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Changes in maximum arterial pressure in the shin in patients with obstruction of the major arteries of the limbs with changes in body position


, : Changes in maximum arterial pressure in the shin in patients with obstruction of the major arteries of the limbs with changes in body position. Izv Akad Nauk La Tv Ssr 7 228: 110-114

To a known degree the initial level of arterial pressure affects the nature of the changes occurring in arterial pressure in the shin when there are changes in body position. In patients having an initial pressure of 50 mm and less there is a significant increase in the pressure in the shin, exceeding the theoretically anticipated increment even when there is a slight turning of the body with the legs downward. In proportion to the subsequent increase in hydrostatic pressure in the lower extremities, this non-correspondence between the actual and the theoretical increment is preserved. In patients with a pressure of from 50-100 mm in the shin, when there is a moderate increase in the hydrostatic pressure in the shin, arterial pressure in a number of cases increases more than that which is anticipated, but on the average corresponds to the anticipated increment. When there is a subsequent increase in the hydrostatic pressure in the shin in most of the patients of this group there is a slight lag between the actual increase in local arterial pressure and the theoretically anticipated one. In patients with relatively good circulation in the limbs (with an initial arterial pressure in the shin of 100 mm and more) there is a linear increase in arterial pressure in the shin in proportion to an increase in hydrostatic pressure in the arteries of the lower limbs; however, this increase lags somewhat behind the theoretically expected one. Thus, in patients with obstruction of the flow of the major arteries in the legs, when there is a change from the horizontal position to the leaning (slanting) or vertical position, resistance is not increased, or only increased to an insignificant degree in the arteries. In patients with severe circulatory disorders in the limbs, when there is very low initial local arterial pressure there is also a drop in arterial resistance even when there is an increase in pressure in them. When there is an initial low tonus of the arteries of the leg affected, an increase in intraarterial pressure caused dilation of the arteries and a drop in their resistance. The result of this should be the decrease in the gradient of arterial pressure in the limb affected, and consequently, a great rise in arterial pressure in the distal parts of the limb that was observed in the patients. The disproportionately great increase in arterial pressure in the shin when there is a change to the slanting position (legs downward) in some of the patients can also be explained by the curtailment of the shunting of the vessels of the distal parts of the limb by the vessels of the proximal part of it.

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