pulse
A pulse check is an auxiliary test method used to check if the pulse is normal. Pulse refers to the pulsation of an artery. The pressure changes caused by the heart beat cause the wall of the aorta to vibrate and pass along the wall of the artery to the periphery, which is a pulse. The so-called pulse usually refers to the pulse that is rubbed on the side of the wrist. The pulse can also be traced with a pulse. The pulse reflects the functional status of the blood circulation system. The contents of the pulse test include checking the rate, rhythm, tone, strength, waveform, and condition of the arterial wall of the pulse. Through this examination, the lesion and the corresponding symptoms can be judged. Basic Information Specialist classification: cardiovascular examination classification: physical examination Applicable gender: whether men and women apply fasting: not fasting Reminder: During the examination, the patient actively cooperates with the doctor. It is not suitable for strenuous exercise one hour before the examination. It is not appropriate to be overly nervous during the examination, so as not to affect the result. Normal value Normal adult pulse rate is 60-100 beats/min in a quiet and awake situation, the elderly are slow, women are slightly faster, children are faster, and children <3 years old are more than 100 beats/min. Normal human pulse rules, the pulse of sinus arrhythmia can change with breathing. Increase when inhaling; slow down when exhaling. The normal pulse wave consists of three parts: the ascending branch (sniper wave), the peak (tidal wave) and the descending branch (heavy beat wave). The ascending branch occurs in the early stage of left ventricular contraction and is caused by left ventricular ejection from the aortic wall. The wave peak, also known as the tidal wave, appears in the middle and late stages of contraction, while the blood runs to the distal end of the artery and partially reverses. Caused by impacting the arterial wall. The descending branch occurs in the ventricular diastolic phase. The aortic valve medical education is collected and closed, the blood is folded back from the peripheral to the proximal end, and the aortic wall is elastically retracted, so that the blood flow continues to flow to the peripheral artery. There are all traces of the beat wave on the descending branch. In the case of obvious aortic sclerosis, this wave tends to be inconspicuous. Clinical significance Abnormal result First, the pulse rate, in addition to the pulse rate, should also check whether the pulse rate and heart rate are consistent. Some arrhythmias, such as atrial fibrillation or premature contraction, due to the low volume of partial cardiac contraction, is not enough to cause peripheral arterial pulsation, so the pulse rate can be less than the heart rate. Second, the pulse, the rhythm of the pulse can reflect the rhythm of the heart. A variety of arrhythmia patients can affect the pulse, such as atrial fibrillation, the pulse is absolutely irregular. The pulse is strong and weak. The pulse rate is less than the heart rate. The latter is called short pulse of the pulse; a pre-contraction is a two-line or triple-law can form a second pulse, a triple pulse; a second degree atrioventricular block can have a pulse leak, called a dropped pulse. Third, the tension and the state of the arterial wall, after the brachial artery is compressed, although the distal finger can not touch the arterial pulse, but can touch the existence of the strip artery, and hard and lack of elasticity like a cord, twist or nodular , suggesting arteriosclerosis. Fourth, strong and weak, weak pulse and low amplitude, due to less heart rate, small pulse pressure and increased peripheral resistance, seen in heart failure, aortic stenosis and shock. Five, pulse wave: 1. Water impulses are common in hyperthyroidism, severe anemia, beriberi, aortic regurgitation, congenital heart disease, patent ductus arteriosus, arteriovenous fistula. 2. Delayed pulse is mainly seen in aortic stenosis, myocardial infarction, constrictive pericarditis, severe heart failure and so on. 3. Severe pulsation is seen in patients with hypertrophic obstructive cardiomyopathy and long-term fever, which reduces peripheral vascular tone. It can also be seen in cardiac tamponade, severe heart failure and hypovolemic shock. 4. Alternate veins are common in hypertensive heart disease, acute myocardial infarction, and aortic regurgitation. Alternate veins are characterized by normal rhythms and alternating changes in pulse strength. This is caused by alternating ventricular contraction and weakness, and is an important sign of cardiac dysfunction. Can be seen in hypertensive heart disease and coronary heart disease. 5. Paradoxicalpulse (sucking pulse) When the inhalation, the pulse is obviously weakened or disappeared, while at the end of exhalation, it becomes called the odd pulse. 6. Pulse-free pulse disappears, which can be seen in severe shock and multiple arteritis. The latter is due to the occlusion of a certain part of the artery and the pulse of the corresponding part disappears. Regular physical examination items for people who need to be examined, abnormal blood vessels. Precautions Forbidden before examination: Maintain a normal diet and schedule. Requirements for examination: The patient actively cooperates with the doctor during the examination. It is not suitable for strenuous exercise one hour before the examination. It is not appropriate to be overly stressed during the examination, so as not to affect the result. Inspection process 1. The pulse test mainly uses the palpation method, and the bedside monitor can continuously display and record the pulse beat condition, and directly observe the changes of the pulse waveform, rhythm and frequency. 2. When checking the pulse, you must choose a superficial artery, usually with a radial artery. In special cases, the radial, carotid, radial, femoral, and dorsal arteries can also be examined. 3. The examiner's fingers are put together, and the index finger, middle finger and ring finger are placed flat on the wrist near the wrist, and the pulse beat is carefully felt. 4. Both sides must be palpated for comparison. The difference between the two sides of the normal person is small and difficult to detect. In some diseases, there is a significant difference in pulse on both sides. The pulse on both sides is not strong, or there is no pulse on one side. 5. The upper and lower extremity pulse should be checked for contrast, and the upper and lower extremity blood pressure should be measured at the same time. To discover certain diseases. Such as multiple arteritis, aortic coarctation and so on. Not suitable for the crowd Inappropriate people: severe blood vessels and heart failure.
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