Anatomy of Foot Circulation

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Questions and Answers

What is one of the reasons why the pulse rate increases in response to elevated body temperature?

Due to the decrease in blood pressure

Due to the peripheral vasodilation associated with elevated body temperature (correct)

Because of the increased sympathetic nervous stimulation

Because of the increased metabolic rate

Which medication is known to decrease the heart rate?

Digitalis preparations (correct)

Epinephrine

Cardiotonic

Atropine

What happens to the pulse rate when there is a loss of blood from the vascular system?

It remains the same

It decreases

It fluctuates

It increases (correct)

Why is the temporal pulse site used?

When the radial pulse is not accessible Signup and view all the answers

What is the effect of stress on the pulse rate?

It increases Signup and view all the answers

What is the effect of position on the pulse rate?

It increases when sitting or standing Signup and view all the answers

Why is the carotid pulse site used?

During cardiac arrest or shock in adults Signup and view all the answers

What can affect the resting pulse rate?

All of the above Signup and view all the answers

Which of the following arteries is used to determine circulation of the foot?

Posterior tibial artery Signup and view all the answers

What is the purpose of assessing the pulse?

To determine heart rate and rhythm Signup and view all the answers

What is the recommended time for a patient to rest before assessing the pulse?

10-15 minutes Signup and view all the answers

What is the characteristic of a normal pulse?

Equal time elapses between beats Signup and view all the answers

What is tachycardia?

A heart rate above 100 beats/min Signup and view all the answers

Which of the following is NOT a factor that affects pulse rate?

Time of day Signup and view all the answers

What is used to assess apical pulses?

Stethoscope Signup and view all the answers

What is the purpose of using a Doppler Ultrasound Stethoscope?

To assess pulses that are difficult to assess Signup and view all the answers

What is the term for a pulse with an irregular rhythm?

Dysrhythmia Signup and view all the answers

What is the term for the force of blood with each beat?

Pulse volume Signup and view all the answers

What is the term for a pulse that is readily obliterated with pressure from the fingers?

Weak or feeble pulse Signup and view all the answers

What is the purpose of apical pulse assessment in patients with known cardiovascular diseases?

To obtain the heart rate of an adult with an irregular peripheral pulse Signup and view all the answers

Where is the apical pulse assessed?

The angle of Louis Signup and view all the answers

What is the term for the movement of air in and out of the lungs?

Ventilation Signup and view all the answers

What is the normal type of breathing?

Costal breathing Signup and view all the answers

What is the term for the intake of air into the lungs?

Inhalation Signup and view all the answers

What represents the stroke volume output or the amount of blood that enters the arteries with each ventricular contraction?

Pulse wave Signup and view all the answers

What is the purpose of assessing a peripheral pulse?

All of the above Signup and view all the answers

What is the effect of age on the pulse rate?

The pulse rate decreases with age Signup and view all the answers

What is an example of a peripheral pulse?

Pulse located in the foot Signup and view all the answers

What is the cardiac output (CO)?

The amount of blood ejected by the heart with each ventricular contraction Signup and view all the answers

What happens to the pulse rate during exercise?

The pulse rate increases Signup and view all the answers

What is an example of a central pulse?

Apical pulse Signup and view all the answers

Why is assessing a peripheral pulse important for clients at risk for pulse alterations?

To monitor clients at risk for pulse alterations Signup and view all the answers

Where is the apical pulse located in adults?

On the left side of the chest at the fifth intercostal space Signup and view all the answers

Why is the radial pulse used in conjunction with some medications?

To determine discrepancies with apical pulse Signup and view all the answers

At what age is the apical pulse located at the midclavicular line (MCL)?

Between 4 and 7 years old Signup and view all the answers

Where is the femoral pulse located?

Where the femoral artery passes alongside the inguinal ligament Signup and view all the answers

What is the purpose of the brachial pulse?

To measure blood pressure Signup and view all the answers

Why is the popliteal pulse used?

To determine circulation to the lower leg Signup and view all the answers

Where is the radial pulse located?

Where the radial artery runs along the radial bone Signup and view all the answers

Why is the apical pulse used in infants?

During cardiac arrest Signup and view all the answers

Study Notes

Pulse Assessment

Two pulse sites used to determine circulation of the foot: posterior tibial and dorsalis pedis
Posterior tibial pulse is located on the medial surface of the ankle, where the posterior tibial artery passes behind the medial malleolus
Dorsalis pedis pulse is located on the foot, over the bones of the foot, on an imaginary line drawn from the middle of the ankle to the space between the big and second toes

Assessing the Pulse

Pulse is commonly assessed by palpation (feeling) or auscultation (hearing)
Middle three fingertips are used for palpating all pulse sites, applying moderate pressure (except apical pulse)
Stethoscope is used for apical pulses
Doppler Ultrasound Stethoscope (DUS) is used for pulses that are difficult to assess

Factors to Consider When Assessing the Pulse

Medications that affect heart rate
Patient's resting heart rate (e.g., physically fit athlete will have a resting heart rate below 60 beats/min)
Position of patient (e.g., sitting position can affect heart rate)
Baseline data about the normal heart rate

What to Obtain When Assessing the Pulse

Rate
Rhythm
Volume
Arterial wall elasticity
Presence or absence of bilateral equality

Abnormal Pulse

Tachycardia: excessively fast heart rate, over 100 beats/min in an adult
Bradycardia: heart rate of less than 60 beats/min in an adult
Dysrhythmia/arrhythmia: pulse with an irregular rhythm

Pulse Volume

Refers to the force of blood with each beat
Can range from absent to bounding
A normal pulse can be felt with moderate pressure of the fingers and can be obliterated with greater pressure

Apical Pulse Assessment

Purposes: obtain heart rate of an adult with irregular peripheral pulse or unavailable, monitor patient with cardiovascular, pulmonary, or renal diseases, and administer medications that affect heart rate
Location: palpate the angle of Louis (angle between the manubrium and the body of the sternum) or the fifth intercostal space towards the medial to mid-clavicle line

Respiration

Respiration: act of breathing
Inhalation/inspiration: intake of air into the lungs
Exhalation/expiration: breathing out or movement of gases from the lungs to the atmosphere
Ventilation: movement of air in and out of the lungs

Types of Breathing

Costal (thoracic) breathing: normal
Other types of breathing: in response to lowered blood pressure or increased metabolic rate

Factors Affecting the Pulse Rate

Medications: some decrease pulse rate, while others increase it
Hypovolemia/dehydration: loss of blood from the vascular system increases pulse rate
Stress: sympathetic nervous stimulation increases heart rate and force
Position: sitting or standing can affect heart rate
Pathology: certain diseases can alter resting pulse rate

Pulse Sites

Temporal pulse: located on the temporal bone of the head, used when radial pulse is not accessible
Carotid pulse: located at the side of the neck, used during cardiac arrest/shock in adults
Apical pulse: located at the apex of the heart, used for infants and children up to 3 years old
Brachial pulse: located at the inner aspect of the bicep muscles of the arms, used to measure blood pressure
Radial pulse: located on the thumb side of the inner aspect of the wrist, readily accessible
Femoral pulse: located alongside the inguinal ligament, used in cardiac arrest/shock
Popliteal pulse: located behind the knee, used to determine circulation to the lower leg

Assessment of Patients

Pulse: a wave of blood created by contraction of the left ventricle of the heart
Pulse wave represents the stroke volume output or the amount of blood that enters the arteries with each ventricular contraction
Compliance of the arteries: ability to contract and expand

Factors Affecting the Pulse

Age: pulse rate gradually decreases with age
Sex: average male pulse rate is slightly lower than the female pulse rate after puberty
Exercise: pulse rate normally increases with activity
Fever: pulse rate increases

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Description

Identify key locations on the foot related to circulation, including the posterior tibial and dorsalis pedis arteries. Important for determining blood flow to the foot.