Pulse rate and jugular venous pulse

Palpation of the radial pulse

The palpable pulse in an artery reflects the pressure wave generated by the ejection of blood into the circulation from the left ventricle.

normal radial pulse

60-100 bpm

rate of pulse

beats per minute

Rhythm of pulse

pattern of beats

Volume of pulse

the perceived degree of pulsation.

State of the arterial wall

Normal arteries are elastic, they cannot be felt but only the pulse.

atherosclerosis

hardening of the arteries.

the artery will be felt rolling under the finger.

character of pulse

an impression of the pulse waveform or shape.

Collapsing pulse

early peak followed by rapid descent

severe aortic regurg

test: place right palm over radial pulse and raise pts arm above head - knocking on palm = collapsing pulse

Equality in both side

(radio-radial delay)

Jugular venous pulse

estimated by observing the level of pulsation in the internal jugular vein.

the internal jugular vein.

Vein located at the side of the neck to collect blood from the brain and parts of the face and neck.

JVP location

Normal JVP= 6 to 8 cm water above the right atrium.

N.B: the distance between sternal angle and right atrium is 5 cm water.

Causes of increase JVP

Right side heart failure.

Fluid overload

Waves of Jugular venous pulse

three upward peaks (a, c, v) and two downward descents (x, y), representing the mechanical events of the cardiac cycle

wave a

atrial contraction

wave c

the bulging of the tricuspid valve back into the right atruim

wave v

venous filling

wave x

the tricuspid valve moves downward.

wave y

aterial emptying