Propedeutics of Internal Diseases Palpitation

1. Propedeutics of Internal Diseases
The methods of determining the pulse
on radial arteries and its properties
MAHESH KUMAR JAT
CASPIAN UNIVERSITY
ALMATY KAZAKHSTAN

2. 1.With your palm up, look at the area between your wrist bone and
the tendon on the thumb side of your wrist. Your radial pulse can be
taken on either wrist.
2.Use the tip of the index and third fingers of your other hand to feel
the pulse in your radial artery between your wrist bone and the
tendon on the thumb side of your wrist.
3.Apply just enough pressure so you can feel each beat. Do not push
too hard or you will obstruct the blood flow.
4.Watch the second hand on your watch or a clock as you count how
many times you feel your pulse.
5.Record your pulse rate.

3. Radial pulse is strong, firm, and regular.
Pulse is weak, difficult to palpate, or absent.
Pulse rate for an adult is greater than 100 bpm (tachycardia).
Pulse rate for an adult is less than 60 bpm (bradycardia).

4. It's actually quite normal, even when both arms are checked
almost simultaneously.
But a large difference in pressure — about 10 points or more —
suggests the presence of artery-clogging plaque in the vessel
that supplies blood to the arm with lower blood pressure.
Generally, a small difference in blood pressure readings between
arms isn't a health concern.
However, a difference of more than 10 millimeters of mercury (mm
Hg) for either your top number (systolic pressure) or bottom number
(diastolic) may be a sign of blocked arteries in the arms, diabetes or
other health problem.

5. Why is my pulse different in each wrist?
Because pulse wave velocity decreases as arterial diameter
decreases, slight difference in local vasculature can cause
inter-site differences not only in pulse transit time but also in
its variations.
Palpation should be done using the fingertips and intensity of
the pulse graded on a scale of 0 to 4 +:0 indicating no
palpable pulse;
1 + indicating a faint, but detectable pulse;
2 + suggesting a slightly more diminished pulse than normal;
3 + is a normal pulse; and
4 + indicating a bounding pulse.

6. Frequency: however, it must be remembered that the pulse
frequency (sphygghage) does not necessarily correspond to the heart
rate.
In the presence of atrial fibrillation or extra-systole for example the
frequency perceived at the centrum cordis does not correspond to
the frequency of the sphynx wave in the periphery, because this
frequency is lower, so not all the heart beats correspond to the
propagation of a wave for which has a bradisfigmia with respect to
the real heart rate.
On the other hand, as well as a bradisfigmia which does not
correspond to a bradycardia, a tachycardia without tachycardia may
also exist.

7. Rhythm, which means if the pulse is equal, with regular
intervals, just like the music and the beats.
Tension or validity: the amount of compression that must be
exercised because the pulsation disappears downstream. The
pulse will be tense when the arterial pressure is high and
hypotensive or soft in the opposite case. Palpando the radial is
exercised with the ring finger that is found upstream, a pressure
on the artery, while the other fingers can grasp the moment in
which the pulsation disappears.

8. Magnitude , measure
of the extent to which
the physical
parameter, quantity, or
phenomenon used to
represent a pulse,
such as an optical,
electronic, radio-
frequency, or sonic
pulse, changes from a
baseline or reference
for a short time,
usually to represent
digital data.