Thursday, 7 March 2013

- Common pulse sites.

Common pulse sites

The pulse may be palpated in any place that allows an artery to be compressed against a bone. 

In Upper limb:
  • Axillary pulse: located inferiorly of the lateral wall of the axilla 
  • Brachial pulse: located on the inside of the upper arm near the elbow, frequently used in place of carotid pulse in infants (brachial artery).
  • Radial pulse: located on the lateral of the wrist (radial artery). 
  • Ulnar pulse: located on the medial of the wrist (ulnar artery).
In Lower limb:
  • Femoral pulse: located in the inner thigh, at the mid-inguinal point, halfway between the pubic symphysis and anterior superior iliac spine (femoral artery).
  • Popliteal pulse: Above the knee in the popliteal fossa, found by holding the bent knee. The patient bends the knee at approximately 124°, and the physician holds it in both hands to find the popliteal artery in the pit behind the knee (Popliteal artery).
  • Dorsalis pedis pulse: located on top of the foot, immediately lateral to the extensor of hallucis longus (dorsalis pedis artery).
  • Tibialis posterior pulse: located on the medial side of the ankle, 2 cm inferior and 2 cm posterior to the medial malleolus (posterior tibial artery). It is easily palpable over Pimenta's Point.
In Head and neck
  • Carotid pulse: located in the neck (carotid artery). The carotid artery should be palpated gently and while the patient is sitting or lying down. Stimulating its baroreceptors with low palpitation can provoke severe bradycardia or even stop the heart in some sensitive persons. Also, a person's two carotid arteries should not be palpated at the same time. Doing so may limit the flow of blood to the head, possibly leading to fainting or brain ischemia. It can be felt between the anterior border of the sternocleidomastoid muscle, above the hyoid bone and lateral to the thyroid cartilage.
  • Facial pulse: located on the mandible (lower jawbone) on a line with the corners of the mouth (facial artery).
  • Temporal pulse: located on the temple directly in front of the ear (superficial temporal artery).
Apical pulse: located in the 4.5th or 5th left intercostal space, just outside the mid-clavicular line. In contrast with other pulse sites, the apical pulse site is unilateral, and measured not under an artery, but below the heart itself (more specifically, the apex of the heart).
 

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