liz askew Dec 1, 2006:

Here are two refs, one in Sp, one in English (I have learnt something too today!): Facultad de Medicina
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maniobra de Landivar: ocluyendo el orificio profundo del canal inguinal, se pide al paciente que tosa, si es una HIOE ésta no se reproduce, asimismo sirve ...
www.mednet.org.uy/cq3/estudiantes/herniainguinal.htm - 29k - Cached - Similar pages

Let us assume that you are satisfied that the lump is an inguinal hernia - the next step is to decide whether it is an indirect hernia (along the full course of the inguinal canal from deep to superficial rings) or a direct hernia (pushing forwards through the anterior abdominal wall in the region of the superficial inguinal ring). Most inguinal hernias are indirect - only 10 to 20 per cent are direct. Examine your patient in the standing position after the swelling has been reduced (reduced in size by pressing it back towards the plane of the abdominal wall). Ask him to cough while you press your finger first over the deep inguinal ring and then over the superficial ring. To do this you will need to be clear about the exact position of both rings. Alternatively the contents of the inguinal canal may be palpated: if a sac comes down the inguinal canal when the patient coughs, an oblique or indirect hernia is present. The detection of an impulse coming through the canal from behind indicates that a direct hernia is more likely. An indirect hernia tends to descend more readily into the scrotum and may extend as far as the testis, while a direct hernia remains outside most of the coverings of the spermatic cord and often presents as a more limited swelling close to the pubic tubercle.

Roxanna Delgado Dec 1, 2006:

Como ves en la M. De valsalva se requiere que las vías aéreas estén cerradas (closed lips and pinched nose). Trata de toser así a ver si puedes!

Roxanna Delgado Dec 1, 2006:

Landivar y Valsalva en este caso no son sinónimos. Estoy de acuerdo con la descripción de Jason en cuanto a el procedimiento que se hace, pero no es lo mismo que la maniobra de valsalva.
In medicine, the Valsalva maneuver is performed by forcibly exhaling against closed lips and pinched nose, forcing air into the middle ear if the Eustachian tube is open. This maneuver with slight modifications can be used as a test of cardiac function and autonomic nervous control of the heart or to ‘clear’ the ears (equalize pressure) when external pressure increases, as in diving or aviation