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Thread: All viva on pulse

  1. #1
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    Wink All viva on pulse

    1.How will you examine pulse and which things will you see?

    Describe briefly.

    ==================

    2. What is collapsing pulse? In which conditions...How to check pulse in such patient?


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    1.
    u examine the pulse using the tips of ur finger.
    the radial is medial to the trochlea

    u'll be looking for :
    rate
    rythem
    character
    volume
    radio-femoral delay
    synchronisity

    2. collapsing pulse, is a bouding pulse .. a type of high volume pulse.
    it occurs in hyperdynamic states or AR
    u check it by pressing on the distal part of the forearm or the mid of it.
    some say according to the brachail art. and some disagree..
    and when u press the forearm should be at the level of the heart. if not felt; left the arm and it'll be exagerated.

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    mostly correct answer..
    in first question still how to examine pulse isn't answered properly..
    Let me wait if someone can answer or i'll reply l8r..

    in 2nd answer.. just adding more info..
    it's also called Corrigan's pulse, Watson's water hammer pulse, collapsing pulse

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    examine pulse by three fingers...
    +2nd finger.....(radial)--distally--apply pressure to obliterate pulse from palmer arch..
    +3rd finger......(middle)--middle--to see all parameters of pulse..
    +4rh finger......(ring))--proximally--dont knw properly but it is for stabilising radial artery...
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    Quote Originally Posted by h1k1j View Post
    examine pulse by three fingers...
    +2nd finger.....(radial)--distally--apply pressure to obliterate pulse from palmer arch..
    +3rd finger......(middle)--middle--to see all parameters of pulse..
    +4rh finger......(ring))--proximally--dont knw properly but it is for stabilising radial artery...
    The 3 fingers are used particularly for measuring force of the pulse

    Pressure is applied by the proximal finger to occlude the artery
    Pressure is applied by the distal finger to occlude collaterals
    Pressure is increased till middle finger feels no pulsation

    Thanks

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    Water hammer pulse is measured by

    Raise the patient arm at 90 degree and forarm to 90 degree of arm. And measure the Pulse as Regular.!

    Main thing is the position of arm and forearm..

    Note:Some are rising the arm of patient more than 90 degree.

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    Lightbulb Pulsus paradoxus..

    This is an exaggeration of a normal physiological phenomenon..inspiratory decrease in pulse volume and expiratory increase in the same..Occurs in COPD,cardiac tamponade,etc.A pulsus paradoxus is diagnosed by an inspiratory reduction in systolic BP of more than 15mm/Hg{a reduction of upto 10mm is considered normal}
    List of causes of PP.

    Cardiac:
    cardiac tamponade
    pericardial effusion
    pulmonary embolism
    cardiogenic shock
    Pulmonary:
    tension pneumothorax
    asthma
    Non-pulmonary and non-cardiac:
    anaphylactic shock
    superior vena cava obstruction
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    Smile more..

    Pulsus parvus et tardus
    A low amplitude pulse (parvus) with a slow rising late peak (tardus).Seen in AS.
    Pulsus alternans
    A pulse with a regular rhythm,but with a beat to beat variation in the volume.
    Seen in CHF.The low volume beats are usually missed.
    Pulsus bisferiens
    seen in AS wid AR.In this there are 2 peaks durin systole.

    Dicrotic pulse
    seen in typhoid.Two peaks-1 in systole n 1 in diastole.

    Pulsus bigeminus nd trigeminus
    -in patients taking Digoxin.
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