- 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