CARDIOVASCULAR SYSTEMppt.pptx

Eg exercise fever patent ductus a 28 d like

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E.G. (EXERCISE, FEVER, PATENT DUCTUS ARTERIOSUS). 27
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49 28 D
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LIKE BISFERIANS PULSE, DICROTIC PULSE TOO HAS TWO PEAKS BUT UNLIKE BISFERIANS PULSE ONE PEAK IS IN SYSTOLE AND THE OTHER ONE IS IN DIASTOLE. IT IS ASSOCIATED WITH DILATED CARDIOMYOPATHY. 29
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51 30
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PULSUS ALTERNANS PULSUS ALTERNANS IS CHARACTERISED BY ALTERNATE STRONG AND WEAK BEAT DESPITE OF REGULAR RHYTHM. IT IS DUE TO ALTERATION IN LEFT VENTRICULAR CONTRACTILE FORCE . IT USUALLY INDICATES SEVERE LEFT VENTRICULAR FUNCTIONAL IMPAIRMENT. IT MAY ALSO OCCUR IN PAROXYSMAL TACHYCARDIA . OTHER CAUSE ARE: - TOXIC MYOCARDITIS. IN ACUTE MYOCARDIAL INFARCTION , THERE IS LEFT VENTRICULAR FUNCTION IMPAIRMENT , SO PULSUS ALTERANS CAN BE SEEN IN M.I. 31
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51 32 Ans. is 'd' i.e., MI . [Ref. Harrison 18"/e p. 1825; 1 7/e p. 1384 & p. 1256].
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PULSUS BIGEMINUS A PULSE WAVE WITH A NORMAL BEAT FOLLOWED BY A PREMATURE BEAT AND A COMPENSATORY PAUSE , OCCURRING IN RAPID SUCCESSION, RESULTING IN ALTERNATION OF THE STRENGTH OF THE PULSE. IN PULSUS ALTERNANS, COMPENSATORY PAUSE IS ABSENT , WHEREAS IN PULSUS BIGEMINUS, COMPENSATORY PAUSE IS PRESENT. PULSUS BIGEMINUS IS A SIGN OF DIGITALIS TOXICITY. 33
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53 34 Ans. is 'b' i.e., Radial artery [Ref: Harrison 18th/ep. 1824; 1711ep. 1384, Repeat]
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54 35 Ans. is 'C' i.e., Compensatory pause is absent
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WATER HAMMER PULSE OR CORRIGANS PULSE IT IS A LARGE BOUNDING PULSE , ASSOCIATED WITH INCREASED STROKE VOLUME OF THE LEFT VENTRICLE AND DECREASE IN THE PERIPHERAL RESISTANCE, LEADING TO A WIDE PULSE PRESSURE. THE PULSE STRIKES THE PALPATING FINGER WITH A RAPID, FORCEFUL JERK AND QUICKLY DISAPPEARS. IT IS BEST FELT IN THE RADIAL ARTERY WITH THE PATIENTS ARM ELEVATED. IT IS SEEN IN AORTIC REGURGITATION. 36
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PATHOPHYSIOLOGV OF WATER HAMMER PULSE IN AORTIC REGURGITATION THE STROKE VOLUME IS HIGH , SO THE SYSTOLIC PRESSURE IS HIGH AND THIS IS RESPONSIBLE FOR SHARP RISE IN THE PULSE. THE STROKE VOLUME IS HIGH BECAUSE THE LEFT VENTRICLE GETS BLOOD FROM TWO SOURCES DURING THE DIASTOLE I.E. BLOOD LEAKING FROM THE AORTA AND THE BLOOD IT RECEIVES FROM LEFT ATRIA. THE COLLAPSE OCCURS BECAUSE:.. DIASTOLIC LEAK OF BLOOD INTO THE LEFT VENTRICLE FROM THE AORTA RAPID RUN OFF. 37
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56 38 B
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4 39
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THE JUGULAR VENOUS PULSE (JVP) REFLECTS PHASIC PRESSURE CHANGES IN THE RIGHT ATRIUM AND IT CONSISTS OF THREE POSITIVE WAVES AND TWO NEGATIVE TROUGHS. 40
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41
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4 42 A
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7 43
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ABNORMALITIES OF THE 'A' WAVE GIANT 'A ' WAVE - THE RIGHT ATRIUM IS CONTRACTING AGAINST INCREASED RESISTANCE. WHICH CAN OCCUR AS A RESULT OF- OBSTRUCTION AT THE TRICUSPID VALVE:- - TRICUSPID STENOSIS. - RIGHT ATRIAL MYXOMA. CONDITIONS WITH INCREASE RESISTANCE TO RV FILLING:- - PULMONARY STENOSIS. - PULMONARY HYPERTENSION. 44
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CANON 'A ' WAVES:- WHEN RIGHT ATRIUM CONTRACTS WHILE THE TRICUSPID VALVE IS CLOSED DURING RV SYSTOLE.
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  • Winter '16
  • jean grey
  • Cardiology, Ans., Constrictive pericarditis

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