Pulse

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In medicine, one's pulse represents the tactile arterial palpation of the heartbeat by trained fingertips. The pulse may be palpated in any place that allows an artery to be compressed against a bone, such as at the neck (carotid artery), at the wrist (radial artery), behind the knee (popliteal artery), on the inside of the elbow (brachial artery), and near the ankle joint (posterior tibial artery). The pulse can also be measured by listening to the heart beat directly (auscultation), traditionally using a stethoscope.

Contents

Physiology

The pulse is a decidedly low tech/high yield and antiquated term still useful at the bedside in an age of computational analysis of cardiac performance. Claudius Galen was perhaps the first physiologist to describe the pulse.[1] The pulse is an expedient tactile method of determination of systolic blood pressure to a trained observer. Diastolic blood pressure is non-palpable and unobservable by tactile methods, occurring between heartbeats. the normal pulse rate is 72.

Practitioners in Chinese Medicine are trained in Pulse Diagnosis and seek six different pulses in each wrist, each corresponding to specific organs of the body. The Chinese practitioner is trained to evaluate the frequency, rhythm and volume of the pulse and may characterize it as strong, thready, slippery or floating.[2]

Pressure waves generated by cardiac systole move the artery walls, which are pliable and compliant. These properties form enough to create a palpable pressure wave.

The Heart Rate may be greater or lesser than the Pulse Rate depending upon physiologic demand. In this case, the heart rate are determined by auscultation or audible sounds at the heart apex, in which case it is not the pulse. The pulse deficit (difference between heart beats and pulsations at the periphery) is determined by simultaneous palpation at the radial artery and auscultation at the heart apex.

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