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Questions and Answers
What is the normal rate of pulse beats, and what is the term for a rate above 100 beats?
The normal rate of pulse beats is 60-100 beats. A rate above 100 beats is termed tachycardia.
What are the causes of big pulse pressure, and what do the abbreviations H, B, and A stand for?
The causes of big pulse pressure are hypoxia, hyperthyroidism, hepatic failure, and hyperthermia (H); pregnancy, beri beri, and Paget's disease of bones (B); and anemia, arterio-venous fistula, and aortic regurge (A).
Why is it important to examine both radial arteries simultaneously, and what does inequality of pulse volume indicate?
It is important to examine both radial arteries simultaneously to check for equality of pulse volume. Inequality of pulse volume indicates compression from outside, vessel wall abnormalities, or lumen obstruction.
What are the sites of examination for pallor, and what are the causes of pallor?
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What is the difference between jaundice and cyanosis, and how are they diagnosed?
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What is the site of examination for lower limb edema below the knees?
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What is the cause of bilateral lower limb edema?
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What is the effect of warming the hands on peripheral cyanosis?
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What is the method of examination for lower limb edema above the knees?
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What is the cause of unilateral lower limb edema?
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Study Notes
Pulse
- Normal pulse rate: 60-100 beats per minute
- Tachycardia: pulse rate above 100 beats per minute
- Bradycardia: pulse rate below 60 beats per minute
- Pulse rhythm can be regular or irregular
Causes of Big Pulse Pressure
- Hyperdynamic circulation due to:
- Hypoxia
- Hyperthyroidism
- Hepatic failure
- Hyperthermia
- Pregnancy
- Beri Beri (Vitamin B1 deficiency)
- Paget's disease of bones
- Anemia
- Arterio-venous (AV) fistula
- Aortic regurge
Pulse Volume
- Equality of pulse volume on both sides is important
- Examine both radial arteries simultaneously to check for equality
- Causes of unequal pulse volume:
- Compression from outside (cervical rib, Pancoast tumors, enlarged cervical lymph nodes)
- Vessel wall abnormalities (vasculitis, aortic coarctation)
- Lumen obstruction (thrombosis, embolism)
- Water hammer pulse (collapsing pulse): a special character of pulse
Peripheral Pulsations
- Sites of examination:
- Radial pulse
- Brachial pulse
- Carotid pulse
- Femoral pulse
- Popliteal pulse
- Dorsal pedis pulse
Pallor
- Decreased visibility of oxyhemoglobin in blood vessels
- Sites of examination:
- Inner aspect of lips
- Tongue
- Skin of the face
- Nails
- Inferior fornix of the conjunctiva
- Palmar creases
- Causes of pallor:
- Anemia
- Shock
- Toxemia
- Edema
Jaundice
- Yellowish discoloration of skin and mucous membranes due to increased serum bilirubin (> 3 mg/dl)
- Sites of examination:
- Soft palate
- Sclera of the eye
- Skin
Cyanosis
- Bluish discoloration of skin and mucous membranes due to increased reduced hemoglobin (> 5 gm/dl)
- Sites of examination:
- Nails
- Lips
- Tongue
- Nose
- Lobule of the ear
- Causes of cyanosis:
- Central: cyanotic heart diseases, respiratory failure, COPD
- Peripheral: cold exposure, shock, Raynaud's phenomenon
Lower Limb Edema
- Method of examination:
- Pressing the thumb for at least 30 seconds below the medial malleolus, on the dorsum of the foot, against the chin of the tibia
- Pinching the skin of the thigh
- Compression of the lower back against the sacrum
- Causes of lower limb edema:
- Bilateral edema: major organ failure (liver failure, renal failure, heart failure, respiratory failure), myxedema, drug-induced (CCB)
- Unilateral edema: cellulitis, DVT, filariasis, lymphedema
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Description
Quiz about heart rate, pulse pressure, and their relations to various medical conditions and factors. Test your knowledge on normal rates, tachycardia, bradycardia, and causes of high pulse pressure.
