The last method is the valsalva test. How is the Valsalva maneuver performed for varicocele?

The Valsalva maneuver reflects the autonomic response nervous system in response to its stimulation.

Used as an emergency method for relief paroxysmal tachycardia, and as a diagnostic technique in urology, gynecology, otorhinolaryngology.

The method consists of changing hemodynamics, intra-abdominal and intrathoracic pressure in response to breath-holding.

This happens as follows:

First done deep breath through the nose, then the patient tries to exhale while closing his nose and mouth. There is a change in pressure between the abdominal and thoracic cavities.
At the beginning of the tension large veins subside, venous pressure decreases, as a result of which the blood flow into the heart decreases, and the ejection of blood from the ventricles into the aorta and pulmonary artery. It turns out that blood pressure drops, but the pulse compensatory increases in order to restore adequate blood circulation due to more frequent heart contractions.
15-20 seconds after the period of straining, the patient makes a full, slow exhalation. At this time, blood flow to the heart is restored, and the reduced pressure increases. Receptors in carotid artery vibration responsive blood pressure respond to changes by irritating the nucleus vagus nerve in the brain. This, in turn, significantly reduces the heart rate.

The concepts of “valsalva maneuver” and “valsalva maneuver” are often used. The only difference between them is to whom these terms are applied.

A test, also known as the Valsalva maneuver, is an action performed by a doctor for therapeutic or diagnostic purposes.

A reception is the actions of the patient himself, which he performs independently to relieve unpleasant symptoms.

The Valsalva effect is said to occur when, when holding your breath and straining, rhythm disturbances, headaches, dizziness, nausea, and possible fainting occur. It often develops when lifting heavy objects, playing sports, or going to the toilet. These symptoms occur as a result of a short-term increase in blood pressure to high levels. It is not considered a pathology, but physiological feature body.

Indications and contraindications

Indications for use of the Valsalva maneuver:

Risk assessment sudden stop heart due to the influence of the vagus nerve on the heart.
Differential diagnosis of tachycardia (with simultaneous ECG recording).
Studying the consistency of venous valves in venous system lower extremities (in combination with ultrasound examination).
Restoration and study of the patency of the auditory tubes in case of otitis media, eustachitis, as well as a decrease in pressure in the middle ear cavity during an airplane flight or scuba diving.
Emergency care for paroxysmal tachycardia.
Diagnosis of varicocele.
Diagnosis of urinary incontinence.

Contraindications:

Signs of acute cardiovascular failure: pain in the heart area, shortness of breath, impaired consciousness, drop in blood pressure.
Thromboembolism of arteries of any location.
History of myocardial infarction or stroke (stroke).
Diseases of the arteries and veins.
Any acute diseases.
Heart failure stage II.
Proliferative retinopathy.
Exacerbation of any chronic disease.
Sepsis.

How and in what cases is it done?

This technique is used in various areas medicine, let's look at each case in more detail.

Phlebology

When performing an ultrasound scan of the veins of the lower extremities to identify venous insufficiency Valsalva maneuver is used. During the test, a slight stagnation of blood occurs in them due to a decrease in pressure in the venous bed.

The fact is that the legs are the area furthest from the heart, so blood circulation is a little slower and more difficult than in other parts of the body. Blood flows here not due to the speed set by the heart, but due to contraction skeletal muscles, which seem to push blood through the vein. To prevent blood from returning in the opposite direction, there are valves in the vessels that prevent retrograde blood flow.

Whether stagnation of blood in the veins will be pronounced depends on the valve apparatus, which should not allow blood to pass in the opposite direction. If the valves are unable to close and remain closed, Doppler ultrasound will determine the reverse flow of blood and dilation of the veins during the test. A positive test indicates the risk of developing varicose veins.

Urology

In urology, this method is used to diagnose varicocele - varicose veins veins of the spermatic cord. On initial stage this disease can be detected by creating iatrogenic overflow of the veins of the spermatic cord with venous blood.

These conditions occur during the Valsalva maneuver. In the scrotum, the testicle and the strands of veins with varicose veins coming from it are palpated. This examination is carried out by urologists during a preventive examination of men.

Valsalva maneuver in combination with ultrasound diagnostics is a modern alternative to outdated X-ray examination.

Cardiology

In cardiology, the sample is used when recording an ECG. The subject of study is the length of the R-R intervals on the cardiogram, or more precisely, the ratio of the duration of the longest interval to the shortest. The lower this ratio, the higher the risk of sudden cardiac arrest.

The Valsalva maneuver is used by doctors to auscultate the heart. In particular, in case of tricuspid valve insufficiency, during the test, systolic murmur subsides or disappears altogether.

Irritation of the vagus nerve and subsequent reflex decrease in frequency heart rate becomes emergency care with paroxysm of supraventricular tachycardia.

It is an analogue of vagal tests (cough and vomiting reflex, carotid sinus massage).

Also used for differential diagnosis arrhythmias:

if after the test the rhythm is restored or the heart rate noticeably decreases, then sinus or supraventricular tachycardia is occurring;
in case of ventricular arrhythmia, the test is negative.

Gynecology

Used in gynecology to diagnose urinary incontinence in women. With a full bladder, the woman inhales and strains. With dysfunction of the urethral sphincter, drops of urine are released from the urinary canal.

This occurs due to an increase intra-abdominal pressure, which compresses a full bladder. If the sphincter is not closed enough, or opens with slight tension, the doctor will see drops of urine.

This method is also used in obstetrics in the second stage of labor to increase the effectiveness of a pregnant woman’s pushing.

Otolaryngology

While straining at the height of inspiration, the patient is asked to try to release air through the ears, without exhaling the air itself. In this case, “blowing” occurs eustachian tube(tube connecting the nasopharynx to the ear cavity).

This technique is used by divers and those who fly on an airplane. When decreasing atmospheric pressure There is a difference in pressure outside and inside the ear cavity, and a feeling of fullness appears in the ears.

In otolaryngology, this method is used to check the patency of the Eustachian tubes.

For purulent otitis media with perforation eardrum The Valsalva maneuver helps to evacuate pus from the ear. In the latter case, the use of the technique is possible only after the recommendation of an ENT doctor.

Neurosurgery

If pleural damage is suspected during surgery thoracic region spine under conduction anesthesia, the doctor asks the patient to strain while exhaling. If the layers of the pleura are damaged, then during straining a whistle of air passing through the pleural cavity. This happens due to a decrease in pressure in chest cavity and air flow through the resulting defect.

Until the advent of highly informative diagnostic methods (for example, CT with angiography), identify vascular pathology it was difficult. That’s why the sample was previously used for diagnosis congenital anomalies cerebral vessels, for example, malformations. During its implementation, patients noted the appearance or sharp increase in headache.

Medical tests and studies do not come to us out of nowhere. Before becoming available to society, they undergo many tests and checks, and only then begin to serve people for diagnostics. various diseases. The Valsalva maneuver is not as popular as, for example, a clinical blood test. This test is used for highly targeted diagnostics. The test is especially often done for varicose veins and some other diseases.

Valsalva maneuver - historical background

Otherwise, this test is called Valsalva stress. This test is named after the famous anatomist Antonio Maria Valsalva. Initially, the test was aimed at removing pus from otitis media from the middle ear. But today it is used by drivers, airplane passengers, and doctors in the treatment of varicose veins and other diseases. The method is that a person inhales forcefully, provided that the mouth and nose are closed. Often this test is prescribed together with other examination methods. This is done with the aim of setting the correct and accurate diagnosis. The test is informative when used with ultrasound examination and electrocardiogram.

How is this method used for varicose veins?

Medical examination for varicose veins begins with a doctor’s examination, palpation and medical history. In addition to the methods listed above, you may need a Valsalva maneuver, which allows you to determine vascular pathology and the functionality of the valve apparatus in the venous system.

At the first examination, the phlebologist determines the presence of “stars”, redness nodes and other changes. After initial examination this specialist often prescribes venous ultrasound, which is a safe and painless diagnostic method, helping the doctor evaluate general state vessels, detect the presence of blood clots. May need additional examination by using:

deep research method - ultrasound scanning (color duplex scanning);
studies of the direction of blood flow, blood flow speed, blood pressure and volume - ultrasound examination (Dopplerography), this method makes it possible to see structural changes vessel walls;
USAS (ultrasound angioscanning);
three-dimensional X-ray - spiral CT (computed tomography);
phlebographic studies;
laboratory tests (blood test, which has a very important) and other studies.

When a Valsalva maneuver is performed, arterial pressure (BP) and heart rate (HR) are measured over a certain period of time. In this case, the patient must lie down (take horizontal position) and inhale through the tube to which the pressure gauge is attached. It is prohibited to conduct it outside the hospital, due to the possible sharp decline pressure in the heart. Thanks to this study, you can see a picture of the enlarged diameter of the veins, and also understand whether there is reflux.

A lot depends on a correctly collected medical history, so the doctor carefully examines the patient, finds out heredity, past illnesses, are there any problems with endocrine system, as well as living conditions, food, and work. Information about pregnancy and childbirth is important for women.

Application of the method for varicocele

Men may develop varicose veins of the ovaries and spermatic cord. This disease is called varicocele. It is most diagnosed among men. The disease occurs in three stages. When using the Valsalva technique, the doctor has the opportunity to see pathological changes even during preventive examination(age does not matter). Such a diagnosis will make it possible to identify the presence of a problem, even in the absence of any symptoms. The doctor palpates the ovaries to identify or, conversely, determine the absence of varicose veins. To identify the true state of the ovarian vein system, the Valsalva maneuver for varicocele is done while standing and lying down, while the doctor examines the veins and makes a comparison.

Features of ultrasound with Valsalva maneuver

Ultrasound examination is also informative method diagnostics It can be used to examine almost any human organ. If the Valsalva maneuver and ultrasound are performed together, the patient will definitely need to stand. First, the doctor examines the patient in general. In this case, the thickness of the veins and their consistency are determined. After general examination The patient, at the doctor’s request, tenses his muscles and inflates his stomach. If there are varicose veins, the doctor observes an increase in the vessels changed due to damage and identifies soft elastic nodes. When performing an ultrasound, the Valsalva maneuver makes it possible to determine how the blood flow in the opposite direction is disrupted, and, of course, the dilation of the veins.

What does a positive test mean?

IN circulatory system There are venous valves - a kind of “locks” that close when blood passes through them and prevent it from going back. When the “locks” are faulty, the blood flows down and stagnates there. If the Valsalva maneuver is positive during the examination, it means that there is a deficiency in the functioning of the valves. When registering reverse blood flow, the doctor diagnoses a deficiency in the functioning of the valves of the superficial vessels. Based on the results of the medical test, further manipulations or drug therapy are prescribed.

Valsalva maneuver is negative - what is it?

But the results of this examination can be not only positive, but also with a minus sign. If the Valsalva test for varicose veins is negative, it means that there are no anomalies in the veins being examined. The patient can be happy with this outcome of the examination.

For what diseases is this test still used?

This medical test can be used not only for varicose veins. There are certain standards for this test when various diseases. It is often prescribed in the following cases:

if diagnosis of certain types of tachycardia is necessary, it is carried out in conjunction with an ECG;
the test is carried out if it is necessary to assess the function of the valve apparatus of the veins in the legs; it is also carried out not alone, but in conjunction with a Doppler examination;
it is also used when it is necessary to determine the patency of the patient’s auditory tubes.

In medicine there is the concept of Valsalva maneuver and maneuver. They must be distinguished, since the sample is prescribed by a specialist for examination and making a specific diagnosis. Most often, it does not even go away on its own, but with some other study. The Valsalva maneuver is necessary when eliminating discomfort or conditions, for example, with a sharp drop in pressure, altitude, or rapid heartbeat.

Valsalva maneuver (Valsalva tension)- this is a forced exhalation with the nose and mouth closed. This test is also called the Valsalva test or Valsalva method.

Named after Antonio Maria Valsalva, the famous Italian anatomist. Interestingly, this method was originally proposed for squeezing out pus from the middle ear during otitis media. Now divers always use it when diving to equalize pressure in the sinuses upper jaw and middle ear, as well as airplane passengers during ascent and descent.

The Valsalva maneuver is as follows. After a complete exhalation and a deep inhalation, exhale and hold your breath.

In one version of this test, the subject (sitting or lying on his back) inhales into a tube connected to a pressure gauge for 15 seconds, creating a pressure of 40 mmHg. Art.

Continuous recording of blood pressure and heart rate is carried out. There are 4 phases of changes in these indicators: phases I and II correspond to exhalation, phases III and IV correspond to the cessation of exhalation. Phases I and III are caused by purely mechanical changes in intrathoracic and intra-abdominal pressure and are not of interest. At the beginning of phase II, as a result of a decrease in venous return and stroke volume, blood pressure decreases, tachycardia occurs and total peripheral vascular resistance (TPVR) increases. This leads to the fact that the drop in blood pressure stops approximately at the 5-8th second of the test and by the end of phase II blood pressure returns to its original value. IN III phase Blood pressure first drops sharply, then begins to rise and in phase IV it becomes higher than the initial value (since TPSS still remains elevated). At the same time, bradycardia develops due to stimulation of baroreceptors. By the end of phase IV, blood pressure, venous return and cardiac output return to the original level.

The Valsalva maneuver reflects the preservation of the afferent, central and efferent parts of the baroreflex. There are several ways to assess the state of the autonomic nervous system based on this test. The Valsalva ratio is calculated: the ratio of the maximum heart rate in phase II to the minimum in phase IV. It reflects the preservation of the entire baroreflex arc. The state of the vasomotor sympathetic fibers assessed by changes in blood pressure in phases II and IV. With values of the Valsalva ratio less than 1.1, we can confidently say that the patient has parasympathetic insufficiency.

When performing a Valsalva maneuver, the Valsalva ratio is also calculated: the ratio of the longest R-R interval within 1 minute after the end of the test to the shortest R-R interval during the test.

The test results are influenced by age, body position, pressure created during exhalation, duration of exhalation, FVC, and medication intake.

The Valsalva maneuver includes the following physiological stages:

Closure of the glottis.
Increased intra-abdominal pressure due to contraction of the diaphragm and abdominal muscles.
Increased intrathoracic pressure due to contraction of the respiratory muscles.

As a result of these actions, air is retained in the lungs and becomes under high pressure. High intra-abdominal and intrathoracic pressure limits venous return, collapsing large veins.

If the Valsalva maneuver continues long time, the volume of blood returning to the heart is significantly reduced, resulting in decreased cardiac output.

Although in some cases this experience gives positive results, it can have a very serious negative impact. People with hypertension or other cardiovascular disorders should not perform the Valsalva maneuver outside of medical institution without medical supervision.

The Valsalva maneuver is used in cardiology to assess prognosis sudden death after myocardial infarction by measuring your heart rate during the test. Thanks to this, heart rate variability can be assessed. Low heart rate variability is an independent predictor of cardiac death after myocardial infarction.

Using the Valsalva maneuver, the patency of the auditory tubes is also examined.

The subject is asked to take a deep breath, close his mouth and nose, tightly squeezing the wings of the nose with his fingers, and then exhale forcefully through the nose. Under the pressure of exhaled air, the auditory tubes open and air forcefully enters the tympanic cavity. This is accompanied by a slight cracking sound, which is felt by the patient, and the doctor listens to a characteristic noise through an otoscope.

Politzer test

Insert the olive of the balloon into the vestibule of the nasal cavity on the right and hold it with the second finger of the left hand, and with the first finger press the left wing of the nose to the nasal septum. Insert one olive of the otoscope into the patient’s external auditory canal, and the second into the doctor’s ear, ask the patient to say the words “steamboat” or “one, two, three.” At the moment of pronouncing the syllable “move” or the word “three”, sharply squeeze the balloon with four fingers of your right hand. At the moment of blowing, when pronouncing the syllable “hod” or the word “three,” the soft palate deviates posteriorly and separates the nasopharynx. Air enters the closed cavity of the nasopharynx and presses evenly on all walls, while some of the air passes with force into the pharyngeal opening of the auditory tubes, which is determined by the characteristic sound heard through the otoscope. Blow from the left in the same way.

Blowing out the auditory tubes during catheterization

Before the procedure, anesthetize the mucous membrane of the nasal cavity and nasopharynx (10% lidocaine solution). Insert the otoscope olives into the ear of the doctor and the patient. Take the catheter in your right hand, like a pen for writing. During anterior rhinoscopy, pass the catheter along the bottom of the nasal cavity with the beak down to the posterior wall of the nasopharynx. Then turn the catheter inward by 90 0 and pull it towards you until its beak touches the vomer. After this, carefully turn the beak of the catheter downwards and then approximately 180 0 towards the ear being examined so that the catheter ring faces approximately the outer corner of the eye of the side being examined. In this case, the beak enters the pharyngeal opening auditory tube. Insert the balloon into the catheter socket and squeeze it lightly. When air passes through the auditory tube, noise is heard.

Hearing test

Indications:

Determination of hearing acuity and the degree of its decrease;

Identification of the nature of hearing loss (impaired sound conduction or sound perception).

Hearing examination using whispered and spoken speech

The study is carried out separately in each ear.

Place the person being examined at a distance of 6 m from you. The ear being examined should be directed towards the doctor, and the opposite ear should be closed with the index finger, tightly pressing the tragus to the opening of the ear canal.

Explain to the subject that he must loudly repeat the words he hears.

It is necessary to exclude lip reading; for this, the subject should not look in the direction of the doctor. The doctor, in a whisper, using the air remaining in the lungs after unforced exhalation, pronounces two-digit numbers from 21 to 99 (Bezold’s method). You can use words with low sounds number, hole, many, sea, frost, etc.), then words with high sounds (example: bowl, already, cabbage soup and etc.). It is necessary to take into account the age and intelligence of the subject.

If the patient cannot hear from a distance of 6 meters, the doctor reduces the distance by 1 meter and examines the hearing again. This procedure is repeated until the subject repeats the spoken words. You can begin to examine hearing at a distance of 0.5-1 m from the ear and move away to a distance when the person being examined correctly repeats at least 5 numbers or words, but no further than 6 m.

Quantitative expression this study produced in meters, indicating the distance from which the subject hears numbers or words spoken in a whisper. The normal perception of whispered speech is 6 meters.

Study colloquial speech do the same, only muffle the second ear with a piece of paper, which is tapped with your fingers, and the cry - when muffling the second ear with a Barani rattle.

The Valsalva maneuver is a technique diagnostic study the functioning of the body’s blood flow system, as well as the valves of the heart organ, the respiratory system, and the identification of many pathologies.

This technique involves the patient attempting to exhale a stream of air with the mouth and nose closed.

What is the Valsalva maneuver?

This technique was invented in the 18th century by the Italian physician Valsalva. This testing was originally intended to remove pus from the eardrums in the ear, with otitis media.

The Valsalva maneuver is used by people on airplanes during takeoff, as well as when landing an airliner. They use the technique and drivers when diving to great depths of the sea to alleviate the condition of the body during a rapid change in atmospheric pressure.

The Valsalva maneuver is diagnostic technique research carried out by a doctor to make a diagnosis and identify pathology.

Indications and contraindications for the Valsalva maneuver

The Valsalva maneuver is a testing method for identifying pathologies in the following disorders in the body:

Diagnosis of heart palpitations;
During an attack of myocardial infarction, to determine the risk fatal outcome;
Assessing the performance of valves in veins;
Diagnosis of varicose veins;
Diagnosis of pathology of the reproductive system - varicocele;
When determining the functioning autonomic system person;
To study patency in ear canals with otitis.

You should not practice the Valsalva method for the following pathologies:

Hypertonic disease;
Rapid heartbeat - tachycardia;
In case of disease of the heart organ - cardialgia;
During an attack of suffocation;
During the period of fainting.

It is prohibited to perform the Valsalva maneuver during the following pathologies:

At acute heart attack myocardium;
With cerebral hemorrhage - stroke;
In case of cardiac pathology, failure of the second or higher degree;
PE disease;
Pathology appendicitis;
With peritonitis;
When the disease is retinopathy;
In a state of fever;
For sepsis;
With thrombosis of large arteries;
Blockage of the arteries of the lower extremities;
Atherosclerosis of cerebral vessels;
Increases in blood flow in cerebral vessels.

The Valsalva maneuver is used for diagnostics in cardiology, but it is also possible to identify diseases that develop in cervical spine- this is a pathology thyroid gland, retrosternal goiter.

The essence and mechanism of performing the Valsalva maneuver

The Valsalva test is a specific method for identifying pathologies, which is used by specialists in the field of cardiology, as well as medicine in urology.

This method allows you to analyze the functioning of the cardiac organ, as well as the blood flow system, the state of the autonomic system and the work of the central nervous system centers, as well as the functions of the auditory organ.

Sample execution mechanism:

The patient takes a deep breath of air through the nose;
Releases air through a special mouthpiece, in which there is a very small hole;
After the procedure for releasing air is completed, the patient restores breathing.

During the procedure, the following indicators are constantly recorded:

The pulse is recorded from the moment the procedure begins until the very end;
Blood pressure index.

Instead of the usual physiological exhalation of air, tension occurs in the muscles of the chest, as well as in the abdominal muscles.

Phases by which pathologies are identified

Phase No. 1 of passing the method- a phase lasting no more than 3 seconds, which is accompanied by high air pressure in chest, as well as in the peritoneum;
Phase No. 2- the tension phase reveals: hypertensive pathology, increased heart rate - tachycardia, as well as vascular resistance peripheral system. During this period of the test, the heart organ is maximally filled with blood, the lungs become more transparent. The second phase stage continues for no more than seven seconds;
Phase No. 3- the period when the exit of air from the body ends, and the period of relaxation of the respiratory system begins. At this stage of the test, the blood pressure index drops, contractions of the heart muscle become less frequent and deeper. The size of the heart organ and lungs comes in normal condition;
Phase No. 4- this is the final period of testing the Valsalva maneuver, and the period of relaxation of the respiratory system. During this period, the blood pressure index increases, heart pathology manifests itself - bradycardia, as well as vasodilation of peripheral vessels. The blood flow system is restored, as well as the venous return of blood.

During the Valsalva maneuver, the indicators on the cardiogram are compared and the length between teeth R-R. The coefficient in cardiography is the distance between the longest tooth and the shortest tooth, calculated in the ratio.

In a person who does not suffer from abnormalities in the heart organ and blood flow system, the coefficient is 1.70.

If the identified coefficient is in the range of 1.30 - 1.70, then this borderline state body.

When the coefficient is lower than 1.30, this is an indicator high probability death due to cardiac failure.

Also, the Valsalva maneuver helps to identify the size of the heart organ, as well as the tone of the heart muscle - the myocardium.

Valsalva maneuver for venous pathology

Quite often for varicose veins, patients together with other instrumental techniques diagnostic study, the Valsalva maneuver is also prescribed.

When the functioning of the venous valves is disrupted, improper blood flow in the veins occurs, and a process of regurgitation often occurs, during which the veins become overstrained and the pathology of varicose veins develops.

This technique helps to identify such disorders in the venous valves, even during the initial development of varicose veins, and the condition vascular walls how common are varicose veins?

When conducting a test during the inhalation period, the flow venous blood becomes weak, in phase No. 2 (tension), the flow of venous blood stops, and only begins in the third phase (on exhalation).

When diagnosed by the Valsalva method, the internal diameter of the venous vessels increases by more than 50.0%. If there is a pathology of the venous valves, then with an increase in venous blood pressure, a retrograde flow of venous blood occurs.

The slow speed in the blood flow of the veins prevents the valves of the veins from closing in a timely manner. The Valsalva maneuver allows you to achieve maximum speed in the venous bloodstream.

Positive and negative results of the Valsalva maneuver

A positive diagnostic test using the Valsalva method reveals:

Poor functionality of venous valves;
Stagnation of venous blood.

Identification of these factors indicates that the patient has high risk the occurrence of venous pathologies.

A negative diagnostic test indicates normal functionality of the veins, as well as good performance venulus

The Valsalva maneuver is not always as objective as possible.

The whole problem is that to achieve the maximum description of information, it is necessary for the abdominal muscles to reach maximum tension, and in some patients this does not happen for the following reasons:

Flabby muscles in abdominal cavity;
Obesity;
Patients whose body is weakened by illness;
The female half of the population.

Such patients undergo a modified type test. Its essence is that a sensor is installed in place of the venous valve.

The patient strains the abdominal muscles, and the doctor presses on the stomach in the navel area.

This method allows you to detect venous reflux.

Another type of modification of the Valsalva maneuver. When the abdominal muscles are tense, the patient lies down in a horizontal position and raises his legs to an angle of 45 degrees.

The duration of this procedure is 15 seconds.

Diagnosis for male pathology - varicocele

When visiting a urologist, men are constantly subjected to a Valsalva maneuver in order to identify varicocele disease at the initial stage of its development. When identifying this pathology, the process of passing the method is that when the patient dials maximum amount

air and retains it, the doctor examines the patient’s testicles and scrotum using palpation.

When undergoing an ultrasound, the test reveals deviations from normal functionality in the affected areas of the veins. During an ultrasound, the patient needs to draw in as much air as possible and strongly strain the abdominal muscles. Spermatic cords

The testicles enlarge and nodules can be felt on them.

If nodules are palpable during palpation, then this is the first symptom of varicocele. Varicoceles can also be detected by palpation of the scrotum.

Diagnosis of ENT diseases

When straining for 30 or 40 seconds, the air mass at its maximum capture, there is an increase in pressure in the cavity of the eardrums, and the auditory tubes open, which allows air flow to enter the middle ear. During the Valsalva maneuver, the patient feels unpleasant symptoms pathologies in auditory organ

. There is a cracking sound in the ear, noise is heard, and discomfort in the organ. Signs of pathology can only be detected by a doctor. For pathology purulent otitis

If the auditory tube is swollen, when patency in it is preserved, at the time of the test, the patient hears a strong squeak in the sore ear, and also feels gurgling in the ear and loud noises.

The maneuver, or Valsalva technique, allows you to compare the pressure in the skull with the pressure of the atmosphere environment when flying by plane (takeoff and landing), and when suddenly immersed in water.
The Valsalva test in gynecology (obstetrics) involves filling Bladder and this test is performed to identify the functioning of the bladder sphincter. A woman should do her best deep breath and strain abdominal muscles.

The amount of fluid that comes out of the urethral canal is assessed. When performing this test, you should not restrain the pelvic muscles. A smooth increase in pressure inside the peritoneum activates the detrusor.

This test allows you to most accurately identify pathologies of the bladder, as well as the functionality of the sphincter of the urethral canal.

Using this technique, it is possible to identify the causes of female infertility.
Functional test using the Muller method

IN this moment the diaphragm is raised and more horizontal arrangement heart organ, cross dimension the heart enlarges due to an increase in its right side.

Happening strong pulsation vena cava, the left side of the organ pulsates noticeably less than before the test. Delayed maximum breathing for no more than 40 seconds.

The faster the recovery process occurs, the higher the tone of the myocardium, as well as the functioning of the blood flow system and respiratory organs.

Conclusion

The Valsalva maneuver is best method to determine varicose veins and study the condition of veins on lower limbs, as well as identifying male pathology varicocele.

Also, using this technique, it is possible to identify problems in gynecology and urinary incontinence, disturbances in the functioning of heart valves, and the presence of blood clots in the bloodstream.

The Valsalva maneuver allows you to identify pathology at the initial stage of its occurrence, when there are no obvious symptoms.