Pulses and JVP

Central venous pulse gives more information than peripheral radial pulse regarding LV function or aortic valve function.

1) Pulsus parvus - Common in diminished LV stroke volume

2) Hypokinetic pulse- Hypovolemia, LV failure, Restrictive pericardial disease, MV stenosis

3) Hyperkinetic pulse- Increased LV stroke volume, Wide pulse pressure, CHB, Anxiety, anemia, Beri-Beri, fever, AV fistula

4) Bisferiens pulse- Aortic regurgitation , HOCM

5) Pulses alternans- Severely diminished LV contractile force

6) Pulses paradoxus- Pericardial tamponade, airway obstruction, SVC obstruction



Jugular Venous Pulse ( JVP) :

JVP reflects phasic pressure changes in right atrium

Normal JVP consists of three positive waves and two negative troughs.

" a " Wave : Due to venous distension due to right atrial contraction

" c " Wave : Positive wave produced by bulging of tricuspid valve into right atrium during right ventricular systole

" v " Wave : Due to increased volume of blood in right atrium during ventricular sysole when tricuspid valve is closed..

Abnormalities:

Large "a" Wave : Tricuspid stenosis

Pulmonar stenosis

Pulmonary hypertension

Cannon " a" wave :

Regularly : Junctional rhythm

Irregularly : AV dissociation or Complete heart block

Absent " a" wave : Atrial fibrillation

" x" descent : Seen in constrictive pericarditis

Prominent " v " wave : Tricuspid regurgitation

" y " descent : Opening of tricuspid valve and rapid flow of blood into right ventricle

Rapid "y" descent : Severe TR

Slow " y" desent : Suggest obstruction to right ventricular filling e. g. tricuspid stenosis and Right atrial myxoma

Kussmaul sign : Increase in CVP during inspiration rather than normal decrease .Seen in

Severe right sided heart failure as in cases of right ventricular infarction and

Constrictive pericarditis

source : www.pgexam.com

Indian MD/MS Entrance Examinations

The main aim of this blog is to help MBBS students preparing for Various PG entrance examination, like All India, AIIMS, PGI, JIPMER, UPSC and Punjab PG exam. After passing the MBBS exam, students start preparing for their MD entrance examination. The whole syllabus consists of various subjects studied at MBBS level.

While there is division of different subjects and each subject is important from its own perspective, yet Medicine is the backbone of all entrance examinations. All questions given in examination have some sort of clinical touch. So we think that medicine subject preparation is very useful for preparing for PG examination .

In addition , some entrance examinations use to ask clinical questions like AIIMS, All India and UPSC exam. So Medicine subject is very important.

As such , Medicine is a very vast subject and incorporates some other subjects like Pathology, Microbiology and Pharmacology.

Presently we will concentrate on medicine subject only.

In this website we will try to focus on Medicine initially and will try our best to present some material for Medicine preparation for PG examination.