Pulse examination By Prof.Dr.Deshpande
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Transcript of Pulse examination By Prof.Dr.Deshpande
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Pulse Examination
• Presented By – • Prof.Dr.R.R.Deshpande (M.D
in Ayurvdic Medicine & M.D. in Ayurvedic Physiology)
• www.ayurvedicfriend.com• Mobile – 922 68 10 630• professordeshpande@gmail.
com
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What is Pulse ?
• Pulse is a wave generated at the base of Aorta & spreading along the arterial wall to the peripheral arteries
• Wave is generated due to pumping of blood by heart
• Pulse is not due to blood flow under the vessel
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Pulse Examination
• Pulse is examined at superficial arteries
• Most common site is Radial Artery
• It can be compressed against the bone ,that is why it is commonly selected
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Pulse Examination
• Done with 3 fingers – Index ,Middle & Ring • Index finger should be kept proximal to heart & Ring
finger should be distal from heart • Proximal finger will check the force of pulse • Purpose of distal finger is to obliterate the back flow
coming from Ulnar artery .Light pressure is given by ring finger to obliterate
• Rest all parameters of pulse are judged by middle finger
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Clinical Examination of Pulse
• 1) Rate • 2) Rhythm• 3) Volume• 4) Force• 5) Tension• 6) Equality on both sides• 7) Condition of vessel wall • 8) Peripheral Pulsations• 9) Apex – Pulse ratio9/18/2016 5Prof.Dr.R.R.Deshpande
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1) Rate
• Count Pulsations with watch for full 1 minute• Minimum 3 readings are essential
• When consecutive 2 readings are same ,that is correct pulse
• Tachycardia & Bradycardia can be diagnosed
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Counting pulse rate in full one minute
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2) Rhythm
• Whether beats are coming at regular interval ?• • In healthy individual ,we get regular or
rhythmic pulse
• Irrgular pulse is obtained in Cardiac Arrythmias
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2) Rhythm
• Rarely in children ,we get regularly irregular pulse .This is called as Sinus Arrythmia
• During Inspiration ,pulse rate increases & during expiration ,pulse rate decreases
• As age increases ,Vagal tone improves & Sinus Arrythmia goes away
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3) Volume
• Uplift to middle finger
• It denotes Pulse Pressure• • Pulse Pressure = SBP – DBP• If patient has high Systolic & low Diastolic BP
,then Pulse pressure is more .Therefore Volume will be more
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Middle Finger
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Uplift to middle finger
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4) Force
• Put pressure on Index finger ,to obliterate the blood flow & stop pulsations
• The amount of pressure required to be applied to obliterate or stop the blood flow indicates Force of pulse
• It gives rough idea of Systolic Blood Pressure
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Pressure by Index finger to Obliterate flow
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5) Tension
• Feel of the Pulse ,between 2 uplifts
• It gives rough idea about Diastolic Blood Pressure
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6) Equality of Pulse
• Pulse of right & left side , should be examined simultaneously
• Normally pulsations on both sides are felt at one & the same time
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Pulse equality on both sides
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7) Condition of vessel wall
• Roll artery under the fingers
• Normally it is elastic
• In old age ,due to atherosclerosis ,it gives wire or cord like feeling
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Rolling of fingers
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8) Pulse examination at other places
• 1) Superficial Temporal Artery • 2) Facial Artery ( Anterior border of Masseter
muscle)
• 3) Carotid Artery ( Medial to Sternocleido mastoid muscle)
• 4) Brachial Artery ( Medial to Bicep Tendon)
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Temporal artery
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Facial Artery
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Carotid artery
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Brachial Artery
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8) Pulse examination at other places
• 5) Femoral Artery ( Inguinal region) • 6) Popliteal Artery ( Behind knees) • 7) Dorsalis Pedis Artery ( 1st Intertarsal space)
• This examination is IMP to diagnose Peripheral vascular diseases like TAO ( Thrombo Agitans Obliterans)
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Popliteal Artery
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Dorsalis pedis artery
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9) Apex Pulse ratio
• Corelate beating of heart with pulse • One hand is put on pulse & 2nd hand is put on
heart ,at Apex beat • Apex beat will be felt first ,followed by pulse
beat • One to one relation indicates HR = PR• If HR > PR – This is Pulsus Deficit ,indicating
Cardiac Arrythmias
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9) Apex Pulse ratio
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Sphymograph
• Examination of pulse = Mirror of heart • Pulse can be recorded in a Graph ,with computerized
instrument ,called as Sphymograph • It will show positive wave or Anacrotic wave
,indicating Ventricular systole• Down stroke is called as Catacrotic wave ,indicating
Ventricular Diastole • There is Dicrotic notch between 2 waves ,Dicrotic
notch ,due to closure of Aortic semilunar valves
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Pulse wave tracing
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Sphymograph
• Whatever we diagnose by clinical pulse examination can be diagnosed by Sphygmograph
• Ayurvedic diagnosis of Vata ,Pitta ,Kapha Nadi can be objectively compared by Sphymograph
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Please see also Videos
• Copy ,Paste Link as URL• Pulse Examination -- By
Prof.Dr.R.R.deshpande
• https://youtu.be/mATZjnD9bF8
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Prof.Dr.R.R.Deshpande
• Sharing of Knowledge
• FOR
• Propagating Ayurved
9/18/2016 34Prof.Dr.R.R.Deshpande