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The Arterial Pulses
Introduction
• The arterial pulse is the rhythmic expansion of pressure waves along
the walls of the arteries which is produced during each systole of
cardiac cycle.
• One of the vital sign that must be checked as it gives information
regarding function of CVS.
• The pulse represents pulse pressure which is the difference between
systolic & diastolic pressure.
• The presence or absence of main peripheral arterial pulses at radial,
brachial, carotid, femoral, popliteal, posterior tibial and dorsalis
pedis arteries should be noted.
Pulse Should Be Checked For:
1- Rate of pulse:-
Number of pulses per minute. Count the pulses rate for not less than
half minute. The pulse rate increases in exercise and decreases in
athletes.
2- Rhythm:-
Regular or irregular. Normal sinus rhythm is regular, but may show
variation in rate beats during respiration. An irregular rhythm usually
indicates atrial fibrillation or ectopic beats.
3- Volume of pulse: -
It is degree of expansion which gives idea about the stroke volume. It
increases in conditions that causes vasodilatation. Physiological causes of
increased pulse volume include exercise, emotion, pregnancy. Examples of
pathological causes of increased pulse volume is aortic regurgitation while
pulse volume decreases in heart failure , peripheral vascular disease and aortic
valve stenosis.
4- The condition of vessel wall:-
In young adult, the wall is not felt while in old people it is like
cord due to atherosclerosis. With advancing age, the arteries
become more rigid. The pulse that is felt in the radial artery at wrist
about 0.1 second after systolic ejection of blood into the aorta and
pulse movement is faster.
Arterial pulse tracing showing in (A) aortic stenosis,
(B) aortic incompetence and (C) pulsus alternans.
5. Character:- Slow rising pulse occurs in aortic stenosis while collapsing pulse
occurs in aortic regurgitation.
Objective:
To examine peripheral arterial pulses.
Materials:
Subjects.
Procedures: The arterial pulses are detected by gently compressing the vessel
against some firm structure usually bones by tip of middle three fingers of
hand. The distal finger is used for empty vessel, the proximal finger is used for
palpate pulse, third middle finger is used for palpate the condition of vessel
wall. Typical pulse in healthy young adult is 70 beats/minute (60 – 100 beats /
minute), regular in rhythm, normal volume, no collapsing and the arterial wall
is just palpable.

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PULSE .pptx

  • 2. Introduction • The arterial pulse is the rhythmic expansion of pressure waves along the walls of the arteries which is produced during each systole of cardiac cycle. • One of the vital sign that must be checked as it gives information regarding function of CVS. • The pulse represents pulse pressure which is the difference between systolic & diastolic pressure. • The presence or absence of main peripheral arterial pulses at radial, brachial, carotid, femoral, popliteal, posterior tibial and dorsalis pedis arteries should be noted.
  • 3. Pulse Should Be Checked For: 1- Rate of pulse:- Number of pulses per minute. Count the pulses rate for not less than half minute. The pulse rate increases in exercise and decreases in athletes. 2- Rhythm:- Regular or irregular. Normal sinus rhythm is regular, but may show variation in rate beats during respiration. An irregular rhythm usually indicates atrial fibrillation or ectopic beats.
  • 4. 3- Volume of pulse: - It is degree of expansion which gives idea about the stroke volume. It increases in conditions that causes vasodilatation. Physiological causes of increased pulse volume include exercise, emotion, pregnancy. Examples of pathological causes of increased pulse volume is aortic regurgitation while pulse volume decreases in heart failure , peripheral vascular disease and aortic valve stenosis. 4- The condition of vessel wall:- In young adult, the wall is not felt while in old people it is like cord due to atherosclerosis. With advancing age, the arteries become more rigid. The pulse that is felt in the radial artery at wrist about 0.1 second after systolic ejection of blood into the aorta and pulse movement is faster.
  • 5. Arterial pulse tracing showing in (A) aortic stenosis, (B) aortic incompetence and (C) pulsus alternans. 5. Character:- Slow rising pulse occurs in aortic stenosis while collapsing pulse occurs in aortic regurgitation.
  • 6. Objective: To examine peripheral arterial pulses. Materials: Subjects. Procedures: The arterial pulses are detected by gently compressing the vessel against some firm structure usually bones by tip of middle three fingers of hand. The distal finger is used for empty vessel, the proximal finger is used for palpate pulse, third middle finger is used for palpate the condition of vessel wall. Typical pulse in healthy young adult is 70 beats/minute (60 – 100 beats / minute), regular in rhythm, normal volume, no collapsing and the arterial wall is just palpable.
  • 7. Heart Rate Pulse Rate Definition The rate at which the heart beats, or contracts. Any contraction (even if it doesn't result in appreciable blood flow through the arteries) is part of heart rate. The temporary increase in arterial pressure that can be felt throughout the body. Pulse rate can be used to measure heat rate for a normal, healthy heart. Resting Heart Rates Men/Women: 60-100 bpm (beats per minute); pre- teens and teens (10-20 years old): 60-100 bpm; children 3-9 years old: 70-130 bpm; infants 1 day to age 3: 70-190 bpm; athletes may have resting heartbeat as low as 40 bpm Men/Women: 60-100 bpm (beats per minute); pre-teens and teens (10-20 years old): 60-100 bpm; children 3-9 years old: 70-130 bpm; infants 1 day to age 3: 70-190 bpm; athletes may have resting heartbeat as low as 40 bpm
  • 8. Normal Pulse Rates Babies to age 1: 100–160 Children ages 1 to 10: 60–140 Children age 10+ & Adults: 60–100 Well-conditioned Athletes: 40–60 Mosby’s Critical Care Nursing Reference, 2002; Perry & Potter (2006)
  • 9. Arteriolar pulses should be assessed above and below the heart. The following locations are most commonly assessed.
  • 10. 1- The radial artery pulse It is best felt when the subject's arm is pronated and the wrist is slightly flexed. The three fingers of examiner's hand are used for feeling the pulse. The index finger is proximal toward the subject. Slight pressure is exerted on the radial artery against the radius by the fingers.
  • 12. 2-The brachial artery pulse: It is best felt when artery is compressed against humerus just above the antecubital fossa, medial to biceps tendon.
  • 15. 3- The carotid artery pulse:- Pulse is best detected by pressing gently carotid artery which is placed adjacent to trachea in upper part of neck, backwards against the front of the cervical vertebrae. The two carotid pulses should never be examined together because of danger of reducing the cerebral arterial supply.
  • 18. 4- The femoral artery pulse:- It is best detected at halfway between the pubic tubercle and the anterior superior iliac spine at the level of the inguinal ligament.
  • 21. 5- The popliteal artery pulse:- It is best detected by pressing the popliteal artery in middle of popliteal fossa while the subject lies on his face, the knee is slightly flexed
  • 23. 6- Posterior tibial artery pulse: The posterior tibial artery is found 1 cm behind the medial malleolus of the tibia
  • 25. 7-The dorsalis pedis artery pulse It is best felt by compressed artery against the tarsal bones at the posterior of foot between the medial and lateral malleolus.