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Adson’s maneuver

Technique

  • decreases interscalene space by tensing anterior and middle scalenes;
  • arm of the affected side placed on the sitting patients thigh with forearm supinated;
  • turn head to the affected side;
  • extend neck and hold breath;
  • positive test is obliteration of the radial pulse;

Hyperabduction maneuver

  • tests for compression against axillary pulley which consists of pectoralis minor tendon, coracoid, and humeral head;
  • components of axillary vessels and plexus bent 90 deg at the junction of the glenoid and humeral head;
  • place extremity in full abduction and reach back as far possible;
  • radial pulse obliteration is not by itself specific, but loss of pulse with reproduction of symptoms is a positive test;
  • creation of a bruit in the supraclavicular area is further evidence;

At attention test

  • narrows the costoclavicular space between the clavicle & 1st rib;
  • pt thrust shoulders down and back as when stading at attention or carrying a backpack
  • positive test is radial pulse obliteration