Ripple (lat. pulsatio, pulsus - push) - jerky fluctuations of blood vessels, heart and adjacent tissues. Distinguish between physiological and pathological surge. Diagnostic significance of pathological pulsation of the heart and blood vessels in the chest, epigastric and hepatic ripple.
Severe aortic pulsation can be found in the I or II intercostal space to the right of the sternum for scaring puckering of the right lung, or because of the sharp expansion of the ascending aorta (see aortic Aneurysm). The pulsation of the aorta may also be determined in the jugular fossa with sclerotic lengthening of the aorta and in expanding or aneurysm its arc. At aneurism nameless artery marked "a throbbing tumor" in the field sternoclavicular joint. Ripple pulmonary artery is defined in II intercostal space on the left, in the case of wrinkling of the left lung, or when extending the pulmonary artery (hypertension in the pulmonary circulation).
Tumors in contact with the heart or large vessels, can cause pathological surge in the chest. The sharp shift in the heart of diseases of the respiratory system and changing the location of the diaphragm causes due to shifting of the heart and apical impulse to the appearance of unusual surge in the chest: in the III, IV intercostal space on the left with a significant shrinkage of the left lung and high standing of the diaphragm, in III-V intercostal space for the left srednesrochnoi line with the accumulation of liquid or gas the right pleural cavity, right in the IV-V intercostal space on the edge of a breast bone with atrophy of the right lung, with left-sided pneumo - or hydrothorax or dextrocardia. The omission of the diaphragm emphysema may lead to bias apex beat down and to the right.
On the neck distinguish between arterial and venous pulsation. Reinforced ripple carotid arteries occurs when the aortic valve insufficiency, aortic aneurysm, diffuse thyroid goitre, arterial hypertension. Odnovolova ripple jugular veins in pathological conditions may be as presistolic and systolic (positive public pulse). The exact nature of pathological pulsing veins is determined on flebogamma (see). When viewed normally you can see a distinct surge in the form of a single wave, less often two, after atrial contraction (presistolic) or synchronously with ventricular systole (systolic). The most characteristic systolic ripple jugular veins with simultaneous systolic P. enlarged liver with the lack of tricuspid valve. Presistolic P. happens when complete heart block, stenosis of the right venous holes, sometimes with atrioventricular rhythm and paroxysmal tachycardia.
Epigastric ripple can be caused by contractions of the heart, abdominal aorta, liver. P. hearts in this field is visible at low position of diaphragm and a significant increase in the right part of heart. Ripple abdominal aorta can be seen in healthy lean people with sluggish abdominal wall; more often, however, it happens in the presence of abdominal tumors in contact with the abdominal aorta, and sclerosis or aneurysm of the abdominal aorta. Hepatic ripple is better determined by palpation of the right lobe of the liver. True P. liver has extensive nature and manifested rhythmic increase and decrease of the liver due to changing filling its blood vessels (see heart Defects). Visible to the eye P. liver is determined when the hemangioma.
Pathological ripple arteries occurs when sealing the walls of blood vessels and increased cardiac activity in different pathological States of organism.
Graphic recording P. using multichannel devices more accurately determine its character.