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20 Cards in this Set
- Front
- Back
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BPs in pts with inaudible Kortokoffs
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Can only get SBP
Underestimates SBP measure using radial pulse |
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BP errors
Applying too much pressure with stethescope |
Underestimates DBP by 10mmHg or more
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PseudoHTN
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pts with stiff, arteriosclerotic arteries.. compression of brachial arteries is difficult. Overestimates SBP. Only way to get accurate measurement is via intra-arterial catheter
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Pulse rate - where to measure/how long
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radial artery, 30 sec reading x2 = HR, if rhythm irregular measure for 60 sec
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Respiratory variation - inspiration
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SBP decreases, pulse increases
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Respiratory variation - expiration
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SBP increases, pulse decreases
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Normal pulse rate (95% normal people)
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50-95 bpm
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Bradycardia
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<50bpm
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Tachycardia
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>95-100 bpm
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Pulse deficit
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irregular/fast pulse where SV of some ventricular cx too small to generate pulse @ radial artery. Measure pulse with stethoscope at apex of heart.
Pulse deficit is difference between apical and radial HR |
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Regular pulse rhythm
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each beat occurs within the same interval
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Irregular rhythm
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variation in time interval between beats - can be predictable or unpredictable (regularly irreg or irregularly irreg =afib)
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Pulsus paradoxus
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changes in strength of pulse correlating to respiration (respiratory variation)
inspiration -> increased pulse expiration -> decreased pulse |
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Pulsus alternans
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pulse strength varies from beat to beat but not correlating to respiration
Systolic pressure difference between beats is 15-20mmHg, indicates CHF, left ventricular systolic dysfunction, a result of changes in myocardial contractibility |
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Strength of pulse correlates with..
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patency of arterial system
the width of pulse pressure compare symmetrically from side to side (does not correlate with level of blood pressure) |
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Pulse asymmetry
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unilateral diminished pulse strength -> highly suspicious for vascular occlusion
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Pulse points
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radial, femoral, popliteal, dorsalis pedis, posterial tibial pulses
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Pulse contour - normal
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swift upstroke followed by a gradual decline, pulse contour is best assessed at carotid artery
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Pulse contour - pulsus bisferiens
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rare, classically characteristic of hypertropic cardiomyopathy
two palpable beats during systole of each cycle severe aortic regurg and some pts with hypertrophic subaortic stenosis |
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Pulse contour - hyperkinetic/Waterhammer pulse
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Waterhammer - aortic insufficiency, severe chronic mitral regurg - PP is normal
chronic aortic regurg - PP increased and produces piston shot, collapsing, or Waterhammer pulse unusually strong and abrupt |
