Compression fistula test

Introduction The Branham-Nicoladoni sign (oppression mouth test) is a symptom of congenital arteriovenous fistula. During any stage of development or development of the circulatory system, developmental arrest or abnormality can lead to vascular aberration, in which the developmental arrest of the reticular stage is more likely to cause CAVF, the expanded blood vessels communicate, aggregate and tend to fuse, histology It can be seen that the vascular communication is often extremely small, called micro arteriovenous fistula; the abnormal development of the vascular trunk formation period causes the abnormal vascular lumen to persist, forming a large arteriovenous fistula.

Cause

Causes of the pressure mouth test

The primordial blood vessels and blood cells are mesenchymes originating from the mesoderm. When the early embryonic body segments have not yet formed, in the outer neutrophils of the yolk sac and the pedicle, some cells concentrate to form a cell group of different sizes, called the blood island. . The blood islands gradually stretch and connect to each other to form the original capillary plexus. Arteries and veins originate from the same capillary plexus at the same time. The embryonic development process of blood vessels can be roughly divided into three stages: the plexus stage, the reticular stage and the tube trunk formation stage. During the reticular period, if the enlarged vascular traffic is concentrated and tends to fuse together, arteriovenous fistula can be produced. In histology, there are countless parallel blood vessels that are incompletely fused, and there are many traffic to each other. These traffic are often extremely small and called micro arteriovenous fistulas. During the formation of the trunk, the abnormally extensive traffic between the general circulatory arteries and veins is called the great arteriovenous fistula. There is still much debate about what causes vascular primordia dysplasia to form vascular malformations. Some scholars believe that congenital arteriovenous fistula is the inheritance of chromosomal abnormalities. However, Desaive and Bessone had 840 congenital malformations, and only 7 cases suggested a genetic history. In early pregnancy, toxic infections, metabolic disorders, abnormal position of the fetal position and umbilical cord cause compression trauma, which can affect normal fetal development. Endocrine and autonomic dysregulation can also affect the development of arteries, veins, and lymphatic systems. The embryonic development of the circulatory system is generally divided into three stages: 1 undifferentiated vascular primitive phase: undifferentiated stromal cells form bundles with vascular cell development, these early capillary cells spontaneously form tubular structures, biology A cell resembling a capillary hemangioma. 2 Reticulum: The original arterial and venous ducts begin to differentiate, but the main arteries and veins have not yet appeared. 3 blood vessels are based on the formation phase: mature blood vessels are formed. During any stage of development or development of the circulatory system, developmental arrest or abnormality can lead to vascular aberration, in which the developmental arrest of the reticular stage is more likely to cause CAVF, the expanded blood vessels communicate, aggregate and tend to fuse, histology It can be seen that the vascular communication is often extremely small, called micro arteriovenous fistula; the abnormal development of the vascular trunk formation period causes the abnormal vascular lumen to persist, forming a large arteriovenous fistula.

an examination

Related inspection

Two-dimensional echocardiography

Inspection and diagnosis of compression mouth test

Branham-Nicoladoni sign (compression mouth test): After compression of the fistula, the blood flow diverted through the branch is forced into the arterial system, the increase in peripheral circulation resistance and the sudden increase in extra blood volume in the arterial system raises blood pressure and stimulates The aortic decompression nerve and the nerve endings in the carotid sinus inhibit the vasomotor center and slow the heart rate. This sign is often absent in patients with no obvious systemic symptoms of CAVF.

Differential diagnosis

Compressed mouthwash test confusing symptoms

Systemic Vasculitis: A group of inflammatory diseases characterized by inflammation and necrosis of blood vessels. The clinical manifestations vary according to the type, size, location and pathological characteristics of the affected vessels. It often involves multiple systems throughout the body, causing multiple system and multiple organ dysfunction, but it can also be limited to a certain organ. The most common sites of systemic vasculitis are the skin, kidneys, lungs, and nervous system. The clinical manifestations of this group of diseases are complex and varied, and many of them are intractable.

Systemic vascular damage: systemic vascular damage caused by various pathological changes, can be seen in allergic purpura, dengue fever and so on.

Hardening of the arteries: Many elderly people have different degrees of hardening of the arteries. The blood vessels are very elastic. In order to make the blood flow smoothly, the inner wall is very soft. However, the blood vessels that form arteriosclerosis will thicken and harden, and the inner wall will have a powdery tumor (a porridge-like hardened nest), which is a bulge caused by the adhesion of cholesterol and platelets. As a result, the lumen of the blood vessel narrows, making the blood circulation unsmooth, and it will completely block when it continues to deteriorate.

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