User:Jmclau1/Adson's Maneuver

Purpose
Adson’s maneuver identifies possible blockage of the medial cord of the brachial plexus, subclavian artery, and subclavian vein secondary to entrapment of the anterior scalene.

Procedure
Have patient seated sitting straight up or patient may also stand. Patient’s shoulder abducted (away from the body) to 30°, with elbows extended and thumbs pointing upward. The patient must also have their humerus externally rotate. The Examiner should stand behind patient with one hand positioned so that the radial pulse is palpable and can also be recorded. The examiner externally rotates and extends the subject’s test arm while palpating the radial pulse. The subject then extends and rotates the neck toward the testing arm and takes a deep breath and hold the breath. The examiner should record the rate and rhythm of the patient’s pulse as reduced or altered, as opposed to one that is completely diminished.

Mechanism
This test assesses vascular structures only and has a high incidence of false positive findings.

Results
A diminished or absent radial pulse is indicative of thoracic outlet syndrome. This is secondary to the compression of the subclavian artery by the scalene muscles. The subclavian artery is being occlued between the anterior and middle scalene muscles and/ or the pectoralis minor. Thoracic outlet syndrome is a rare condition that involves pain in the neck and shoulder, numbness and tingling of the fingers, and a weak grip. The thoracic outlet is the area between the rib cage and collar bone.