ARTERIAL PULSE

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ARTERIAL PULSE

Post by Admin on Fri Mar 19 2010, 21:37

vital signs :
first why r these four alone called as vital signs??
the answer is any abnormal increase or decrease in the four parameters wil endanger life. eg. hypothermia and hyperthermia (above 108 f proteins coagulate and person dies)


PULSE :
Defn : the blood forced onto the aorta during the systole sets up an pressure wave that travels alond the arteries which expands the arterial wall which is palpable as pulse..

(c) : HOW TO DESCRIBE A PULSE IN CLINICAL EXAM.
make sure all these things are ther while describing a pulse:
rate , rhythm , volume , character , all palpable peripheral pulses , radio radial , radio femoral delay .pulse deficit (if present) and condition of vessel wall.

RATE, RHYTHM - look for radial pulse
VOLUME AND CHARACTER - better appreciated carotids.(collapsing pulse - radial a.)
why? character best appreciated at carotids as they r close to the heart so that waves are transmitted without any distortion.

NOTE :
Always compare with the opposite side.
Its better to palpate both pulses simultaneously except carotids.
Its wise to comment on the volume after finding the bloodpressure. (narrow pulse pressure indicates low/small volume pulse and vice versa)
When the pulse is regular its not wise to comment on the volume as it varies regularly.

TRISECTION OF PULSE:
Its a method for assessment of pulse character. while looking for character one should always appreciate the ascent, peak and descent of the pulse and the abnormal character in each component . this method is called trisection of pulse.


(C):
radial pulse : semipronate forearm and flex the wrist
Brachial pulse: partially flex the elbow and feel for the vessel just medial to the biceps tendon.(palpate with thumb)
carotid : adk patient to look straight , use thumb to palpate near the medial border of sternomastoid jus lateral to thyroid cartilage. carotid is felt against the carotid tubercle of sixth vertebra.USE THUMB. right carotid left thumb.
Femoral pulse: supine legs partially flexed abduct and externally rotate the hip feel th pulse below midinguinal point.
Popliteal pulse: supine and knee partiallly flexed , feel the pulse with fingers encircling and supporting knee from both sides.
Posterior tibial : supine fell the pulse midway between medial malleolus and tendoachilles.
Dorsalis pedis: lateral to extensor hallucis longus and proximal to first metatarsal space. normally absent in 1o% poP

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Admin
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