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Assessment and Differentiation > Pulse diagnosis & palpation > Flashcards

Pulse diagnosis & palpation Flashcards

1
Q

What can the pulse indicate?

A

The pulse tells us how qi is flowing in the channels in the current moment.
It tells us about the state of the ZangFu.
The pulse can indicate if a treatment has been successful.

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2
Q

What is a normal pulse speed?

A

The speed of the pulse should be 4-5 beats per respiratory cycle, 60-90 beats per minute. 70-75bpm for a healthy adult.

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3
Q

What are the pulse positions?

A

Left: Organs related to blood
Cun / Front: Heart
Guan / Middle: Liver
Chi / Back: Kidney Yin

Right: Organs related to Qi.
Cun / Front: Lungs
Guan / Middle: Spleen
Chi / Back: Kidneys

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4
Q

What are the 3 qualities of a healthy pulse?

A

stomach qi, spirit, root. Root means the pulse is solid in the lower jiao.

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5
Q

What is a slippery pulse?

A

Associated with Damp
A pearl rolling around a china plate.

Indicates:
A slippery pulse represents an excess of damp in the body.

A rapid slippery pulse represents damp heat

A slow slippery pulse signifies damp cold

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6
Q

What is a wiry pulse?

A

A wiry pulse has the tautness of a guitar string, the beat has clearly defined edges and a pointy shape.

The qi feels constricted as the Liver’s function of free flow is impeded.

Indicates:
Indicates Qi stasis

Often associated with the Liver as the Liver dislikes qi stagnation.

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7
Q

What is a choppy pulse?

A

Pulse comes and goes with difficulty.

Associated with blood stasis and can be driven by blood deficiency.

Could be a straight excess condition.

If deficiency is the cause of choppy quality the pulse may also be thin

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8
Q

What is a full pulse?

A

Large and forceful.
The force is felt even under pressure.

Excess

The pulse presentation represents an excess condition and associated channel should be drained.

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9
Q

What is a flooding pulse?

A

The pulse arrives forcefully but when it leaves it goes slowly away.

Heat excess

Usually seen in a pathogenic attack such as in acute febrile disease.

If it is found at a single position it will indicate excess heat in that channel or organ.

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10
Q

What is a tight pulse?

A

Tight pulse is tense, has string force and feels firm like a large twisted rope

Indicates cold excess

Indicates the presence of pathogenic cold in the body.

The deeper and slower the pulse, the more internal the cold is lodged.

A tight pulse may also be present in a patient suffering from pain and accumulation.

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11
Q

What is a floating pulse?

A

The pulse is strong, superficial and lacks a wave form.

In a yin deficiency this pulse is rapid, superficial and thin / hollow. Heat creates a rapidness to the pulse while deficient yin makes the pulse hollow and thin.

Indicates:
Indicates an external pathogen.

Not feeling it at the deeper levels, only at the surface.

Floating and tight would indicate wind cold.

Floating and rapid would indicate wind heat.

Floating = superficial / pathogen
Tight = cold
Rapid = heat
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12
Q

What is an empty pulse?

A

Feels present at the upper level, but lacks substance and force under pressure.

No substance underneath

If the empty quality is felt throughout all pulse levels it could indicate a deficiency of zheng qi &/or yin/blood.

If it is present at one level there is most likely a chronic deficiency of that organ.

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13
Q

What is a scattered pulse?

A

Evaporates under the fingers and its form is not maintained.

Extreme deficiency of qi, blood, jing or yang with qi having gone wild.

Yin and yang have lost contact.

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14
Q

What is a weak pulse?

A

A weak pulse is forceless and soft under pressure. Soft thready and sunken without floating,

Yang falls into yin.

Qi and blood deficiency

Expected in chronic disease and long term disease

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15
Q

What is a thready / fine pulse?

A

Arrives weakly, as fine as a thread. It can be palpated at the deep level continuously.

Blood &/or yin deficiency.

Fine and thready = insufficient blood and yin to ‘plump the pulses.

Weak and thready = blood and qi deficiency is the cause.

Thready with hardness = more driven by yin deficiency.

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16
Q

What is the Lung pulse quality according to the Mai Jing?

A

Superficial, short, choppy (light and feathery)

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17
Q

What is the Heart pulse quality according to the Mai Jing?

A

Swift in coming, slow in retreating. Floating, large and dissipated (like being tapped with a hammer).

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18
Q

What is the Liver pulse quality according to the Mai Jing?

A

Bowstring, firm, deep (prone to being wiry)

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19
Q

What is the Spleen pulse quality according to the Mai Jing?

A

Moderate and centred (slow, easy & relaxed)

20
Q

What is the Kidney pulse quality according to the Mai Jing?

A

Deep and slippery like a stone (comes from the bone level).

21
Q

What changes affect the pulse?

A

Pulse will change seasonally (deeper in winter, more superficial in summer)

Age, pregnancy, medication (BP medication), oral contraceptive affects the liver (making it superficial and wiry)

Pregnancy being an accumulation of damp.

22
Q

How does menstruation change the pulse in women?

A
  • Menstruation – pulse becomes slippery as the blood moves
  • After menstruation – pulse becomes thin and empty in the liver position (due to blood loss)
  • Ovulation – kidney pulse can sometimes be weak, due to strain in ovulation on the kidneys.
  • Pre-menstrually the pulse becomes wiry and more-full, qi and blood build before menstruation.
23
Q

What are we looking for with abdominal palpation?

A
  • Abdominal palpation: what is the temperature? Is the area warm (heat) or cool? (cold/deficiency), Resilience: is the area hard (excess) or loose (deficiency)? Pain: is there some pain? (Qi stagnation) or severe pain? (blood stagnation)
  • Symmetry: Is there left/right symmetry? IS the belly button being oulled up or down?
  • Fluid: swelling, noises, accumulation?
  • Scarring: Operations? Internal or external scarring affecting an organ or channel.
  • Front mu points: Helpful when doing abdominal palpation, mu points are accumulation points, soreness of these points will reflect disharmony of the pertaining organ. Palpating the point not the area, can use two fingers one to feel and one to provide strength.
24
Q

What can palpating points tell us?

A
  • Palpating points: provide specific information, can tell us deficiency or excess, or suggest a type of imbalance occurring in the body. A hollowness or emptiness at a point represents deficiency while fullness represents excess.
  • Water point = fluid metabolism
  • Fire point = inflammation and excess heat
25
Q

What are the three levels if the pulse?

A

Superficial: reflects the state of Qi (and the yang organs)
Middle level: reflects the state of blood
Deep level: Reflects the state of yin. (and the yin organs)

26
Q

What is the quality of a normal pulse?

A

Stomach qi (relatively soft, calm and gentle)
Spirit (regular, soft)
Root (Clearly felt on a deep level and third position)

27
Q

What is the procedure for pulse taking?

A

Feel the pulse as a whole
Feel whether the pulse has spirit, stomach-qi and root
Feel the three levels and three positions
Feel the strength of the pulse
Feel the overall quality of the pulse
Feel the quality of individual pulse positions.

28
Q

What does the temperature of the skin indicate when palpating?

A

Cold = cold pattern
Four limbs are cold: Deficiency of yang of Spleen and stomach.
Loins, lower back or feet cold = deficiency of kidney yang
Cold lower abdomen = deficiency of spleen-yang

29
Q

Name how the seasons influence the pulse quality?

A 
Spring = Wiry 
Summer = Flooding 
Autumn = Floating 
Winter = Deep
30
Q

What can a Deep pulse indicate?

A

Indicates interior condition, indicates potential problems with the Yin organs.

Pathogenic factor in the interior = Deep and full pulse
Yang deficiency = Deep / Weak

31
Q

What is a slow pulse?

A

A slow pulse indicates a cold pattern. If it is slow and weak it indicates empty-cold from deficiency of Yang. If it is slow and full, it indicates full-cold.

32
Q

What is a rapid pulse?

A

Indicates a heat pattern. If it is floating, empty and rapid it indicates empty heat from yin deficiency. If it is full and rapid, it indicates full heat.

33
Q

What is a long pulse?

A

Indicates a heat pattern.

The pulse is longer than normal, it extends beyond the normal pulse position.

34
Q

Where is the kidney located in relation to abdominal palpation?

A

Below the umbilicus.

35
Q

Where is the heart located in relation to abdominal palpation?

A

Below the xiphoid process.

36
Q

Where is the Liver located in relation to abdominal palpation?

A

Left of the umbilicus

37
Q

Where is the Lung located in related to abdominal palpation?

A

Right of the umbilicus

38
Q

Where is the spleen / stomach located in relation to abdominal palpation?

A

Below the heart (xiphoid process) and above the umbilicus.

39
Q

What does tightness under the right ribcage indicate?

A

Indicates stasis of Liver Qi

40
Q

What does tightness just under the left ribcage indicate?

A

Liver is invading the Spleen

41
Q

What does the Liver side of the abdomen indicate?

A

Stasis of Liver blood

42
Q

What does the region near the heart and left ribcage indicate?

A

Spleen. Often shows hollowness / puffiness with spleen deficiency.

43
Q

What does the Lung side of the abdomen indicate?

A

Reflects a challenged immune system. It can show up if there is inflammation in the small intestine such as Crohns and colitis.

44
Q

What does the are just underneath the umbilicus indicate?

A

Sore and tight can indicate Kidney Yin deficiency.

45
Q

What does hardness and softness indicate?

A 
Hardness = excess
Softness = deficiency
46
Q

What do nodules indicate?

A

Stagnation of phlegm or blood

Assessment and Differentiation (25 decks)

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