Clinical Essentials of Pulse Assessment

Vocabulary flashcards covering the anatomical sites, diagnostic triad, physiological variables, assessment techniques, and clinical formulas of pulse assessment.

Palpable Pulse

A pulsating wave traveling through the arterial system created when the left ventricle contracts and forces blood into an expanding aorta.

Inverse Relationship of Age to Pulse

The physiological rule stating that resting pulse rate gradually decreases as a person ages, transitioning from an average of $140\,\text{bpm}$ in infants (birth to $1\,\text{yr}$) down to $80\,\text{bpm}$ in adults and $74\,\text{bpm}$ in adults after age $60$.

Athletic Exception

The clinical observation that well-trained athletes maintain a baseline resting pulse averaging $50\,\text{bpm}$, within a typical range of $40\text{ - }60\,\text{bpm}$.

Digitalis

A medication whose clinical effect decreases the pulse rate.

Epinephrine

A medication whose clinical effect increases the pulse rate.

Three-Finger Technique

A clinical palpation method using the pads of the three middle fingertips with moderate pressure; the thumb must never be used because it has its own pulse, which can cause the clinician to count their own heart rate.

Stealth Respiration Check

A diagnostic technique where the provider maintains finger placement and pressure on the pulse site after taking the pulse to surreptitiously count respirations for another $30\,\text{seconds}$, avoiding patient awareness that alters breathing.

Radial Artery Site

An anatomical pulse site located in the groove of the inner wrist below the thumb, evaluated via palpation as the most common site for routine monitoring in adults and athletes.

Apical Pulse Site

An anatomical site located over the apex of the heart at the fifth intercostal space, left midclavicular line, assessed via auscultation using a stethoscope; primary site for infants, children up to $3\,\text{years}$, and patients with irregular rhythms.

Carotid Artery Site

An anatomical pulse site located on the anterior side of the neck, evaluated by palpation as the best site to find a pulse during cardiac arrest and exercise monitoring in children and adults.

Brachial Artery Site

An anatomical pulse site located in the antecubital space of the inner elbow, palpated to measure blood pressure and assess cardiac arrest in infants.

Femoral Artery Site

An anatomical pulse site located in the middle of the groin, palpated during cardiac arrest and to evaluate arterial circulation to the lower leg in infants, children, and adults.

Temporal Artery Site

An anatomical pulse site located on the head in front of the ear, palpated when the radial pulse is inaccessible or during pediatric evaluations.

Popliteal Artery Site

An anatomical pulse site located at the back of the flexed knee, assessed by palpation to evaluate leg circulation and serve as a backup blood pressure measurement site.

Posterior Tibial Artery Site

An anatomical pulse site located on the inner aspect of the ankle, assessed via palpation to determine the circulatory status of the foot.

Dorsalis Pedis Artery Site

An anatomical pulse site located on the upper surface of the foot, palpated to assess arterial circulation to the foot.

Ulnar Artery Site

An anatomical pulse site located on the inner wrist on the little finger (pinky) side, palpated to assess peripheral circulation to the hand.

Diagnostic Triad

The three clinical characteristics assessed during pulse evaluation: Rate (number of pulsations per minute), Rhythm (time intervals between beats), and Volume (physical strength of the beat).

Bradycardia

A pulse rate anomaly defined as a resting heart rate of less than $60\,\text{bpm}$, considered normal during sleep or in well-trained athletes.

Tachycardia

A pulse rate anomaly defined as a resting heart rate greater than $100\,\text{bpm}$, triggered by vigorous exercise, strong emotional states, or pathologies like hemorrhaging and heart disease.

Thready Pulse

A pulse volume abnormality characterized by a weak, difficult-to-detect arterial beat caused by decreased circulating blood volume, often accompanied by a rapid heart rate.

Bounding Pulse

A pulse volume abnormality characterized by an extremely strong and full arterial beat caused by a sudden increase in blood volume pumped by the left ventricle.

Pulse Deficit

A condition occurring when inefficient heart contractions fail to transmit a pulse wave to peripheral arteries, measured by two providers simultaneously counting apical and radial pulses for exactly $1\,\text{full minute}$ (frequently associated with atrial fibrillation).

Target Heart Rate (THR)

A safe exercise pulse range between a lower bound of $60\%$ ($\text{MHR} \times 0.6$) and an upper bound of $80\%$ ($\text{MHR} \times 0.8$) of Maximum Heart Rate, where $\text{MHR} = 220 - \text{Age}$.

AHA Aerobic Exercise Prescription

The American Heart Association standard recommending adults engage in $30\,\text{mins/day}$, $5\,\text{days/week}$ of moderate activity (or $20\,\text{mins}$, $3\,\text{days/week}$ of vigorous activity) and children engage in $60\,\text{mins/day}$, including $5\text{-minute}$ warm-up and cool-down periods.