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Updated: June 28, 2025
It is to be borne in mind that occasionally, when the interchange of blood between an aneurysm and the artery from which it arises is small, pulsation and bruit may be slight or even absent. This is also the case when the sac contains a considerable quantity of clot.
It may extend beneath the clavicle into the neck, or, extending inwards may form adhesions to the chest wall, and, after eroding the ribs, to the pleura. The usual symptoms of aneurysm are present, and the pressure effects on the veins and nerves are similar to those produced by an aneurysm of the subclavian.
It is convenient to describe in this section also certain conditions in which there is an abnormal communication between an artery and a vein arterio-venous aneurysm. In this class are included such dilatations as result from weakening of the arterial coats, combined, in most cases, with a loss of elasticity in the walls and increase in the arterial tension due to arterio-sclerosis.
To withstand the pressure the external coat becomes thickened, and as the aneurysm increases in size it forms adhesions to surrounding tissues, so that fasciæ, tendons, nerves, and other structures may be found matted together in its wall. The wall is further strengthened by the deposit on its inner aspect of blood-clot, which may eventually become organised.
"I expect that when you first began to go round the wards, you doubted whether you were cut out for medical practice. I did. For special work one needs special knowledge and an acquired faculty for making use of it. What does a second year's student make of a small thoracic aneurysm?
You know, the first lady has received now almost a million letters from people all across America and from all walks of life. I'd like to share just one of them with you. Richard Anderson of Reno, Nevada, lost his job and, with it, his health insurance. Two weeks later, his wife, Judy, suffered a cerebral aneurysm. He rushed her to the hospital, where she stayed in intensive care for 21 days.
It is a striking fact that aneurysm is seldom met with in women who have not suffered from syphilis. #Varieties Fusiform Aneurysm.# When the whole circumference of an artery has been weakened, the tension of the blood causes the walls to dilate uniformly, so that a fusiform or tubular aneurysm results.
Many heart patients are overdrugged. This sort of treatment is contraindicated in some kinds of heart disease, as heart weakness due to arteriosclerosis with high blood pressure, to aneurysm of the thoracic or abdominal aorta, and to nephritis.
A comparison of the pulse in the artery beyond the seat of the aneurysm with that in the corresponding artery on the healthy side, shows that on the affected side the wave is smaller in volume, and delayed in time. A pulse tracing shows that the normal impulse and dicrotic waves are lost, and that the force and rapidity of the tidal wave are diminished.
In the lower extremity the best place to apply a tourniquet is the middle third of the thigh; in the upper extremity, in the middle of the arm. A tourniquet should never be applied tighter or left on longer than is absolutely necessary. The screw tourniquet of Petit is to be preferred when it is desired to intermit the flow through the main artery as in operations for aneurysm.
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