THE VENOUS PULSE. 



195 



10. indicated by b, c. Lastly, the sudden closure of the pulmonary 

 valves may even be indicated (g). As the aorta lies in direct relation 

 with the pulmonary artery, the sudden closure of its valves may also be 

 indicated (Fig. 86, 9, at d). During the diastole of the auricle and 

 ventricle, blood flows into the heart, so that the vein partly collapses 

 and the lever of the recording instrument descends (Riegel, Fran^ois- 

 Franck). 



The blood in the sinuses of the brain also undergoes a pulsatile movement, owing 

 to the fact that during cardiac diastole much blood flows into the veins (Mosso). 

 Under favourable circumstances, this movement may be propagated into the veins 

 of the retina, constituting the venous retinal pulse of the older observers (Helfrich). 



Jugular Vein Pulse. The venous pulse in the jugular vein is far better 

 marked in insufficiency of the tricuspid valve, and the vein may pulsate violently, 

 but if its valves be perfect the pulse is not propagated along the vein, so that a 

 pulse in the jugular vein is not necessarily a sign of insufficiency of the tricuspid valve, 

 but only of insufficiency of the valve of the jugular vein (Friedreich). 



Liver Pulse, The ventricular systole is propagated into the valve-less 



Fig. 86. 



Various forms of venous pulses, chiefly after Friedreich 1-8 from insufficiency of 

 the tricuspid ; 9 and 10, pulse of the jugular vein of a healthy person. In all 

 the curves, a, 6= contraction of the right auricle; b, c, of the right ventricle ; 

 d, closure of the aortic valves ; e, closure of the pulmonary valves ; e, f, 

 diastole of the right ventricle. 



inferior vena cava, and causes the liver pulse. With each systole blood passes into 

 the hepatic veins, so that the liver undergoes a systolic swelling and injection. 



