Describe Valsalva's maneuver by stating the role of the vocal cords and the abdominal muscles in accomplishing this maneuver. How does it affect venous return of blood to the heart? Why is it used as a test for the presence of a space-occupying lesion in the spinal canal?
The Valsalva maneuver was first described as a diagnostic tool for ear ailments by Antonio Maria Valsalva (Yale, 2005). The maneuver consists of inhaling and then "forcibly exhaling while keeping the mouth and nose closed, and thus resulting in increased pressure transmitted to the tympanic membrane" (Yale, 2005, ¶2).
The Valsalva is generally divided into four separate physiological phases (Mistovich, 2008, April 22). The first one is considered the onset of strain (Yale, 2005). During this phase the person inhales and the forcefully exhales using his abdominal and thoracic muscles against closed airways (Mistovich, 2008, April 22). This force against the closed glottis increases the intrathoracic and systolic blood pressure due to the initial compression of the aorta (Mistovich, 2008, April 22; Yale, 2005).
The second phase consist on "persistent straining and maintenance of the increased intrathoracic pressure"(Mistovich, 2008, April 22, ¶8) which causes the vena cava, aorta, and ...
The solution involves a detail description of the Valsalva's Maneuver including its four physiological phases. It also addresses the role of the abdominal muscles and the vocal chords in the maneuver, how it can be use to assess left-heart problems due to its effect on the venous return, and to detect the presence of a lesion in the spinal canal.