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Course of the brachial plexus and subclavian artery between the anterior scalene and middle scalene muscles. Dilatation of the subclavian artery just distal to the anterior scalene muscle is illustrated. Immediately distal to the anterior and middle scalene muscles is another potential area of constriction, between the clavicle and the first rib. With extension of the neck and turning of the chin to the affected side (Adson maneuver), the tension on the anterior scalene muscle is increased and the subclavian artery compressed, resulting in a supraclavicular bruit and obliteration of the radial pulse. Source: Pain in the Back, Neck, and Extremities, Adams and Victor's Principles of Neurology, 11e Citation: Ropper AH, Samuels MA, Klein JP, Prasad S. Adams and Victor's Principles of Neurology, 11e; 2015 Available at: http://mhmedical.com/ Accessed: April 29, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved