Download MBBS Examination of peripheral pulses aneena Lecture PPT

Examination of
peripheral pulses

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CHARACTERISTICS
? Rate,Rhythm,volume,character,condition of
vessel wall,radiofemoral delay,other

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peripheral pulses

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Peripheral pulses
1. Superficial temporal
2. Carotid
3. Brachial

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4. Radial
5. Femoral
6. Popliteal
7. Poterior tibial
8. Dorsalis pedis

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RATE
Number of pulses/min. 60-100/min
Tachycardia:>100/min
a)sinus tachycardia
? exercise,emotion,

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excitement,smoking,intense pain,anxiety,in
children.
? Thyrotoxicosis,severe
anaemia,pyrexia,shock,myocarditis,a/c
hemorrhage,hypoxia,drugs

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b)Relative tachycardia
c)Paroxysmal tachycardia >160/min

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Bradicardia:<60/min
a)sinus
? Athletes,deep sleep,yoga

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? Hypothyroidism,obstructive jaundice,raised
ICT,sino atrial disease,organophosphorous
poisoning,drugs.
b)relative

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Pulse apex deficit

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Difference b/w heart rate and pulse rate.
AF(>10/min),multiple ectopic beats.(<10/min)

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RHYTHM
Spacing b/w two beats.
Normal is regular,sinus rhythm

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1. Regularly irregular-secondary heart
block,sinus arrythmia
2. Irregularly irregular-AF,multiple ventricular
extrasystoles,atrial flutter .

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VOLUME

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Amplitude of pulse wave.
Reflects width of pulse pressure,depends on :
stroke volume
condition of vessel wall
a)High volume:(PP>60mmhg)

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anxiety,fever,thyrotoxicosis,AR,PDA,atherosclerosis
b)Low volume(PP<30mmhg):shock ,severe aortic
stenosis,CCF,pericardial effusion,constrictive
pericarditis

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CHARACTER

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1. Anacrotic pulse
2. Dicrotic pulse
3. Water hammer pulse
4. Pulsus bisferisns
5. Pulsus alterns

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6. Pulses bigeminus
7. Pulsus paradoxicus
8. Thready pulse,jerky pulse,bounding pulse

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Water hammer pulse /high volume
collapsing pulse

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High volume pulse,sharp rise,ill sustained,sharp
fall
aortic incompetence

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Condition of arterial vessel wall
Palpable in old age due to atherosclerosis

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Radio-radial delay
1. Normal anatomical variation
2. Thoracic inlet syn
3. Aneurysm of arch of aorta
4. Pre-subclavian coarctation

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5. Peripheral embolism
6. Atherosclerosis of aorta
7. Pressure over axillary artery by lymph nodes

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Radio-femoral delay
1. Coarctation of aorta

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2. Atherosclerosis of aorta
3. Thrombosis or embolism of aorta
4. Aortoarteritis

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Normal arterial pulse
Rate is 72/min regular in rhythm normal and in

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equal in volume no radioradial delay as well
as no radio-femaral delay.condition of vessel
wall is normal and pulses are of normal
character.All other peripheral pulses are
symmetricaly palpable.

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