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Physical Diagnosis > Pulse > Flashcards

Pulse Flashcards

1
Q

What is the pulse?

A

wave created by 5 Tbs. of blood being pumped into the arteries with every heartbeat.

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2
Q

What are you measuring when you take pulse?

A

rate, rhythm, and amplitude

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3
Q

Which pulse is taken as a quick screen of heart function?

A

checking radial pulse for 30 seconds

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4
Q

How do you take a radial pulse?

A

1st 2 fingers compress radial artery against radius

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5
Q

What is the normal adult resting rate range?

A

60-90 bpm

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6
Q

What is the average adult resting rate?

A

72 bpm

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7
Q

What is bradycardia?

A

less than 60 bpm

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8
Q

What is tachycardia?

A

more than 100 bpm

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9
Q

What is physiologic tachycardia?

A

normal response to exertion, anxiety, or elevated temperature, exercise and excitement.

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10
Q

What is the rate for physiologic tachycardia?

A

10 bpm for every degree over 100

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11
Q

What is pathologic tachycardia?

A

response to an oxygen deficit

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12
Q

What examples can cause pathologic tachycardia?

A

anemia, hemorrhage, shock or congestive heart failure

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13
Q

What is the normal rhythm like for pulse?

A

REGULAR, steady, consistent

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14
Q

What are arrhythmias?

A

irregular heartbeats

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15
Q

What kind of arrhythmias are there?

A

regular and irregular

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16
Q

What are three common irregularities of pulse?

A

sinus arrhythmia
premature ventricular contraction (PVC)
atrial fibrillation

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17
Q

Which pulse irregularity is common in children?

A

sinus arrhythmia

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18
Q

What is sinus arrhythmia?

A

heart rate speeds up with each inspiration and slows again with expiration

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19
Q

What is premature ventricular contraction?

A

ventricular depolarization occurs earlier than expected resulting in occasional skipped beats

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20
Q

How can PVC show up?

A

a regular pattern of skips or

several sequential skips

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21
Q

What is atrial fibrillation?

A

disorganized electrical activity in the atria accompanied by a rapid, irregular ventricular response.

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22
Q

Atrial fibrillation is significant how?

A

usually accompanies pre-existing heart disease and necessitates emergency care

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23
Q

What is characterized by alternation of pulsation of small amplitude with pulsation of large amplitude while the rhythm is regular?

A

pulsus alternans (alternating pulse)

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24
Q

What is the best way to detect pulsus bisferiens?

A

palpation of the carotid artery

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25
Q

What are the two main peak called in pulsus bisferiens?

A

percussion wave and second, tidal wave

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26
Q

The first peak in pulsus bisferiens is believed to be what?

A

pulse pressure

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27
Q

The second peak in pulsus bisferiens is believed to be what?

A

reverberation from the periphery

28
Q

Normal pulsation followed by a premature contraction is known as what?

A

bigeminal pulse

29
Q

What is the amplitude of the premature contraction like?

A

less than the normal pulsation

30
Q

This is characterized by an exaggerated decrease in the amplitude of pulsation during inspiration and increased amplitude during expiration?

A

paradoxic pulse (pulsus paradoxus)

31
Q

What is amplitude of the pulse?

A

perceive FORCE of the wave generated by blood being ejected from the left heart

32
Q

What is used to grade pulse amplitude?

A

a scale of 0-4

33
Q

pulse amplitude of 0 =

A

absence

34
Q

pulse amplitude of 1 =

A

weak, thread or feeble

35
Q

What kind of pressure stops the pulse in grade 1 amplitude?

A

light pressure

36
Q

pulse amplitude 2 =

A

expected or typical

37
Q

Does a light pressure stop the pulse in grade 2 amplitude?

A

no

38
Q

pulse amplitude of 3 =

A

full or increased

39
Q

T/F A firm pressure will stop the pulse in grade 3 amplitude?

A

FALSE

40
Q

pulse amplitude of 4 =

A

bounding, water-hammer

41
Q

What stops a grade 4 pulse amplitude?

A

only heavy pressure

42
Q

What is another name for a grade 4 amplitude pulse?

A

Corrigan pulse

43
Q

A healthy heart and arteries produce what sort of contour?

A

smooth, domed shape wave form

44
Q

Neural paresthesia affect:

A

all or part of a dermatome

45
Q

Vascular paresthesia is different that neural paresthesia how?

A

it crosses dermatomes

46
Q

Vascular paresthesia may present with:

A

a cooler and discolored extremity including cyanosis
Amplitude may be diminished in that extremity
capillary refill time may be greater than 2 seconds

47
Q

What are the palpable arteries for the head?

A

carotid and temporal

48
Q

What are the palpable arteries to the hands?

A

subclavian, brachial, and radial

49
Q

What are the palpable arteries to the feet?

A

femoral, popliteal, posterior tibial and dorsal pedis

50
Q

Bilateral pulses are compared for what?

A

amplitude and contour

51
Q

What is the expected finding in upper and lower extremities?

A

+2 bilaterally on a 0-4 scale

52
Q

Unequal amplitude between left and right extremities suggest …?

A

impaired circulation on the low side.

53
Q

On peripheral vascular assessment, one side may feel weaker because and arterial lumen is ?

A

constricted, compressed, or turbulence within an aneurysm

54
Q

Constriction could be because what?

A

vasoconstriction, atherosclerosis, clot

55
Q

Compression could be because?

A

swollen lymph node, TOS - thoracic outlet syndrom, Pancost tumor

56
Q

What is a Pancost tumor?

A

lung tumor that forms at the top of the lungs

57
Q

Upper and lower extremity pulses are compared for what?

A

equal amplitude

58
Q

A strong radial and a weak or absent femoral pulse suggests what?

A

coarctation of the aorta

or some other form of constriction, compression, or obstuction

59
Q

What is another means of assessing for arterial compromise?

A

capillary refill time

60
Q

How do you check capillary refill time?

A

Blanch fingernail or toenail pressure for several seconds then release and time the return to full color.

61
Q

When assessing capillary refill time, what time indicates arterial compromise?

A

more than 2 seconds

62
Q

Arteries can also be auscultated for what?

A

bruit

63
Q

What is bruit?

A

a typically low pitch, pulsed, and relatively quiet sound

64
Q

What part of the stethoscope do you use in assessing bruit?

A

bell

65
Q

The presence of bruit suggests what?

A

compressed, constricted, or partially obstructed arterial lumen.

66
Q

How do you assess venous insufficiency?

A

patient is standing, inspect for swelling, varicosities, edema, erythema, and/or cyanosis…

Physical Diagnosis (6 decks)

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