Cardiovascular and Pulmonary: Examination of Pulse

Question 1

Apical Pulse

Answer 1

• 5th interspace mid-clavicular vertical line
• May be displaced upward by pregnancy or high diaphragm
• May be displaced laterally by congestive heart failure
• Cardiomyopathy
• Ischemic Heart Disease

Question 2

Radial Pulse

Answer 2

• Radial artery pulse at base of thumb

Question 3

Carotid Pulse

Answer 3

• Between sternocliedomastoid and trachea
• Assess one at a time to avoid stimulating the carotid sinus baroreceptors which produces a reflexes drop in pulse rate and and blood pressure

Question 4

Brachial

Answer 4

• Medial aspect of the antecubital fossa

- Best in infants

Question 5

Femoral

Answer 5

• Palpate over femoral artery in inguinal region

Question 6

Popliteal

Answer 6

• Back of the knee with the knee flexed slightly

Question 7

Dorsalis Pedis

Answer 7

• Palpate over dorsal medial aspect of foot

Question 8

Normal HR

Answer 8

• Adults=60-100bpm
• Children=60-140bpm
• Newborn=Average=127 (range of 90-164)

Question 9

Tachycardia

Answer 9

• Greater than 100bpm

Question 10

Postural Tachycardia Syndrome

Answer 10

• Sustained HR increase of greater than or equal to 30 bpm within 10 minutes of standing
  (Greater than or equal to 40 in teenagers)

Question 11

Pulse abnormalities: Irregular Pulse

Answer 11

• Variations in force and frequency
• Arrhythmia
• Myocarditis