Pulse
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Pulse | |
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Organisms | Amphioxus . |
In
Physiology
Claudius
The
Pulse velocity, pulse deficits and much more physiologic data are readily and simplistically visualized by the use of one or more
The rate of the pulse is observed and measured by tactile or visual means on the outside of an artery and is recorded as beats per minute or BPM.
The pulse may be further indirectly observed under light absorbances of varying wavelengths with assigned and inexpensively reproduced mathematical ratios. Applied capture of variances of light signal from the blood component hemoglobin under oxygenated vs. deoxygenated conditions allows the technology of pulse oximetry.
Characteristics
Rate
Normal pulse rates at rest, in beats per minute (BPM):[2]
newborn (0–3 months old) |
infants (3–6 months) |
infants (6–12 months) |
children (1–10 years) |
children over 10 years & adults, including seniors |
well-trained adult athletes |
---|---|---|---|---|---|
99–149 | 89–119 | 79–119 | 69–129 | 59–99 | 39–59 |
The pulse rate can be used to check overall heart health and fitness level. Generally lower is better, but bradycardias can be dangerous. Symptoms of a dangerously slow heartbeat include weakness, loss of energy and fainting.[3]
Rhythm
A normal pulse is regular in rhythm and force. An irregular pulse may be due to
Volume
The degree of expansion displayed by artery during diastolic and systolic state is called volume. It is also known as amplitude, expansion or size of pulse.
Hypokinetic pulse
A weak pulse signifies narrow
Hyperkinetic pulse
A bounding pulse signifies high pulse pressure. It may be due to low
The strength of the pulse can also be reported:[4][5]
- 0 = Absent
- 1 = Barely palpable
- 2 = Easily palpable
- 3 = Full
- 4 = Aneurysmal or bounding pulse
Force
Also known as compressibility of pulse. It is a rough measure of
Tension
It corresponds to
Form
A form or contour of a pulse is palpatory estimation of
Equality
Comparing pulses and different places gives valuable clinical information.
A discrepant or unequal pulse between left and right radial artery is observed in anomalous or aberrant course of artery, coarctation of aorta,
Condition of arterial wall
A normal artery is not palpable after flattening by digital pressure. A thick radial artery which is palpable 7.5–10 cm up the forearm is suggestive of arteriosclerosis.
Radio-femoral delay
In coarctation of aorta, femoral pulse may be significantly delayed as compared to radial pulse (unless there is coexisting aortic regurgitation). The delay can also be observed in
Patterns
Several pulse patterns can be of clinical significance. These include:
- Anacrotic pulse: notch on the upstroke of the carotid pulse. Two distinct waves (slow initial upstroke and delayed peak, which is close to S2). Present in AS.
- Dicrotic pulse: is characterized by two beats per cardiac cycle, one systolic and the other diastolic. Physiologically, the dicrotic wave is the result of reflected waves from the lower extremities and aorta. Conditions associated with low cardiac output and high systemic vascular resistance can produce a dicrotic pulse.[6][7]
- Pulse deficit: difference in the heart rate by direct cardiac ausculation and by palpation of the peripheral arterial pulse rate when in atrial fibrillation (AF).
- Pulsus alternans: an ominous medical sign that indicates progressive systolic heart failure. To trained fingertips, the examiner notes a pattern of a strong pulse followed by a weak pulse over and over again. This pulse signals a flagging effort of the heart to sustain itself in systole. It also can be detected in HCM with obstruction.
- Pulsus bigeminus: indicates a pair of hoofbeats within each heartbeat. Concurrent auscultation of the heart may reveal a gallop rhythm of the native heartbeat.
- Pulsus bisferiens: is characterized by two beats per cardiac cycle, both systolic, unlike the dicrotic pulse. It is an unusual physical finding typically seen in patients with aortic valve diseases if the aortic valve does not normally open and close. Trained fingertips will observe two pulses to each heartbeat instead of one.
- Pulsus tardus et parvus, also pulsus parvus et tardus, slow-rising pulse and anacrotic pulse, is weak (parvus), and late (tardus) relative to its expected characteristics. It is caused by a stiffened aortic valve that makes it progressively harder to open, thus requiring increased generation of blood pressure in the left ventricle. It is seen in
- Pulsus paradoxus: a condition in which some heartbeats cannot be detected at the radial artery during the inspiration phase of respiration. It is caused by an exaggerated decrease in blood pressure during this phase, and is diagnostic of a variety of cardiac and respiratory conditions of varying urgency, such as cardiac tamponade.
- electrocardiogram(ECG) is required to identify the type of tachycardia.
- that expand and contract the pulmonary and systemic circulations.
- A collapsing pulse is a sign of hyperdynamic circulation, which can be seen in AR or PDA.
Common palpable sites
Sites can be divided into peripheral pulses and central pulses. Central pulses include the carotid, femoral, and brachial pulses.[11]
Upper limb
- Axillary pulse: located inferiorly of the lateral wall of the axilla
- Brachial pulse: located on the inside of the upper arm near the elbow, frequently used in place of carotid pulse in infants (brachial artery)
- Radial pulse: located on the lateral of the wrist (anatomical snuff box.
- Ulnar pulse: located on the medial of the wrist (ulnar artery).
Lower limb
- Femoral pulse: located in the inner thigh, at the mid-inguinal point, halfway between the pubic symphysis and anterior superior iliac spine (femoral artery).
- Popliteal pulse: Above the knee in the popliteal fossa, found by holding the bent knee. The patient bends the knee at approximately 124°, and the health care provider holds it in both hands to find the popliteal artery in the pit behind the knee (popliteal artery).
- Dorsalis pedis pulse: located on top of the foot, immediately lateral to the extensor of hallucis longus (dorsalis pedis artery).
- Tibialis posterior pulse: located on the medial side of the ankle, 2 cm inferior and 2 cm posterior to the medial malleolus (Pimenta's Point.
Head and neck
- fainting or brain ischemia. It can be felt between the anterior border of the sternocleidomastoid muscle, above the hyoid bone and lateral to the thyroid cartilage.
- Facial pulse: located on the mandible (lower jawbone) on a line with the corners of the mouth (facial artery).
- Temporal pulse: located on the temple directly in front of the ear (superficial temporal artery).
Although the pulse can be felt in multiple places in the head, people should not normally hear their heartbeats within the head. This is called
Torso
- Apical pulse: located in the 5th left intercostal space, 1.25 cm lateral to the .
History
Pulse rate was first measured by ancient Greek physicians and scientists. The first person to measure the heart beat was Herophilus of Alexandria, Egypt (c. 335–280 BC) who designed a water clock to time the pulse.[12] Rumi has mentioned in a poem that "The wise physician measured the patient's pulse and became aware of his condition." It shows the practice was common during Rumi's era and geography.[13] The first person to accurately measure the pulse rate was
See also
- Heart rate
- Pulse meter
- Tempo
- Pulse diagnosis – a practice in various types of traditional medicine
- Pulse pressure
References
- ^ Temkin 165;BBC[a]
- ^ US Department of Health and Human Services – National Ites of Health Archived 2016-07-05 at the Wayback Machine Pulse
- ^ "Pulse Rate Measurement". Healthwise. WebMD. Archived from the original on 23 July 2012. Retrieved 14 March 2011.
- ^ "www.meddean.luc.edu". Archived from the original on 2008-09-07. Retrieved 2009-05-20.
- ^ "Vascular Surgery, University of Kansas School of Medicine". Archived from the original on 2009-02-04. Retrieved 2009-05-20.
- ISBN 9780729585613. Archivedfrom the original on 2023-07-03. Retrieved 2018-01-02.
- ^ ISBN 9780323508711. Archivedfrom the original on 2023-07-03. Retrieved 2018-01-02.
- from the original on 2020-05-10. Retrieved 2018-01-02.
- ISBN 0-07-146303-8.
- ISBN 9780781748698. Archivedfrom the original on 2023-07-03. Retrieved 2018-01-02.
- ISBN 9780781741903. Archivedfrom the original on 2023-07-03. Retrieved 2020-10-03.
- PMID 31007864.
- ^ "Rumi poem on the afflicted patient". Archived from the original on 2022-12-16. Retrieved 2022-12-16.
- PMID 30854144.
External links
- Measure Pulse Online Tap along with your pulse