Pulse clinical characteristics main indexes:

1. Freaquency – shocks (beats) amount per minute. Norma: 60-80 per minute (sometimes it is considered to 90). It may be estimated both on sphygmogram and by palpation.

1. Freaquent pulse (tachycardy, trachysphygmy) – it takes place at hyperthermia, in course of physical loading. At body temperature increasing on 1°C in adults pulse freaquency increases on 8-10 beats, in children – on 15-20 beats per 1 min.

2. Seldom pulse (bradycardy, bradysphygmy) – in sportsmen, in well-trained people.

3. Pulse freaquency is changing in course of ageing:

• new-borns – 130-140 beats per min;

• 1 year – 120-130;

• 7 years – 90-100.

2. Rhythm – is determined both on sphygmogram and by palpation.

1. Rhythmical (regular) pulse – it is observed at equal spaces between pulse waves.

2. Arythmical (irregular) - it is observed at unequal spaces between pulse waves. Physiological arhythmias may be at intensive muscular loading, thermal procedures.

3. Pulse velocity – intensivity with which pressure in artery is increased during pulse wave arising and is reduced in course of its drop (it is determined the best on sphygmogram).

1. Rapid pulse - it may be in course of physical activity, aortal valve insufficiency.

2. Slow pulse – at faint, aortal ostium constriction.

4. Pulse altitude – is determined on sphygmogram.

1. High pulse -it is rapid or fast at the same time.

2. Low pulse – it is slow at the same time.

5. Pulse tension – vascular wall force or resistance degree to its pressure with fingers.

1. Solid pulse – pulse is accelerated and becomes stronger after vessel wall pressure. As a rule, it is observed at elderness due to vascular elasticity reducing; at hypertonic disease.

2. Soft pulse – pulse becomes slower and low-expressed after vessel wall palpation. It is under norma.

Diagnostic value: on tension degree one can tell about maximal blood pressure level. There is direct correlation between these 2 indexes.

6. Pulse filling – consists of pulse altitude and its tension. The higher systolic pressure plus blood volume and pulse altitude, the filling is stronger.

1. Full pulse.

2. Empty pulse – if pulse is small by its size, it is empty, as a rule.

3. Filliformis pulse – it is practically unexpressed - it is observed at strong bleeding, collaps and so on.

Capillary circulation and its peculiarities

Circulation in this part provides its main function – exchange between blood and tissues. That’s why main link in this system – capillaries – they are called exchangeable vessels. Thir function is tightly linked with vessels they are originated from - arterioles and vessels they come into (inflow) – venules. There exist direct arterio-venous anastomoses, connecting them out off capillaries. Mentioned vessels plus lymphatic capillaries are microcirculation system. This is main link of blood circulation system. Main reasons of diseases biggest part are in this region. Capillaries are the base of this system. Under rest state in norma only 25-35 per cent of them are opened, i.e. in working state; if more – one can see haemorrhagias and even organism death from internal bleeding, because blood is accumulated in capillaries and doesn’t reach heart.

Capillaries are located in intercellular spaces and that’s why metabolism occurs between blood and intercellular fluid.

Capillary exchange factors:

1. Hydrostatic pressure difference between capillary origin and its end (30-40 mm and 10 mm merc col correspondingly).

2. Low blood movement velocity (0,05 m/sec).

3. Filtration pressure (difference between oncotic pressure in intersticium and hydrostatic pressure in arterial capillary end – 15 mm merc col.). At its increasing – liquid comes into vessels and cellular dehydratation is developed.

4. Reabsorbtion pressure (difference between hydrostatic pressure in venous capillary end and oncotic pressure in intersticium – 15 mm merc col.). At its increasing – liquid (fluid) maily comes into tissues and oedemas are developed (for example, at proteins deficiency).

Capillary pulse (or Kwinke pulse) – pseudopulse, linked with rhythmical oscillations at small arteries dilation in course of ventricules systole. It is easily observed at thermal procedures: if one attaches mirror to lips small vessels pulsation is seen. But more often such pulse is pathology sign: aortal insufficiency, thyreotoxicosis.