pulse examination by prof.dr.deshpande

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

9/18/2016 Prof.Dr.R.R.Deshpande 1

http://www.ayurvedicfriend.com/

mailto:[email protected]

mailto:[email protected]

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

9/18/2016 2Prof.Dr.R.R.Deshpande

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


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


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

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


Counting pulse rate in full one minute


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


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


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


Middle Finger


Uplift to middle finger


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


Pressure by Index finger to Obliterate flow


5) Tension

• Feel of the Pulse ,between 2 uplifts

• It gives rough idea about Diastolic Blood Pressure


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


Pulse equality on both sides


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


Rolling of fingers


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)


Temporal artery


Facial Artery


Carotid artery


Brachial Artery


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)


Popliteal Artery


Dorsalis pedis artery


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


9) Apex Pulse ratio


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


Pulse wave tracing


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


Please see also Videos

• Copy ,Paste Link as URL• Pulse Examination -- By

Prof.Dr.R.R.deshpande

• https://youtu.be/mATZjnD9bF8

9/18/2016 Prof.Dr.R.R.Deshpande 33

https://youtu.be/mATZjnD9bF8

Prof.Dr.R.R.Deshpande

• Sharing of Knowledge

• FOR

• Propagating Ayurved


pulse examination by prof.dr.deshpande

Education