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Old 11-11-2013
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Question Kussmaul Sign

"during inspiration the jugular venous pressure and level of distension normally decreases"
itz written in UW.

i want to know how it decresses because during inspiration venous blood to right side increases so it should increase JVP.
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Old 11-11-2013
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Quote:
Originally Posted by medicalbiology View Post
"during inspiration the jugular venous pressure and level of distension normally decreases"
itz written in UW.

i want to know how it decresses because during inspiration venous blood to right side increases so it should increase JVP.
maybe its coz more blood goes in the lungs, as the pul. capacity increases, i know right atrium vol increases first but then more blood goes in the lungs eventually ..
maybe that's the concept behind this..

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Old 11-11-2013
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Okay, so this is the physio behind kussmal's sign. There is an increase of JVP on inspiration instead of a normal increase. So normally, on inspiration, we have a negative pressure developing in the chest, so that allows the lung to expand and the right heart to fill up. But Constrictive pericarditis and restrictive cardiomyopathies arent allowing the heart to expand so that the right side can fill adequately. So we get blood backing up into the venae cavae, which leads to jugular venous distension. Now FA also says we get this with cardiac tamponade, which makes sense, as it is restricting the expansion of the heart.
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Old 11-11-2013
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Quote:
Originally Posted by medicalbiology View Post
"during inspiration the jugular venous pressure and level of distension normally decreases"
itz written in UW.

i want to know how it decresses because during inspiration venous blood to right side increases so it should increase JVP.
see your concept is wrong, and i will use wikipedia to correct you :

Ordinarily the JVP falls with inspiration due to reduced pressure in the expanding thoracic cavity and the increased volume afforded to right ventricular expansion during diastole. Kussmaul's sign suggests impaired filling of the right ventricle due to either fluid in the pericardial space or a poorly compliant myocardium or pericardium. This impaired filling causes the increased blood flow to back up into the venous system, causing the jugular vein distension (JVD) and is seen clinically in the external jugular veins becoming more readily visible."

The basic point is, JVP falls during inspiration because the pressure is becoming less in the thoracic cavity (i.e more negative). Kaplan physio has a really nice cartoon about this..
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