J.Jpn. Surg. Soc.. 60(12): 1932-1961, 1960
FUNDAMENTAL STUDIES ON PHOTOELECTRIC PLETHYSMOGRAPHY OF FINGER TIPS
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1st Surgical Department, Tokyo University School of Medicine (Director: Prof. Kentaro SHIMIZU) Hiromi KOREHISA |
1) The vasoreflex is manifested by two responses, namely vasoconstriction and tachycardia noted by means of photoelectric plethysmography of the finger tip. These responses vary along with the nature of stimulus, but strictly speaking, they are assumed to be essentially dependent on the intensity of stimulus and on the sensibility of an individual.
2) The vasoconstrictive response in vasoreflex is inhibited by the Histamin Iontophoresis, and even then, when the tachyardia occurs, amplitude of the digital pulse wave decreases. This fact is presumably due to the hemodynamic effect such as reduction of stroke volume, low pulse pressure etc.
3) In fingers with disturbed circulation, vasoconstriction tends to be less remarcable and to disappear more readily than in the normal fingers by Histamin Iontophoresis.
This phenomenon was assumed to be not due to the nervous disturbance, but to the abnormality of the vessel itseIf.
4) The author showed that vasospastic and occlusive states of the finger arteries or arterioles could be differentiated from the normal state with the aid of Histamin Iontophoresis.
(B) Several findings concerning the constitution of the pulse wave at finger tips are as follows :
1) Physiological and anatomical studies showed that the volume pulse at the finger, especially at the nail root, was the total of the pulsations of small arteries of approximately 50~1000μ in diameter; and also showed that the arteries of several hundreds in diameter played the most significant role in constitution of the volume pulse.
2) The anatomical and functional correlations between these arteries suggested some informations about the cause of sudden fall in the peripheral blood pressure.
(C) Correlation between amplitudes of volume pulses at five fingers.
1) In the record of the photoelectric phlethysmography of five fingers, we found that there was a regular or irregular correlation between amplitudes of the pulsewaves of each finger. The pulse amplitudes are perhaps influenced by the thickness of fingers and by the direct branches from the middle sized arteries in the fore-arm. The author proved that the dominant factor was the hemodynamic effect of the palmar arch, the radial artery and the ulnar artery.
The digital circulation is classified into 4 types, namely radio-ulnar type with sufficient arch, radio-ulnar type with insufficient arch, radial type and ulnar type. The .author also proved that the digital circulatirn of radio-ulnar type had a tendency to show the irregularity among pulse amplitudes of each finger, while the circulation of radial type or ulnar type had a tendency to show the regularity.
2) The finger with organic circulatory disorders or with congenital vascular abnormality shows the other abnormal type of circulation different from 4 types which have just been described.
3) The author pointed out the imperfection of "Allen's ulnar confirmatory test" and devised the new diagnostic method.
(Author's abstract)
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