Pulse

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Pulse

In medicine

Medicine

Medicine is the art and science of healing. It encompasses a range of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
, a person's pulse is the throbbing of their arteries

Artery

Arteries are blood vessels that carry blood away from the heart. All arteries, with the exception of the pulmonary and umbilical arteries, carry oxygenated blood....
. It can be palpated in any place that allows for an artery to be compressed against a bone, such as at the neck

Neck

The neck is the part of the body on many limbed vertebrates that distinguishes the head from the torso or trunk. The scientific term signifying "of the neck" is nuchal....
(carotid artery), at the wrist

Wrist

In human anatomy, the wrist is the flexible and narrower connection between the forearm and the hand. The wrist is essentially a double row of small short bones, called carpals, intertwined to form a malleable hinge....
(radial artery), behind the knee

Knee

----The knee is the lower extremity joint connecting the femur, patella, and the tibia and the surrounding anatomical region which includes the popliteal fossa, also known as "knee pit"....
(popliteal artery

Popliteal artery

In human anatomy, the popliteal artery is defined as the extension of the "superficial" femoral artery after passing through the adductor canal and adductor hiatus above the knee....
), on the inside of the elbow

Elbow

The elbow is the region surrounding the elbow-joint—the ginglymus or hinge joint in the middle of the arm. Three bones form the elbow joint: the humerus of the upper arm, and the paired radius and ulna of the forearm....
(brachial artery), and near the ankle joint (posterior tibial artery). The pulse rate can also be measured by measuring the heart beats directly (the apical pulse).

sure waves move along the artery walls, which are pliable; these waves are not caused by the forward movement of the blood

Blood

Blood is a specialized bodily fluid that delivers necessary substances to the body's Cell s ? such as nutrients and oxygen ? and transports waste products away from those same cells....
itself, however.

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Physiology

Pressure waves move along the artery walls, which are pliable; these waves are not caused by the forward movement of the blood

Blood

Aorta

The aorta is the largest artery in the human body, originating from the left ventricle of the heart and bringing oxygenated blood to all parts of the body in the systemic circulation....
and the aorta stretches. At this point, the wave of distention (pulse wave) is pronounced but relatively slow-moving (3–6 m/s). As it travels towards the peripheral blood vessels, it gradually diminishes and becomes faster. In the large arterial branches, its velocity is 7–10 m/s; in the small arteries, it is 15–35 m/s. The pressure pulse is transmitted fifteen or more times more rapidly than the blood flow

Blood flow

Blood flow is the flow of blood in the cardiovascular system.It can be calculated by dividing the vascular resistance into the pressure gradient....
.

PULSE is also used to denote the frequency of the heart beat, usually measured in beats per minute

Beats per minute

Beats per minute is a unit typically used as either a measure of tempo in music, or a measure of one's heart rate. A rate of 60 bpm means that one beat will occur every second....
. In most people, the pulse is an accurate measure of heart rate

Heart rate

Heart rate is a measure of the number of heart beats per minute . The average resting human heart rate is about 70 bpm for adult males and 75 bpm for adult females....
. Under certain circumstances, including arrhythmias, some of the heart beats are ineffective, and the aorta is not stretched enough to create a palpable pressure wave. The pulse is too irregular and the heart rate can be (much) higher than the pulse rate. In this case, the heart rate should be determined by auscultation

Auscultation

Auscultation is the technical term for listening to the internal sounds of the body, usually using a stethoscope; based on the Latin verb auscultare "to listen"....
of the heart apex, in which case it is not the pulse. The pulse deficit (difference between heart beats and pulsations at the periphery) should be determined by simultaneous palpation

Palpation

Palpation is used as part of a physical examination in which an object is felt to determine its size, shape, firmness, or location. Palpation should not be confused with palpitation, which is an awareness of the beating of the heart....
at the radial artery

Radial artery

In human anatomy, the radial artery is the main blood vessel, with oxygenated blood, of the lateral aspect of the forearm....
and auscultation at the heart apex.

Ranges

A normal pulse rate for a health

Health

In 1948, the World Health Organisation defined health as ?a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.? ...
y adult, while resting, can range from 60 to 100 beats per minute (BPM), although well-conditioned athletes may have a healthy pulse rate lower than 60 BPM. Bradycardia

Bradycardia

Bradycardia , as applied to adult medicine, is defined as a resting heart rate of under 60 beats per minute, though it is seldom symptomatic until the rate drops below 50 beat/min....
occurs when the pulse rate is below 60 per minute, whereas tachycardia

Tachycardia

The word tachycardia comes from the Greek words tachys and kardia .Tachycardia typically refers to a heartrate that exceeds the range of the normal resting heartrate, based upon age:...
occurs when the rate is above 100 BPM. During sleep, the pulse can drop to as low as 40 BPM; during strenuous exercise, it can rise as high as 150–200 BPM. Generally, pulse rates are higher in infants and young children. The resting heart rate for an infant is usually close to an adult's pulse rate during strenuous exercise (average 110 BPM for an infant).

Evaluation

A collapsing pulse is a sign of hyperdynamic circulation

Hyperdynamic circulation

Hyperdynamic circulation is an increase in pulse pressure and blood pressure caused by certain physiological and psychiatric illnesses.The patient often presents with a collapsing pulse and sinus tachycardia....
.

Several pulse patterns can be of clinical significance. These include:

Pulsus alternans
Pulsus alternans

Pulsus alternans is a physical finding with arterial pulse waveform showing alternating strong and weak beats. It is almost always indicative of heart failure, and carries a poor prognosis....
Pulsus bigeminus
Pulsus bigeminus

Pulsus bigeminus is a cardiovascular phenomenon characterized by groups of two heartbeats close together followed by a longer pause. The second pulse is weaker than the first....
Pulsus bisferiens
Pulsus bisferiens

In medicine, pulsus bisferiens, also bisferious pulse or biphasic pulse, is a sign where, on palpation of the pulse, a double peak per cardiac cycle can be appreciated....
Pulsus tardus et parvus
Pulsus tardus et parvus

In medicine, pulsus tardus et parvus, also pulsus parvus et tardus, slow-rising pulse and anacrotic pulse, is a sign where, upon palpation, the pulse is weak/small , and late relative to its usually expected character....
Pulsus paradoxus
Pulsus paradoxus

In medicine, a pulsus paradoxus , also paradoxic pulse and paradoxical pulse, is an exaggeration of the normal variation in the pulse during the inspiratory phase of respiration, in which the pulse becomes weaker as one inhales and stronger as one exhales....

Common pulse sites

Axillary pulse: located inferiorly of the lateral wall of the axilla
Apical pulse: located in the 4.5th or 5th left intercostal space, just to the left of the sternum
Sternum

The sternum is a long flat bone located in the center of the chest . It connects to the rib via cartilage, forming the rib cage with them, and thus helps to protect the lungs, heart and major blood vessels from physical trauma....
. In contrast with other pulse sites, the apical pulse site is unilateral, and measured not under an artery, but below the heart
Heart

The heart is a muscle organ in all vertebrates responsible for pumping blood through the blood vessels by repeated, rhythmic contractions, or a similar structure in annelids, mollusks, and arthropods....
itself (more specifically, the apex of the heart).
Brachial pulse: located on the inside of the upper arm near the elbow, frequently used in place of carotid pulse in infants (brachial artery
Brachial artery

The brachial artery is the major blood vessel of the upper arm.It is a continuation of the axillary artery beyond the lower margin of teres major muscle....
)
Carotid pulse: located in the neck (carotid artery). The carotid artery should be palpated gently and while the patient is sitting or lying down. Stimulating its baroreceptors with low palpitation can provoke severe bradycardia
Bradycardia

Bradycardia , as applied to adult medicine, is defined as a resting heart rate of under 60 beats per minute, though it is seldom symptomatic until the rate drops below 50 beat/min....
or even stop the heart in some sensitive persons. Also, a person's two carotid arteries should not be palpated at the same time. Doing so may limit the flow of blood to the head, possibly leading to fainting or brain ischemia
Ischemia

In medicine, ischemia is a restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue....
. It can be felt between the anterior border of the sternocleidomastoid muscle, above the hyoid bone and lateral to the thyroid cartilage.
Dorsalis pedis pulse: located on top of the foot (dorsalis pedis artery
Dorsalis pedis artery

In human anatomy, the dorsalis pedis artery , is a blood vessel of the lower limb that carries oxygenated blood to the Dorsum surface of the foot....
).
Facial pulse: located on the mandible (lower jawbone) on a line with the corners of the mouth (facial artery
Facial artery

The facial artery is a branch of the external carotid artery that supplies structures of the face....
).
Femoral pulse: located in the thigh, halfway between the pubic symphysis and anterior superior iliac spine (femoral artery
Femoral artery

The femoral artery is a large artery in the muscles of the thigh....
).
Popliteal pulse: Above the knee in the popliteal nasal, found by holding the bent knee. The patient bends the knee at approximately 124°, and the physician holds it in both hands to find the popliteal artery in the pit behind the knee.
Radial pulse: located on the lateral of the wrist (radial artery
Radial artery

In human anatomy, the radial artery is the main blood vessel, with oxygenated blood, of the lateral aspect of the forearm....
). It can also be found in the anatomical snuff box
Anatomical snuff box

The anatomical snuffbox, or radial fossa, , is a triangular deepening on the Anatomical position#Relative_directions, Dorsum aspect of the hand - at the level of the carpal bones, specifically, the scaphoid and trapezium bones forming the floor....
.
Temporal pulse: located on the temple
Temple (anatomy)

Temple indicates the side of the head behind the eyes. The bone beneath is the temporal bone....
directly in front of the ear (superficial temporal artery
Superficial temporal artery

In human anatomy, the superficial temporal artery is a major artery of the head. It arises from the external carotid artery when it bifurcates into the superficial temporal artery and maxillary artery....
).
Tibialis posterior pulse: located on the medial side of the ankle around medial malleolus (posterior tibial artery
Posterior tibial artery

The posterior tibial artery of the lower limb carries blood to the posterior compartment of the leg and plantar surface of the foot, from the popliteal artery....
).
Ulnar pulse: located on the medial of the wrist(ulnar artery
Ulnar artery

The ulnar artery is the main blood vessel, with oxygenated blood, of the medial aspect of the forearm. It arises from the brachial artery and terminates in the superficial palmar arch, which joins with the superficial branch of the radial artery....
).

External links

http://www.heartbeatcd.com CD containing sounds of the human heart

Pulse

Physiology

Ranges

Evaluation

Common pulse sites

See also

External links