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What is felt is not the blood pulsing through the arteries (as is commonly supposed) but a shock wave that travels along the walls of the arteries as the heart contracts. This shock wave is generated by the pounding of the blood as it is ejected from the heart under pressure. It is analogous to the hammering sound heard in steam pipes as the steam is forced into the pipes under pressure. A pulse in the veins is too weak to be felt, although sometimes it is measured by sphygmograph (see below); the tracing obtained is called a phlebogram.
The pulse is usually felt just inside the wrist below the thumb by placing two or three fingers lightly upon the radial artery. The examiner's thumb is never used to take a pulse because its own pulse is likely to be confused with that of the patient. Pressure should be light; if the artery is pressed too hard, the pulse will disappear entirely. The number of beats felt in exactly 1 minute is the pulse rate.
In taking a pulse, the rate, rhythm, and strength or amplitude of the pulse are noted. The average rate in an adult is between 60 and 100 beats per minute. The rhythm is checked for possible irregularities, which may be an indication of the general condition of the heart and the circulatory system.
The amplitude of a pulse can range from totally impalpable to bounding and full; however, such terms are vague and subject to misinterpretation. To provide a more standardized description of pulse amplitude some agencies and hospitals use a scale that provides a more objective evaluation and reporting of the force of a pulse. On such a scale zero would mean that the pulse cannot be felt; +1 would indicate a thready, weak pulse that is difficult to palpate, fades in and out, and is easily obliterated with slight pressure; +2 would be a pulse that requires light palpation but once located would be stronger than a +1; +3 would be considered normal; and a +4 pulse would be one that is strong, bounding, easily palpated, and perhaps hyperactive, and could indicate a pathological condition such as aortic regurgitation.
If a pulse is noted to be weaker during inhalation and stronger during exhalation (pulsus paradoxus), this could indicate either greater reduction in the flow of blood to the left ventricle than is normal, as in constrictive pericarditis or pericardial effusion, or a grossly exaggerated inspiratory maneuver, as in tracheal obstruction, asthma, or emphysema.
An instrument for registering the movements, form, and force of the arterial pulse is called a sphygmograph. The sphygmographic tracing (or pulse tracing) consists of a curve having a sudden rise (primary elevation) followed by a sudden fall, after which there is a gradual descent marked by a number of secondary elevations.
pulse(puls) the rhythmic expansion of an artery that may be felt with the finger.
A general term for lentils, beans and peas. The Food and Agricultural Organization (FAO) reserves the term pulse for crops harvested solely for dry seed, thus excluding green beans and green peas, which the FAO calls vegetable crops; it also excludes crops primarily grown for oil extraction (e.g., soybeans and peanuts).
See Round of chemotherapy.
The tactile sensation imparted by the flow of blood through a particular artery. The most commonly measured pulses are the radial pulse at the wrist and the dorsalis pedis over the foot.
pulseCardiology The rhythmic expansion of a blood vessel, which for certain large arteries can be evaluated clinically using the fingers or stethoscope; the 'ritual' of taking the Pt's pulse provides information about the heart rate, and a marked ↓ in the strength of the pulse suggests severe atherosclerosis, ↓ pumping activity by the heart, or vascular defects in the form of AV shunts or fistulas. See Bisferiens pulse, Corrigan's pulse, Dorsalis pedis pulse, Femoral pulse, Paradoxic pulse, Pistol shot pulse, Quincke's pulse, Radiofrequency pulse, Water hammer pulse. Cf Pulse diagnosis Nuclear medicine
pulse(puls) [L. pulsus, beating]
A tracing of this is called a sphygmogram and consists of a series of waves in which the upstroke is called the anacrotic limb, and the downstroke (on which is normally seen the dicrotic notch), the catacrotic limb.
The normal resting pulse in adults is between 60 and 100 beats per minute. The resting pulse is faster, for example, in febrile patients, anemic or hypovolemic persons, persons in shock, and patients who have taken drugs that stimulate the heart, such as theophylline, caffeine, nicotine, or cocaine. It may be slower in well-trained athletes; in patients using beta blockers, calcium channel blockers, or other agents; and during sleep or deep relaxation.
In patients complaining of chest pain, pulses should be assessed in at least two extremities (e.g., both radial arteries). A strong pulse on the right side with a weak one on the left may suggest an aortic dissection or a stenosis of the left subclavian artery. Young patients with high blood pressure should have pulses assessed simultaneously at the radial and femoral artery because a significant delay in the femoral pulse may suggest coarctation of the aorta. Patients with recent symptoms of stroke or claudication should have pulses checked at the carotid, radial, femoral, popliteal, and posterior tibial arteries, to see whether any palpable evidence of arterial insufficiency exists at any of these locations. If a decreased pulse is detected, further evaluation might include ultrasonography or assessments of the ankle brachial index. Patients who are lightheaded or dizzy or who notice palpitations may have detectable premature beats or other pulse irregularities (e.g., the irregularly irregular pulse of atrial fibrillation).
asymmetrical radial pulseUnequal pulse.
basal pulseResting pulse.
collapsing pulseBounding pulse.
Corrigan's pulseSee: waterhammer pulse
coupled pulseBigeminal pulse.
dorsalis pedis pulse
filiform pulseThready pulse.
irregular pulseIntermittent pulse.
irregularly irregular pulse
Kussmaul's pulseSee: Kussmaul, Adolph
pulse parvusPulsus parvus et tardus.
Quincke's pulseSee: capillary pulse
Riegel's pulseSee: Riegel's pulse
small pulseSee: pulsus parvus et tardus
triphammer pulseWaterhammer pulse.
pulseThe rhythmic expansion of an artery from the force of the heart beat. In health, the pulse is regular, moderately full and at a rate of between about 50 and 80 beats per minute.
pulsethe expansion of an artery as the left ventricle contracts (see BLOOD PRESSURE which can be detected where the artery is close to the body surface, such as the radial artery at the human wrist and the carotid artery in the neck.
pulsethe transmitted heart beat felt, or recorded by a sensor, from pulsation of an artery, commonly the radial artery at the wrist. pulse rate the heart rate in beats per minute, counted by feeling the pulse.
pulsepalpable 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
|Classification||Explanation 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|
pulse (pls) (puls),
Patient discussion about pulse
Q. It is very amazing to me. How did he diagnose the illness by just listening to ones’ pulse? I’m Zakary, 36 years old. Last week I had the symptoms of fever, vomiting and head ache. I get infection most of the time may be due to poor immunity. This time I went to a Chinese doctor who is near to my place. He just touches my pulse and for a minute he starts to listening it, after that he diagnoses my sickness and prescribe Chinese herbal. I took the meds properly and I was completely cured. Before that I don’t have any experience with Chinese herb. It is very amazing to me. How did he diagnose the illness by just listening to ones’ pulse?
In traditional Chinese medicine, reading the pulse is a common diagnostic system. I know that a good Chinese doctor can diagnose by feeling the patient pulse and looking at their tongue. I am treating my entire problem only with acupuncture and Chinese herbs. I no longer had allergies. I am satisfied user of Chinese meds.
Q. my wife feels weak. her pulse is only 45. What should we do
Is she sensitive to cold weather (e.g. wearing warm clothes when others don't)? Has she gained weight recently?
Has her hair changed? Does she have any heart diseases? Diabetes?
The combination of slow pulse and weakness in a woman (what's her age?) may suggests hypothyroidism. In this case, than she needs to see a doctor in order to diagnose and treat this condition.
You ma read more about it here:
Q. Would anybody be interested in a workshop in holistic pulsing. Benefits are wide spread for many conditions Holistic pulsing is a simple technique that has many benefits for a wide variety of problems. What is nice about the technique is that it is easy and fast to learn. I have helped people with headaches, back problems, breathing problems, assisted in relieving pain for people with severe cancer etc. Would like to put together some workshops for anybody interested in learning. Good for nurses, bodywork people and any lay person that wants to benefit family and friends. You can look it up on the internet or contact me with any questions. Etan
Where do you practice your technique?