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so she has a fistula upper arm fistula okay this here this connection here this right here that is the anastomosis okay so for those of you that have been asking how does the anastomosis look this is her anastomosis so thats where the vein which this part is the vein connect with the artery the artery is coming below that anastomosis okay so remember that when we have a fistula we stick the vein portion of that fistula and since this fist this vein is connected to the artery you can see in the in the area that is closer to the artery you can actually see it like pumping stronger do you see that you can probably see that from where youre at yeah you see so when you come to see her when you come to um experience the fistula what youre going to do youre going to go with your two fingers youre going to start at the anastomosis okay youre going to apply pressure many students usually just do like this and they cant feel it and corin pushes their their fingers down so just come it doe