Circulation

Question 1

• Bounding / “Water Hammer” pulse
• Quincke pulse (pulsating nail beds)
• Durasane’s Sign (femoral art)
• Head bobbing

Answer 1

Aortic Regurgitation

Due to↑S.V / Pulse Pressure -> Hyperdynamic circulation

Question 2

“Pulsus parvus et tardus”

Def’n, Seen In?

Answer 2

Pulses WEAK compared to HS.

SEEN IN: Aortic Stenosis

Question 3

“Pulseless disease”

weak upper extremity pulses

Answer 3

Takayasu’s Arteritis

Question 5

JVD

Seen In (2)?

Answer 5

SEEN IN:

• RHF
• SVC Sx

Question 5

Kussmaul’s Sign

Def’n, Mech (4 steps), Seen In (3)?

Answer 5

↑in JVP on INSPIRATION (instead of normal ↓).

MECH:
-ve intrathoracic P that devels on insp NOT transmitted to Heart ->
Impaired filling of R.H -> Bl backs up into Vena Cava -> JVD.

SEEN IN:

• Restrictive Cardiomyopathies
• Constrictive Pericarditis
• R Heart Tumors (ie Rhabdomyomas)

Question 6

Pulsus Paradoxus

Def’n, Seen In (4)?

Answer 6

Exaggerated drop ( > 10 mmHg) in SYS bp during INSP.

SEEN IN:

• • Cardiac Tamponade
• Constrictive Pericarditis
• Asthma (severe) / COPD
• Hypovolemic Shock