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22. RESEARCH OF PERIPHERAL VESSELS. PROPERTIES OF THE ARTERIAL PULSE UNDER PATHOLOGY (CHANGE OF RHYTHM, FREQUENCY, FILLING, VOLTAGE, WAVE FORM, PROPERTIES OF THE VASCULAR WALL OF THE VESSEL).

On palpation of the common carotid, humeral, ulnar, temporal, femoral, popliteal, and rear art stops, the tasks are narrowed down to an approximate assessment of the pulsatory movements by voltage and filling. The carotid artery is palpated on the left and right in a delicate way, removing the sternoclavicular-nipple muscle outwards at the level of the thyroid cartilage, palpating the facts of the common carotid artery on the left and right. The hanging artery of the palpate is relatively easy, since they are not covered by a thick layer of soft tissue and spread on a hard bone base. Hip art is found in the inguinal region and immediately above the pupartic ligament. In this case, the thigh of the patient should be straightened and slightly rotated outwards. The popliteal artery is the palpera in the medial part of the popliteal fossa, but this is often difficult in individuals with obesity and muscle development. Examine the wire in the position of the G-th on the stomach. The back arter of the foot belongs to the arteries of small caliber, so it is most often located abnormally. At normal spread, she felt in the proximal part of the first intertarsal space. The absence of her pulsat does not always speak of patol. In such cases, it is necessary to study the posterior tibial artery. She is easily probing behind her inner ankle. The conclusion was made taking into account the palpation of both arteries. Pathological types of pulse: 1. When examining the pulse on both hands, you can find a different pulse - differens cat means that the pulse is better on one of the two radial arteries, that is, on this arteries pulse has a greater filling and / or tension. 2. According to the filling of the differences, the pathologist types P: full - empty, large - small, high - low filiform; 3. Stress P. N. P. defined as solid and means that a large degree of pressure in the vessel requires more force to be pinched and the flow of cr. Counterfield quality - soft П- means v art. P 4. The shape of the pulse wave: equal - unequal, fast - slow, prancing, short - long, dicrotic;

Fast P means a fast rise of the wave and its rapid fall. Jumping pulse This is a kind of fast P, when the height of the pulse of the wave, filling of P, large pulse P is clearly predominant in the mechanism. Short P is the result of the prevalence of the rate of rise and fall of the pulse wave with a lesser degree of fullness P. Medl 1st P means slower rise and pulse of the wave is lowered.
Dicrotic P lies in the fact that dicrotic rise in the area of ​​the catacrotis is determined by palpation. At the same time, the dicrotic wave is barely palpable and is characteristic of P with hypotension, especially after the infect. Examination of the pulse wave shape will reveal special types, very important for the diagnosis of the pathologist, types P - alternating P Differences in pulse waves in amplitude and voltage make up the essence of alternation. Paradoxical P-called in those cases when the pulse of the wave on inspiration becomes less. With a delay in breathing, differences in filling and pulse voltage associated with breathing disappear. 5. Nar-i rhythm. Bigeminia means that the pulse wave is connected in pairs: the pulse wave and the wave of a smaller floor and voltage are normal. The following is a longer pause. Then again the repetition of norms and reduce the wave. Norm pulse heart rate corresponds to the abbreviation C. The 2nd wave is due to the extrasystic abbreviation C. The pause between the norms and the pathologist has less waves, therefore there is less diastolic filling of the stomachs, less ejection volume and, therefore, less filling and tension heart rate. Trigeminia After two normal waves, a pathologist detected a wave, having less filling and less tension. As in the previous type of arrhythmia, the pathologist wave is due to the extrasystole Quadrigeminia. In this case, after 3 wave norms, the extrasystole wave is determined with the same qualities as in the previous types of arrhythmia. Intermittent P is characteristic of the blockade of the sinoauricular node. Against the background of a rhythmic pulse, this revealed an outbreak of one wave and the pause between the pulse waves doubles, after which the researcher catches the previous rhythm. 6. Frequency P. Determination of frequency P allows you to identify two main types of pathologist, conditional - rare P, deficient P-reflects a condition when the contraction of C is not accompanied by a pulse wave. This happens with different forms of heart rhythm, when the contraction With hemodynamic is ineffective: atrial fibrillation, different types of extrasystoles arit 7. Elastic vessel wall. Sclerotic betrayals of art make them twisted hard with strands. The practical definition of the compaction of the walls of blood vessels is that when clamping the artery, n is not definable, but art is palpated.
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22. RESEARCH OF PERIPHERAL VESSELS. PROPERTIES OF THE ARTERIAL HEART UNDER PATHOLOGY (CHANGE OF RHYTHM, FREQUENCY, FILLING, VOLTAGE, WAVE FORM, PROPERTIES OF THE VASCULAR WALL OF THE VESSEL).

  1. 21. INSPECTION AND PALPATION OF PERIPHERAL VESSELS. RESEARCH OF THE ARTERIAL PULSE. PULSE PROPERTIES (7 BASIC PROPERTIES).
    Inspection of arteries: In young people, at rest, a pulsation can be observed: 1. Carotid artery on the neck. 2. Truncus brachiocephalicus in the jugular fossa. 3. Connect the arter in the subhole. 4. Abdominal aorta. In older people, an additional definition of pulsating arteries: 5. Shoulder 6. Elbow 7. Superficial temporal temporal pulsation; art can be detected in healthy people, which means physical and / or emotional stress. when ^
  2. The main types of iatrogenic pathology that occurs in the treatment of vascular diseases
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  3. 16. INSPECTION AND PALPATION OF THE HEART AREA. RESEARCH OF THE TOP APPLICATION, EDUCATION MECHANISM, ITS PROPERTIES IN NORMAL AND PATHOLOGY. PUSH OF RIGHT VENTRICLE, EDUCATIONAL MECHANISM, DIAGNOSTIC VALUE.
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  4. Acute arterial obstruction of the main vessels of the extremities
    DIAGNOSTICS The first subjective symptom of acute arterial obstruction is severe localized pain. With embolism, it comes on suddenly, is permanent, then there is a feeling of numbness in the fingers of the limbs, a feeling of "crawling creeps", the impossibility of active movement of the fingers, and later bending of the joints. Objective signs of acute arterial obstruction include:
  5. Acute arterial obstruction of the main vessels of the extremities (embolism and thrombosis)
    D - ka: The first cardinal subjective symptom of acute arterial obstruction is severe localized pain. With embolism, it occurs suddenly, the pain is permanent. Then patients have a feeling of anemia in the fingers of the limbs, a feeling of “crawling creeps,” the impossibility of active movement of the fingers, and then flexion of the joints. Objective signs of acute
  6. Physical properties of water (temperature, transparency, color, taste, smell) and the effect of these properties on human health.
    These include smell, taste, color and transparency, that is, those properties that can be determined by the human senses. Turbid, dyed in any color or having an unpleasant smell and taste, water is defective in sanitary-hygienic terms, even if it is harmless to the human body. Deterioration of the properties of water adversely affects the drinking water regime, reflexively
  7. Preservation by changing environmental properties
    Preservation of food products by changing the properties of the environment aims to change the chemical properties of the product to a level at which the growth and reproduction of microorganisms becomes impossible. Preservation by increasing the osmotic pressure Preservation by increasing the osmotic pressure can be carried out by the methods of salting the product and using sugar. In a microbial cell for her
  8. VESSEL RESEARCH
    The study of arteries: temporal, carotid, radial, femoral, popliteal, tibial arteries, arteries of the rear foot painless, elastic, their surface is smooth. The tortuosity of arteries is absent. Aortic pulsation in the jugular fossa is absent. When listening to the carotid, femoral, renal, arteries of the abdominal aorta, noises or pathological tones (double Traube tone, double noise
  9. 20. HEART NOISES. CLASSIFICATION. Intracardial noises. MECHANISM OF EDUCATION, PROPERTIES (7 PROPERTIES). DIAGNOSTIC VALUE
    The gray noises are the sounds that are called. Instead of heart sounds (C), accompanied by sounds of C or arise without any connection with the tones of C. Classification: I. Inside the sulfur: a-organ is 1 valve, 2 non-valve; b-functions are 1-intermediate, 2-pure functions, 3-physical ones; II extra-e: a-perekardia-e, b-pleuropericardi-e, c-cardiopulmonary Mech m of internal noise Noises C - these are mechanical oscillations of the engine caused by
  10. Autopsy and examination of the heart and blood vessels
    To open the heart, the drug should be in the following position: the entire organ complex lies on the table with the back surface down, the front up, the tongue from the prosector, the diaphragmatic surfaces of the lungs to the prosector. If the lungs were opened, as indicated, then at the end of their opening, the drug appears in this position. Organocomplex turned over only once. For
  11. Anesthesia during surgery on large vessels
    Operations on peripheral arteries and veins do not present any particular problems in the anesthesiological aspect, with the exception of cases associated with large blood loss. Difficult are anesthesia during operations on the main arteries (aorta, carotid artery). A high risk of such operations is associated with possible massive bleeding, ischemia of the organs supplying these circulatory
  12. VASCULAR DISEASES. Atherosclerosis and Arteriosclerosis. ARTERIAL HYPERTENSION. Hypertensive disease and arteriolosclerosis. VASCULITES
    VASCULAR DISEASES. Atherosclerosis and Arteriosclerosis. ARTERIAL HYPERTENSION. Hypertensive disease and arteriolosclerosis.
  13. STOP OF BLEEDING IN DAMAGE OF THE UPPER DEPARTMENT OF THE LOWER EXTREME VESSELS
    With multiple punctures by a trocar of the anterior abdominal wall, especially the right and left lower quadrants, there is a high probability of damage to the upper divisions of the lower epigastric vessels located along the lateral edges of the rectus abdominis muscle. Damage to these vessels is accompanied by the formation of a large hematoma in the anterior abdominal wall. If vascular ruptures are combined with significant
  14. Pulmonary edema with increased permeability of the vascular wall
    In many conditions called acute RDSV, the ultrastructure of the lungs is damaged and vascular permeability increases, which leads to the redistribution of water into the lung tissue. The concentration of protein in the interstitial fluid and in the alveoli increases. One of the main signs of RDSV is a large amount of protein in the pulmonary extravascular fluid and alveoli. Diagnostics. Cardiogenic edema
  15. Rheological properties of blood and their disorders in intensive care
    Hemorheology studies the physicochemical properties of blood, which determine its fluidity, i.e. ability to reversible deformation under the influence of external forces. A common quantitative measure of blood flow is its viscosity. The deterioration in blood flow is typical for patients in the intensive care unit. Increased blood viscosity creates additional resistance to blood flow and
  16. RHEOLOGICAL PROPERTIES OF BLOOD AND THEIR DISORDERS IN INTENSIVE THERAPY
    Hemorheology studies the physicochemical properties of blood, which determine its fluidity, i.e. ability to reversible deformation under the influence of external forces. A common quantitative measure of blood flow is its viscosity. The deterioration in blood flow is typical for patients in the intensive care unit. Increased blood viscosity creates additional resistance to blood flow and
  17. 23. ARTERIAL PRESSURE. METHOD OF DETERMINATION (N.S. KOROTKOV). ARTERIAL PRESSURE IN NORMAL AND PATHOLOGY. DIAGNOSTIC VALUE
    Velana P in arterium oscillates rhythmically, reaching the highest level during systole and decreasing at the time of diastole. This is explained by the fact that when systole is selected, blood meets sop of the walls of art and blood mass, filling up the art system, P in art ^, there is some stretching of their walls. During the period of diastole, art P v and is maintained at a definite level due to the elastocreservation of the walls of art and arterioles matching,
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