and the anterior horn cells are damaged Atrophy and sputum reflex disappeared (the dyskinesia of this disease tends to appear first than the sensory disorder, because the circumference of the motor fiber is large and easy to be compressed). Although the upper limb has autonomic dysfunction, there is no vascular compression sign. MRI is of great value in identifying this disease.

3, lower motor neuron lesions - progressive muscular atrophy: the disease of the forearm medial cutaneous nerve innervation area without sensory disturbance; ulnar wrist flexor muscle is often damaged; ulnar nerve conduction velocity slowing down the site completely different; no vascular compression symptoms And signs.

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