Pulses Flashcards
What is pulsus paradox?
- Greater than the normal (10 mmHg) fall in systolic blood pressure during inspiration → faint or absent pulse in inspiration
Where do you get pulsus paradox?
- Severe asthma
- Cardiac tamponade
Where do you get a slow rising pulse?
Aortic stenosis
Where do yo get a collapsing pulse?
- Aortic regurgitation
- Patent ductus arteriosus
- Hyperkinetic states (anaemia, thyrotoxic, fever, exercise/pregnancy)
Where do you get pulsis alternans?
Severe LVF
What is pulsus alternans?
Regular alternation of the force of the arterial pulse
What is bisferiens pulse?
‘Double pulse’ - two systolic peaks
Where do you get bisferiens pulse?
Mixed aortic valve disease
Where do you get a jerky pulse?
Hypertrophic obstructive cardiomyopathy*
*HOCM may occasionally be associated with a bisferiens pulse
What can the long saphenous vein be used for?
- This vein may be harvested for bypass surgery
- Removed as treatment for varicose veins with saphenofemoral junction incompetence
Describe the course of the long saphenous vein
- Originates at the 1st digit where the dorsal vein merges with the dorsal venous arch of the foot
- Passes anterior to the medial malleolus ==> runs up the medial side of the leg
- At the knee: runs over the posterior border of the medial epicondyle of the femur bone
- Passes laterally to lie on the anterior surface of the thigh before entering an opening in the fascia lata called the saphenous opening
- It joins with the femoral vein in the region of the femoral triangle at the saphenofemoral junction
What are the tributaries of the saphenous vein?
- Medial marginal
- Superficial epigastric
- Superficial iliac circumflex
- Superficial external pudendal veins
Describe the course of the short saphenous vein
- Originates at the 5th digit where the dorsal vein merges with the dorsal venous arch of the foot, which attaches to the great saphenous vein.
- It passes around the lateral aspect of the foot (inferior and posterior to the lateral malleolus) and runs along the posterior aspect of the leg (with the sural nerve)
- Passes between the heads of the gastrocnemius muscle, and drains into the popliteal vein, approximately at or above the level of the knee joint