Question

Which of the following highly indicates cerebral perfusion insufficiency for a patient with a history of cardiac disorder?

	A.	Mental confusion
	B.	Distended neck veins
	C.	Bounding carotid pulses
	D.	Muffled heart sounds

Answer 1

The answer is -------- B. Distended neck veins.

Distended neck veins is a symptom of cardiac insufficiency. The heart pumps blood to the brain through carotid and vertebral artery. When there is inadequate cardiac output due to the factors such as acute MI with right ventricle involvement there is disruption in the upward flow of blood to brain via carotid and vertebral artery. The external jugular veins gets distended inorder to compensate for the loss. This can be seen as a bulge at the lateral part of the neck . Therefore, distended neck veins indicates cardiac insufficiency to supply blood to the brain.

While the other options include :

• Mental confusion occurs due to many factors such as trauma, intoxication, fever etc. It also occurs when there is cardiac insufficiency on later stages.
• Bounding carotid pulses is observed when there is irregular electric activity of heart.
• Muffled heart sounds is heard when fluid or muscle is in between heart and the stethoscope.

Thank you.