Examination of pulses

Question 1

what should the right hand be used to do when feeling right radial pulse with left hand fingers

Answer 1

hold patients right fingers

Question 2

what tendon is the radial pulse lateral to?

Answer 2

flexor carpi ulnaris

Question 3

order of pulses

Answer 3

radial
brachial
carotid
popliteal 
dorsalis pedis
posterior tibial

Question 4

where is the brachial pulse found

Answer 4

medial aspect of antecubital fossa

palpate biceps tendon and move medially

Question 5

where is the carotid pulse found?

Answer 5

medial to sternocleidomastoid and lateral to larynx

do not examine once as may cause syncope

Question 6

where is the popliteal pulse found

Answer 6

popliteal fossa
patient flexes knee
place thumbs on both sides of patella
fingers deep into popliteal fossa

Question 7

where is the dorsalis pedis palpated

Answer 7

tarsal bones on the dorsum of the foor

Question 8

where is the posterior tibial pulse palpated

Answer 8

1 cm behind medial malleolus

Question 9

what features of pulse should be noted

Answer 9

rate 
rhythm 
character
volume
symmetry
presence of bruits
character of vessel wall

Question 10

what does the radial pulse assess

Answer 10

rate

rhythm

Question 11

what does the carotid pulse assess

Answer 11

volume and character

Question 12

how is symmetry assessed

Answer 12

compare right and left of each pulse

left and right and radial and femoral should be in synch

Question 13

rate

Answer 13

how fast or slow pulse is

count for 30 seconds and give as bpm

Question 14

normal rate

Answer 14

60-100 pm

Question 15

rhythm

Answer 15

is the pulse regular or irregular

time interval between beats
regularly irregular / irregulary irregular

Question 16

what is a regular pulse described as

Answer 16

normal rhythm

Question 17

what causes regularly irregular rhythms

Answer 17

abnormal rhythms of the heart eg second degree heart block

Question 18

what causes irregularly irregular pulse

Answer 18

atrial fibrillation

Question 19

pulse character

Answer 19

pattern in rise and fall

Question 20

pulse volume

Answer 20

maximum rise of pulse, estimate of how much blood is pushed out of the heart with each contraction

Question 21

what is character of pulse altered by

Answer 21

things changing eash at which blood flows from ventricle to arteries

eg aortic incompetence - valve doesnt close properly after blood leaves heart, pressure wave rises steeply and falls quickly

Question 22

assessing radial pulse and elevating wrist above shoulder level , exagerrates rapid rise and fall of pulse this is called a collapsing pulse what pulse assessment is this part of

Answer 22

character

Question 23

where may a slow rising pulse be detected

Answer 23

carotid

Question 24

slow rising and falling pulse character in the carotid with a small volume indicates what

Answer 24

aortic stenosis

Question 25

if the heart cannot contract/hypovolaemia what pulse volume is expected

Answer 25

low volume

Question 26

co2 retention, anaemia and fever have what effect on pulse volume

Answer 26

increased pulse volume

Question 27

what may asymmetry indicate

Answer 27

disease of the vessels

Question 28

what does radio radial delay indicate

Answer 28

coarctation of aorta proximal to left subclavian artery /aortic aneurysm

Question 29

what does a radio femoral delay indicate

Answer 29

coarctation of aorta

disease of vessels eg athersclerosis

Question 30

how is prescence of bruits assessed

Answer 30

auscultation over a large vessel eg carotid artery

Question 31

what are bruits

Answer 31

noise caused by turbulent blood flow

Question 32

what do bruits indicate

Answer 32

arterial lumen has been narrowed by atheroma

Question 33

what vessels have a more rigid feel

Answer 33

diseased arteries