Arterial pulse (The Guyton and Hall Physiology)

It is the pressure wave which travel along the walls of Arteries when blood is ejected from the left ventricle into the aorta
Aorta expands to accommodate the ejected blood volume, when it expands it has got elastic recoil, so it shortens back. This causes pressure wave which leads to expansion of arterial wall which can be palpated as arterial pulse.

Normally arterial pulse ends at arterioles.

So normally there is no capillary pulsations
FACTORS
The velocity of blood flow

The velocity of transmission of pressure wave

1. ARTERIAL PULSE Maryam Fida (o-1827) Source: The  Guyton  and Hall Physiology

2. The main pulse points

3. The pressure wave expands the arterial walls as it travels.

4. ARTERIAL PULSE It is the pressure wave which travel along the walls of Arteries when blood is ejected from the left ventricle into the aorta

5. Aorta expands to accommodate the ejected blood volume, when it expands it has got elastic recoil, so it shortens back. This causes pressure wave which leads to expansion of arterial wall which can be palpated as arterial pulse. Normally arterial pulse ends at arterioles. So normally there is no capillary pulsations

6. FACTORS The velocity of blood flow The velocity of transmission of pressure wave

7. The velocity of transmission of pressure wave Is much higher than blood flow When pressure pulse wave is transmitted to peripheral arteries, its velocity increases. The velocity of pressure pulse wave is much faster and independent of the velocity of blood flow. In the aorta, velocity of pressure pulse wave is 15 times greater than the velocity of blood flow In the peripheral arteries it is 100 times greater than the velocity of blood flow.

8. Velocity of blood flow in large arteries=50 cm/sec The rate of travel of pulse wave is about 4 meter/sec in aorta and its branches 8 meter/sec in large arteries 16 meter/sec in small arteries

9. Methods of recording arterial pulse 1. Manometric technique 2. Electronic transducer technique

10. The difference between systolic pressure and diastolic pressure (120- 80 = 50 mmHg ) is called the pulse pressure. It can be felt as a pulsation or throb in the arteries of the wrist or neck with each heartbeat.

11. Pulse pressure depends upon three factors 1. Stroke volume : 2. Elasticity of Arteries 3. Character of ejection of blood from the left ventricle into aorta:

12. 1. Stroke volume : Greater the stroke volume, greater will be the pulse pressure. This stroke volume is also effected by total peripheral resistance. When there is decreased total peripheral resistance, i.e. arterioles are dilated so more blood will flow to the tissues. So venous return increases. So this will in turn lead to increased stroke volume. Mean systemic filling pressure also increases stroke volume.

13. 2. Elasticity of Arteries Pulse pressure is inversely proportional to elasticity of arteries. Greater the elasticity of arteries, less will be the pulse pressure. As we pass from aorta to peripheral arteries elasticity decreases so the pulse pressure increases as we pass away from aorta.

14. 3. Character of ejection of blood from the left ventricle into aorta: Sudden ejection results into greater pulse pressure as compared to prolonged blood ejection.

15. Significance of arterial pulse Part of routine clinical examination and from this we can find out the heart rate and of course psychologically it is very important. There is also help in the diagnosis of different diseases. When we palpate the arterial pulse we have to know the following points: Rate, rhythm, volume, character, condition of vessel wall.

16. WEAK OR THREADY PULSE : very low pulse pressure as in blood loss or extreme of dampening as in circulatory shock. PULSUS ALTERNANS : there is strong and weak pulse in alternate beats. One beat is strong and other is weak. Feature of LVF.

17. PULSUS PARADOXUS Pulse becomes weak during inspiration and becomes strong during expiration . Occurs physiologically. Less blood returns to the atrium during inspiration. Becomes very prominent in pericardial effusion and constrictive pericarditis  

18. COLLAPSING OR WATER HAMMER PULSE seen in aortic incompetence. There is rapid rise in pressure during systole and then it collapses rapidly. PLATEAU PULSE : seen in aortic stenosis. Slow rise in pressure

19. REGULARLY IRREGULAR : ATRIAL FLUTTER. IRREGULARALY IRREGULAR : Atrial fibrillation STRONGER PULSE : During fever, exercise, pregnancy, hyperthyroidism, anxiety, excitement. Old age because of increased pulse pressure.