Fundamental Pulse PDF

Pulse (heart rate) Anatomy and physiology of the heart The heart is the part of the circulatory system ,it is a hollow muscular pump, irregularly conical in shape placed obliquely in the middle -sternum where the lungs partially overlap it. The heart is relatively small organ that weigh...

Pulse (heart rate) Anatomy and physiology of the heart The heart is the part of the circulatory system ,it is a hollow muscular pump, irregularly conical in shape placed obliquely in the middle -sternum where the lungs partially overlap it. The heart is relatively small organ that weighs 250-300 grams, pumping more than 5 liters of blood each minute, pump beats approximately 72 times /min.  There are 3 layers of cardiac muscle tissue Endo cardium (inner layer),myocardium is (middle layer)responsible for the heart's contractile force ,and epi cardium ( outer layer).  The heart is enclosed by the pericardium ,which consists of two layers between them space that contains approximately 10-20ml of clear pericardial fluid ,this lubricating fluid and reduces the friction during pumping.  The heart is divided into 4 chambers :two upper atria (right, left )and two lower ventricles (right ,left).The 4 chambers are separated by septa walls the right atrium (RA) receives blood from inferior and superior venae cava s.The right ventricle (RV)receives blood from (RA)through the tricuspid valve. When (RV)contracts blood is ejected through the pulmonary valve into the pulmonary artery.  The pulmonary artery carries blood to lungs, where it releases carbon dioxide as waste and picks up O2 to tissues. Pulmonary veins carry blood from lungs to left atrium (LA).The blood passes from (LA)through mitral valve into left ventricle then (LV) contracts blood is ejected through aorta to all the body.  Definition: The pulse rate is the number of pulsation felt over peripheral artery or heard over the apex of the heart in 1 min. OR The pulse is throbbing sensation as wave of blood is pumped into arteries by contraction of left ventricle.  The pulse is regulated by autonomic nervous system through sinoatrial node ( called pacemaker). sympathetic stimulation ……increase heart rate Para sympathetic stimulation ……decrease heart rate  Normal heart rate ranges between 60-less than 100 Tachycardia Is the rapid heart rate ( 100 to more than 180 beats / min.), there are factors contribute to increase heart rate i.e. Pain –exercise –strong emotion ( fear, anger &anxiety). May due to some medications i.e. epinephrine COPD or anemia ( poor oxygenation) Increase temperature which usually increase heart rate 7-10 beats /min.), for each 0.6°C elevation above normal. Bradycardia: Is pulse rate decrease than 60 beats /min. (adult) i.e. rest &sleep Male have slower pulse than female Thin body have slower pulse than obese Increase age have slower pulse Medication effect on heart rate ( decrease) Any irregularity in the heart beat should reported immediately  Characteristic of the heart rate Rate: ( normal / tachycardia/bradycardia) Rhythm(regular/ irregular) Intensity(strong /weak)  Methods of assessing the pulse by palpating ( feeling),or auscultation (listening). - the middle 3 fingers may be used to palpate all pulse sites except apical pulse.  Stethoscope used to Auscultate apical pulse. -Doppler ultrasound to assess apical pulse.  cardiac monitor to assess apical pulse  Apical – radial pulse: By counting at the apex of the heart & radial pulse.The difference between the apical and radial pulse rates called pulse deficit ( this mean not all heat beats reach to peripheral arteries ), or too week to be palpated.