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Updated: May 15, 2025
When the heart's action is weak and the blood tension low the flow may appear to be continuous and not in jets. The blood from a divided artery at the bottom of a deep wound, escapes on the surface in a steady flow. Venous bleeding is not pulsatile, but occurs in a continuous stream, which, although both ends of the vessel may bleed, is more copious from the distal end.
The aneurysm usually springs from the third part of the artery, and appears as a tense, rounded, pulsatile swelling just above the clavicle and to the outer side of the sterno-mastoid muscle. It occasionally extends towards the thorax, where it may become adherent to the pleura. The radial pulse on the same side is small and delayed.
He knew that the pulsatile force was resident in the walls of the heart and in the arteries, and he knew that the expansion, or diastole, drew blood into its cavities, and that the systole forced blood out.
They consist in a pulsatile swelling sometimes in the supra-sternal notch, but usually towards the right side of the sternum with an increased area of dulness on percussion. With the X-rays a dark shadow is seen corresponding to the sac. Pain is usually a prominent symptom, and is largely referable to the pressure of the aneurysm on the vertebræ or the sternum, causing erosion of these bones.
You may remember that through the errors of Praxagoras and Erasistratus, the arteries were believed to contain air and got their name on that account: Galen showed by experiment that the arteries contain blood and not air. He studied particularly the movements of the heart, the action of the valves, and the pulsatile forces in the arteries.
In the median line, corresponding to the absence of sternum, was a longitudinal groove bounded on either side by a continuous hard ridge which articulated with the costal cartilages. The skin passed naturally over the chest from one side to another, but was raised at one part of the groove by a pulsatile swelling which occupied the position of the right auricle.
Between the clavicles another pulsatile swelling was easily felt but hardly seen, which was doubtless the arch of the aorta, as by putting the fingers on it one could feel a double shock, synchronous with distention and recoil of a vessel or opening and closing of the semilunar valves. Madden also mentions several analogous instances on record.
#Differential Diagnosis.# The diagnosis is to be made from other pulsatile swellings. Pulsation is sometimes transmitted from a large artery to a tumour, a mass of enlarged lymph glands, or an inflammatory swelling which lies in its vicinity, but the pulsation is not expansile a most important point in differential diagnosis.
It is pulsatile, and a systolic bruit or a "thrilling" murmur may be heard over it. The chief risk is hæmorrhage from injury or ulceration. [Illustration: FIG.
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