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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