CHAPTER XV

PRACTICAL SUGGESTIONS 256

ILLUSTRATIONS

FIG. PAGE

1. Cross section of a large artery 28

2. Cross section of a coronary artery 36

3. Arteriosclerosis of the thoracic and abdominal aorta 39

4. Arteriosclerosis of the arch of the aorta 40

5. Normal aorta 41

6. Radiogram showing calcification of both radial and ulnar arteries 42

7. Syphilitic aortitis of long standing 44

8. Diagrammatic representation of strain hypertrophy 48

9. Strain hypertrophy 49

10. Cross section of small artery in the mesentery 56

11. Enormous hypertrophy of left ventricle 58

12. Aortic incompetence with hypertrophy and dilatation of left ventricle 61

13. Cook's modification of Riva-Rocci's blood pressure instrument 72

14. Stanton's sphygmomanometer 73

15. The Erlanger sphygmomanometer with the Hirschfelder attachments 74

16. Desk model Baumanometer 75

17. Faught blood pressure instrument 76

18. Rogers' "Tycos" dial sphygmomanometer 77

19. Detail of the dial in the "Tycos" instrument 78

20. Faught dial instrument 79

21. Detail of the dial of the Faught instrument 79

22. The Sanborn instrument 80

23. Method of taking blood pressure with a patient in sitting position 81

24. Method of taking blood pressure with patient lying down 82

25. Observation by the auscultatory method and a mercury instrument 84

26. Observation by the auscultatory method and a dial instrument 85

27. Schema to illustrate decrease in pressure 86

28. Chart showing the normal limits of variation in systolic blood pressure 89

29. Tracing of auscultatory phenomena 94

30. Tracing of auscultatory phenomena 95

31. Clinical determination of diastolic pressure, fast drum 96

32. Clinical determination of diastolic pressure, slow drum 96

33. Venous blood pressure instrument 121

34. New venous pressure instrument 122

35. Events in the cardiac cycle 124

36. Simultaneous tracings of the jugular and carotid pulses 125

37. Jugular and carotid tracings 125

38. Right side of the heart showing distribution of the two vagus nerves 127

39. Normal electrocardiogram 128

40. Auricular flutter 132

41. Auricular fibrillation 134

42. Auricular fibrillation 134

43. Pulse deficit 135

44. Ventricular fibrillation 137

45. Auricular extrasystoles 139

46. Ventricular extrasystole 139

47. Delayed conduction 141

48. Partial heart block 141

49. Complete heart block 142

50. Alternating periods of sinus rhythm and auriculoventricular rhythm 144

51. Auriculoventricular or "nodal" rhythm 144

52. Influence of mechanical pressure on the right vagus nerve 144

53. Schematic distribution of right and left vagus 145

54. Blood pressure record from a normal reaction to ether 149

55. Chart showing the method of recording blood pressure during an operation 150

56. Method of using blood pressure instrument during operation 151

57. Finger-tip palpation of the radial artery 178

58. Finger-tip palpation of the radial artery 178

59. Aneurysm of the heart wall 196

60. Large aneurysm of the aorta eroding the sternum 198

ARTERIOSCLEROSIS AND HYPERTENSION