peripheral pulses

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Related to peripheral pulses: apical pulse

peripheral pulses

Physical exam Pulses palpable at the periphery–eg, radial, dorsal pedal, which signal vascular compromise–especially in the legs


palpable rhythmical dilatation and contraction of an artery, reflecting pressure imposed by cardiac contraction, palpable where superficial arteries overlie bone; three pulses (dorsalis pedis, posterior tibial and peroneal) are palpable in the foot, reflecting arterial supply to the foot by three branches of the popliteal artery; difficult to palpate in oedematous feet; reduced/absent in peripheral vascular disease; enhanced ('bounding') with autonomic neuropathy, e.g. patients with diabetes (Table 1); palpation of foot and limb pulses is facilitated by prior location with a Doppler probe
  • dorsalis pedis pulse palpable at dorsum of foot, approximately two fingerwidths distal to proximal end of first intermetatarsal space (where perforating artery diverges from dorsal arcuate artery); absent in 5-10% of population

  • femoral pulse palpable in inguinal fossa, halfway along an imaginary line joining outer and inner margins of anterior aspect of the thigh

  • peroneal pulse palpable at lateroproximal area of dorsum of foot, approximately 2cm distal to anterior aspect of lateral malleolus

  • popliteal pulse palpable deep within popliteal fossa, lateral to centre and medial to medial aspect of lateral hamstring

  • posterior tibial pulse palpable at medial aspect of heel, approximately halfway along an imaginary line from tip of medial malleolus and the point of the heel

  • tibialis posterior pulse see posterior tibial pulse (above)

  • venous pulse pathological pulsation in veins, e.g. jugular venous pulse, associated with cardiac dysfunction

Table 1: Classification of palpated arterial pulses on a scale of 0-4
ClassificationExplanation of classification
0 (0/4)No pulse detectable = absence of pulses
1 (1/4)Weak pulse = indicative of arterial impairment
2 (2/4)Normal pulse = no arterial disease, no reduction in arterial flow
3 (3/4)Full pulse = pulse greater than expected, perhaps high blood pressure, possible autonomic neuropathy
4 (4/4)Bounding pulse = pulse much greater than expected, probable autonomic neuropathy, possible aneurysm
References in periodicals archive ?
She gets Joe to rest for 20 minutes on the examination bed in her clinic room and at the end performs a lower Limb examination which includes palpation for peripheral pulses, capillary refill test, observation of tropic changes and pre/post exercise ankle brachial pressure indices (ABPIs).
Visual inspection of the foot and palpation of peripheral pulses are important.
The catheterization assessment includes monitoring the catheterization site, heart rate and rhythm, blood pressure, and peripheral pulses (Chair, Thompson, & Li, 2007).
Clinically, this parameter is used in the authors' facility with other assessment parameters of perfusion, such as the quality of peripheral pulses, color, blood pressure, urine output, and serum lactate.
Moreover, the 30 days follow-up included physical examination with palpation and assessment of the access site and peripheral pulses, and late complications such as pseudoaneurysm and arteriovenous fistula.
1) Most clinicians diagnose PAD from symptoms such as intermittent claudication and rest pain, and signs such as diminished peripheral pulses, ischaemic ulceration and gangrene.
Complete foot examinations including visual inspection, tuning fork testing, palpation of peripheral pulses, and monofilament sensation testing should be done at least annually.
10) Absence of peripheral pulses in posterior tibial, popliteal or femoral arteries, indicate significant occlusive PAD especially if associated with symptoms like claudication.

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