The last way is a variant of the valsalva test. How is a valsalva test performed for varicocele

The Valsalva test displays the reaction of the autonomic nervous system in response to her stimulation.

It is used as a method of emergency relief for relief paroxysmal tachycardia, and as a diagnostic technique in urology, gynecology, otorhinolaryngology.

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

It happens like this:

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

Often there are the concepts of "test" and "reception" of Valsalva. The only difference between the two is who the terms apply to.

A test, also known as the Valsalva maneuver, is the actions that a doctor performs for a therapeutic or diagnostic purpose.

Reception is the actions of the patient himself, which he performs on his own to relieve unpleasant symptoms.

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

Indications and contraindications

Indications for the 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).
The study of the viability of venous valves in venous system lower extremities (in combination with ultrasound).
Restoration and study of the patency of the auditory tubes in otitis media, eustachitis, as well as a decrease in pressure in the middle ear cavity during an airplane flight, scuba diving.
Emergency care for paroxysmal tachycardia.
Diagnosis of varicocele.
Diagnosis of urinary incontinence.

Contraindications:

Signs of acute cardiovascular insufficiency: pain in the region of the heart, shortness of breath, impaired consciousness, drop in blood pressure.
Thromboembolism of arteries of any localization.
Myocardial infarction or stroke (stroke) in history.
Diseases of the arteries and veins.
Any acute illness.
Heart failure stage II.
proliferative retinopathy.
Exacerbation of any chronic disease.
Sepsis.

How and in what cases is it done?

This approach is used in various areas medicine, let's take a closer look at each case.

Phlebology

When performing ultrasound of the veins of the lower extremities to detect venous insufficiency use the Valsalva maneuver. 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 farthest 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 muscle, which, as it were, push the blood through the vein. To prevent the return of blood in the opposite direction, there are valves in the vessels that prevent retrograde blood flow.

Whether stagnation of blood in the veins will be expressed depends on the valvular apparatus, which should not let blood flow in the opposite direction. If the valves are unable to close and remain closed, Doppler ultrasound will determine the reverse flow of blood and vein expansion 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 the initial stage this disease can be detected by creating an iatrogenic congestion of the veins of the spermatic cord with venous blood.

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

Valsalva maneuver combined 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 rather, the ratio of the duration of the longest interval to the shortest. The smaller this ratio, the higher the risk of sudden cardiac arrest.

The Valsalva maneuver is used by doctors to auscultate the heart. In particular, with 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 paroxysmal 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 has noticeably decreased, then there is sinus or supraventricular tachycardia;
with ventricular arrhythmia, the test is negative.

Gynecology

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

This happens due to the 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.

Also, this method is used in obstetrics in the second stage of childbirth, to increase the effectiveness of the attempts of a pregnant woman.

Otolaryngology

During straining at the height of inhalation, the patient is asked to try to release air through the ears, while not exhaling the air itself. In this case, "blowing" occurs eustachian tube(tube connecting the nasopharynx with the ear cavity).

This technique is used by divers and those who fly by plane. With a decrease atmospheric pressure there is a difference in pressure outside and inside the ear cavity, there is a feeling of congestion in the ears.

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

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

Neurosurgery

If there is a suspicion of damage to the pleura during surgery on thoracic region spine under conduction anesthesia, the doctor asks the patient to strain on exhalation. If the pleural sheets are damaged, then during straining, a whistle of air passing into pleural cavity. This is done by reducing the pressure in chest cavity and air intake through the formed defect.

Before the advent of highly informative diagnostic methods (for example, CT with angiography), to identify vascular pathology it was difficult. That's why they used a sample for diagnostics congenital anomalies cerebral vessels, such as malformations. During the procedure, patients noted the appearance or sharp increase in headache.

Medical tests and research do not come to us from nowhere. Before becoming public property, they undergo many tests and checks, and only then they begin to serve people for diagnosis. various diseases. The Valsalva test is not as popular as, for example, a clinical blood test. This test is used for a narrowly focused diagnosis. Especially often the test is done for varicose veins and some other diseases.

Valsalva test - historical background

Otherwise, this test is called Valsalva tension. This test is named after the well-known anatomist Antonio Maria Valsalva. Initially, the test was aimed at removing pus in otitis media from the middle ear. But today it is used by drivers, aircraft passengers, doctors in the treatment of varicose veins and other diseases. The method consists in the fact that a person inhales forcefully, provided that the mouth and nose are closed. Often this test is prescribed along with other examination methods. This is done in order to establish the correct and accurate diagnosis. The test is informative when applied with ultrasound and electrocardiogram.

How is this method used for varicose veins?

A medical examination for varicose veins begins with a doctor's examination, palpation and anamnesis. In addition to these methods, you may need a Valsalva test, which allows you to determine the pathology of the vessels and the performance of the valve apparatus in the venous system.

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

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

When a Valsalva maneuver is performed, the pressure in the arteries (BP) and the heart rate (HR) are measured for a certain time. In this case, the patient should lie down (take horizontal position) and inhale through the tube to which the manometer is attached. It is forbidden 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 expanded diameter of the veins, as well as understand whether there is reflux.

A lot depends on a correctly collected anamnesis, 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, work. For women, information about pregnancy and childbirth is important.

Application of the method for varicocele

Men can develop varicose veins of the ovaries and spermatic cord. This disease is called varicocele. It is the most diagnosed among men. The disease occurs in three stages. When using the Valsalva method, 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, state the absence of varicose veins. To identify the true state of the ovarian vein system, the Valsalva test for varicocele is done standing and lying down, while the doctor examines the veins and makes a comparison.

Features of ultrasound with a Valsalva test

Ultrasound is also informative method diagnostics. With it, you can examine almost any human organ. If the Valsalva test, ultrasound are performed together, then the patient will definitely need to stand up. First, the doctor examines the patient in general. In this case, the thickness of the veins and their consistency are determined. After general inspection the patient, at the request of the doctor, tenses the muscles and inflates the abdomen. If there are varicose veins, then the doctor observes an increase in the vessels changed due to damage and reveals soft elastic nodes. When conducting an ultrasound, the Valsalva test makes it possible to determine how the blood flow is disturbed in the opposite direction, and, of course, the expansion of the veins.

What does a positive test mean?

AT circulatory system there are venous valves - a kind of "locks" that close when blood passes through them, and do not allow it to go back. When the "locks" are faulty, the blood flows down and stagnates there. If during the study the Valsalva test is positive, then there is a lack of valve operation. When registering reverse blood flow, the doctor diagnoses a deficiency in the operation of the valves of superficial vessels. According to the results of the medical test, further manipulations or drug therapy are prescribed.

Valsalva test is negative - what is it?

But the results of this survey can be not only positive, but also with a minus sign. If the Valsalva test for varicose veins is negative, then there are no anomalies in the studied veins. 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 diagnostics of some types of tachycardia is necessary, it is carried out in conjunction with an ECG;
the test is carried out if it is necessary to evaluate the performance of the function of the valve apparatus of the veins on the legs, it is also carried out not alone, but in conjunction with a Doppler study;
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 the Valsalva test and the reception. 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 pass on its own, but with some other study. The Valsalva maneuver is necessary for the elimination discomfort or conditions, for example, with a sharp drop in pressure, altitude, heart palpitations.

Valsalva test (Valsalva tension) Forced exhalation with closed nose and mouth. This test is also called the Valsalva test or the 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 in otitis media. Now divers must use it when diving, to equalize the pressure in the sinuses upper jaw and middle ear, as well as aircraft passengers during climb and descent.

The Valsalva test is as follows. After a full exhalation and a deep breath, exhale and hold the breath.

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

Carry out continuous recording of blood pressure and heart rate. There are 4 phases of changes in these indicators: phases I and II correspond to exhalation, III and IV - to the cessation of exhalation. Phases I and III are due to a purely mechanical change in intrathoracic and intra-abdominal pressure and are of no 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 (OPVR) increases. This leads to the fact that the fall in blood pressure at approximately the 5-8th second of the test stops and by the end of phase II, blood pressure returns to its original value. AT III phase BP first falls sharply, then begins to rise and in phase IV becomes higher than the original (since OPSS is still elevated). At the same time, due to the stimulation of baroreceptors, bradycardia develops. By the end of phase IV, BP, venous return and cardiac output return to the original level.

The Valsalva test reflects the safety 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 coefficient 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 II and IV phases. With values of the Valsalva coefficient less than 1.1, we can confidently speak about the presence of parasympathetic insufficiency in the patient.

When performing the 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 interval R-R during the test.

The test results are affected by age, body position, expiratory pressure, expiratory duration, FVC, and medication.

The Valsalva test includes the following physiological steps:

Covering the glottis.
Increased intra-abdominal pressure due to contraction of the diaphragm and abdominal muscles.
An increase in intrathoracic pressure due to contraction of the respiratory muscles.

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

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

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

The Valsalva maneuver is used in cardiology to assess prognosis sudden death after myocardial infarction by measuring 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.

With the help of the Valsalva test, a study of the patency of the auditory tubes is also carried out.

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 as if intensified through the nose. Under the pressure of exhaled air, the auditory tubes open and air enters the tympanic cavity with force. This is accompanied by a slight crackle, which is felt by the subject, and the doctor listens to the characteristic noise through the otoscope.

Politzer test

Insert the olive of the balloon in the vestibule of the nasal cavity on the right and hold it with the II finger of the left hand, and press the left wing of the nose against the nasal septum with the I finger. 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 pronounce 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 the right hand. At the moment of blowing, when pronouncing the syllable "move" or the word "three", the soft palate deviates posteriorly and separates the nasopharynx. Air enters the closed cavity of the nasopharynx and evenly presses on all walls, while part 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. Do the same on the left side.

Blowing the auditory tubes during catheterization

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

Hearing study

Indications:

Determination of hearing acuity and the degree of its decrease;

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

The study of hearing in whispered and colloquial speech

The study is carried out separately for each ear. Place the subject at a distance of 6 m from you. The ear to be examined should be directed towards the doctor, and the opposite ear should be closed with the index finger, firmly pressing the tragus against the opening of the ear canal.

Explain to the subject that he should loudly repeat the words he heard.

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 an unforced exhalation, pronounces two-digit numbers from 21 to 99 (Bezold's method). You can use words with low sounds, (example: 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 does not hear from a distance of 6 meters, the doctor reduces the distance by 1 meter and re-examines the hearing. This procedure is repeated until the subject repeats the spoken words. You can start examining hearing at a distance of 0.5-1 m from the ear and move away, at a distance when the subject repeats correctly at least 5 numbers or words, but no further than 6 m.

quantitative expression this study produce in meters indicating the distance from which the subject hears numbers or words uttered in a whisper. The perception of whispered speech is normally 6 meters.

Study colloquial speech produce also, only drown out the second ear with a piece of paper, on which they tap with their fingers, and scream - when the second ear is drowned out with the Barani rattle.

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

This technique consists in the patient's attempt to exhale a stream of air with the mouth organ and nose closed.

What is a Valsalva test and maneuver?

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

The Valsalva maneuver is used by people on airplanes when a ship is taking off, as well as when an airliner is landing. They use the technique and drivers, when diving to a great depth of the sea, to alleviate the state of the body with a rapid drop in atmospheric pressure.

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

Indications and contraindications for the Valsalva maneuver

The Valsalva test is a testing method for detecting pathologies with such disorders in the body:

Diagnosis of palpitations;
At an attack of myocardial infarction, to determine the risk lethal outcome;
Evaluation of the performance of valves in the veins;
Diagnosis of varicose veins;
Diagnosis of the pathology of the reproductive system - varicocele;
When determining the functioning vegetative system person;
For the study of patency in auditory canals with otitis.

You should not practice the Valsalva method with such pathologies:

Hypertonic disease;
Rapid heartbeat - tachycardia;
With a disease of the heart organ - cardialgia;
During an asthma attack;
During the period of fainting.

Do not perform a Valsalva test with the following pathologies:

At acute infarction myocardium;
With cerebral hemorrhage - stroke;
In cardiac pathology, insufficiency of the second and higher degree;
PE disease;
Pathology appendicitis;
With peritonitis;
With a disease of retinopathy;
In a state of fever;
With 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 test is used for diagnostics in cardiology, but it is also possible to identify diseases that develop in cervical region is a pathology thyroid gland, retrosternal goiter.

The essence and mechanism of the Valsalva test

The Valsalva test is a specific method for detecting pathologies, which is used by specialists from 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 function 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 end of the air release procedure, the patient restores breathing.

At the time of the procedure, the following indicators are constantly recorded:

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

Instead of the usual physiological exhalation of air, there is tension in the muscles of the chest, as well as in the muscles of the abdomen.

Phases by which pathologies are detected

Phase #1 of 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 #2- the tension phase reveals: hypertensive pathology, increased heart rate - tachycardia, as well as vascular resistance peripheral system. The heart organ at this period of the test is filled with blood to the maximum, the lungs become more transparent. The stage of the second phase continues, no more than seven seconds;
Phase #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 falls, the contractions of the heart muscle become less frequent and deeper. The size of the heart organ and lungs comes in normal condition;
Phase #4- this is the final period of the study of the Valsalva test, and the period of relaxation of the respiratory system. During this period, the blood pressure index rises, the pathology of the heart manifests itself - bradycardia, as well as vasodilation of the vessels of the peripheral sphere. The blood flow system is restored, as well as venous return of blood.

During the Valsalva test, there is a reconciliation of indicators according to the cardiogram and the length between R-R teeth. 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 in the blood circulation system, the coefficient is 1.70.

If the revealed coefficient is in the range of 1.30 - 1.70, then this border state organism.

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

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

Valsalva test in venous pathology

Quite often with varicose veins, patients, along with other instrumental techniques diagnostic study, a Valsalva test is also prescribed.

In case of violations of the venous valves, there is an incorrect blood flow in the veins, the process of regurgitation often occurs, during which there is an overstrain of the veins and the pathology of varicose veins develops.

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

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

When diagnosed by the Valsalva method, the inner 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 does not allow the valves of the veins to close in a timely manner. The Valsalva maneuver allows you to achieve top speed in the venous circulation.

Positive and negative Valsalva test

A positive diagnostic test by the Valsalva method reveals:

Poor functionality of venous valves;
Stagnation of venous blood.

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

A negative diagnostic test indicates the normal functionality of the veins, as well as good working capacity venule

The Valsalva test is not always as objective as possible.

The whole problem is that to achieve the maximum description of information, it is necessary that the abdominal muscles 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 the disease;
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 muscles of the abdominal cavity, and the doctor presses on the abdomen in the navel area.

This method allows to detect venous reflux.

Another type of modification of the Valsalva test. With tension in the abdominal muscles, the patient lies down in a horizontal position, and raises the legs to an angle of 45 degrees.

The duration of this procedure is 15 seconds.

Diagnostics in male pathology - varicocele

When men see a urologist, they constantly do a Valsalva test in order to identify varicocele disease at the initial stage of its development.

When this pathology is detected, the process of passing the method consists in the fact that when the patient gains maximum amount air and delays it, the doctor examines the testicles of the patient and his scrotum by palpation.

When passing through an ultrasound, the test reveals a deviation from the norm of functionality in the affected areas of the veins.

During the ultrasound, the patient needs to gain the maximum amount of air and strongly strain the muscles of the abdominal cavity. spermatic cords testicles are enlarged, and nodules can be felt on them.

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

Diagnosis in ENT diseases

When straining for 30 or 40 seconds, the air mass at its maximum capture, there is an increase in the cavity of the tympanic membranes, and the auditory tubes open, which allows the air flow to enter the middle ear.

At the time of the test according to the Valsalva technique, the patient feels unpleasant symptoms pathologies in auditory organ. There is a crackling in the ear, noise is heard, discomfort in the organ. Signs of pathology can only be detected by a doctor.

With pathology purulent otitis media perforation of the eardrum occurs, and pus comes out of it.

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

The maneuver, or the 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 with a sharp immersion in the water.
A test according to the Valsalva technique in gynecology (in obstetrics) provides for filling Bladder and this test is performed to detect the work of the sphincter of the bladder. A woman should do her best deep breath and strain abdominal muscles.

An assessment is made of the amount of fluid that came out of the urethral canal. When performing this test, do not hold back the muscles of the small pelvis. A gradual increase in pressure inside the peritoneum activates the detrusor.

This test allows you to accurately identify the pathology 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 according to the Muller method

AT this moment the diaphragm rises and X-ray shows more horizontal arrangement heart organ, transverse dimension heart increases due to an increase in its right side.

going on strong pulsation vena cava, the left side of the organ pulsates noticeably less than before the start of the test. delayed maximum breath no more than 40 seconds.

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

Conclusion

The Valsalva test 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 method, it is possible to identify problems in gynecology and urinary incontinence, abnormalities in the operation of heart valves, the presence of blood clots in the bloodstream.

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