. Medical diagnosis for the student and practitioner. Fig. 384.—Usual maxima of audi-bility and lines of transmission ofbruit of aortic regurgitation. AORTIC INSUFFICIENCY 711 RATIONALE.—The Mental Picture.—77/1 second sound of the heartrepresents the closure of the aortic and pulmonic valves and thus marks, clinically,the end of systole ami the beginning of diastole. As regards the left heart* the term diastole at once brings before theminds eye the picture of an aorta overdistended by, and exerting compressionupon the blood which, having been forced at this instant into it by theventricular
. Medical diagnosis for the student and practitioner. Fig. 384.—Usual maxima of audi-bility and lines of transmission ofbruit of aortic regurgitation. AORTIC INSUFFICIENCY 711 RATIONALE.—The Mental Picture.—77/1 second sound of the heartrepresents the closure of the aortic and pulmonic valves and thus marks, clinically,the end of systole ami the beginning of diastole. As regards the left heart* the term diastole at once brings before theminds eye the picture of an aorta overdistended by, and exerting compressionupon the blood which, having been forced at this instant into it by theventricular systole and shut off from the heart by the closure of the aorticvalve, must seek normally the one open pathway represented by the systemicarteries. One sees also the left ventricle relaxed in diastole and the now openedmitral orifice through which the blood is rushing in from the left auricle aboveto reload the pumping chamber for its next systolic discharge. Fig. 385.—Configuration of heart and aorta in compensated aortic insufficiency. Theapex is so blunt in this case as to suggest masked stenosis. Compare with normal heartoutline and similar figures under mitral lesions. (Schwarz. modified.) Essentials of Valvular Efficiency.—Accurate closure of the aortic valve is The normal ventricle. absolutely essential to the maintenance of normal conditions of ventricularrefilling and the proper distribution of the force of the ventricular drive(pressure energy). This, in fractional part, (one per cent.) is required imme-diately to maintain the blood flow and, in far greater measure, to store poten-tial energy in the distended elastic aorta, and stabilize pressure and flow alikeuntil the next systolic discharge. This manifestly demands perfect freedomof movement and entire integrity of both the surface and outline of the three Normal valves 0 - t and ring cusps of the valve itself, together with adequate strength and consistence of essential,t
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectdiagnos, bookyear1922
