Pulse and pulse points

What is Pulse and Definition

The pattern of contractions in the arteries as BLOOD passes through them, typically synchronized with the contractions of the HEART. Where an ARTERY is close to the surface, it is possible to feel the pulse by applying pressure with two fingers (but not the thumb, which has its own perceptible pulse).

Pulse Points

ArteryBody Location
abdominal aorta solar plexus area of the abdomen
brachial inside of the upper arm
carotid each side of the neck, below the jaw
femoral groin
pedal top of the foot
popliteal behind the knee
radial wrist, below the base of the thumb
temporal side of the forehead
tibial inside of the lower leg, behind the inner ankle
ulnar wrist, at the base of the hand on the opposite side from the thumb

ARRHYTHMIAS in which the heart contracts but does not eject blood with the contraction, such as with some tachycardias, may result in a disparity between the pulse and the heart rate. The nature of the pulse aids in diagnosis:

  • An alternating pulse has a regular rhythm though some beats are strong and others are weak. It may suggest left HEART FAILURE.
  • A bigeminal pulse is a pattern of two beats, a strong beat then a weak beat with a long pause after. It suggests PREMATURE VENTRICULAR CONTRACTIONS (PVCS).
  • A bounding pulse may be rapid and forceful. It may indicate HYPERTENSION, FEVER, ANEMIA, or RENAL FAILURE. A bounding pulse also may occur following intense physical exercise, in which case it is normal.
  • A rapid pulse, also called an accelerated pulse, indicates tachycardia (heart rate of 100 beats per minute or faster). It may suggest an arrhythmia, cardiovascular SHOCK, fever, HYPERTHYROIDISM, or CORONARY ARTERY DISEASE (CAD). A rapid pulse also may occur normally following intense physical exercise.
  • A trigeminal pulse is a pattern of two equally strong beats then a third weak beat with a long pause after. It may suggest CARDIOMYOPATHY.
  • A water-hammer pulse is a pattern in which there is a rapid surge of blood at the pulse point followed by a complete collapse of the artery. It suggests aortic regurgitation, a condition in which the aortic valve fails to close after the left ventricle pumps blood into the aorta, allowing blood to flow back into the heart.

Characteristics of the Pulse

The characteristics of the pulse change with fitness level and age. People who exercise regularly and people who are over age 70 tend to have slower pulse rates than people who are sedentary or young. The average resting pulse for an adult is 60 to 100 beats per minute. Children typically have more rapid pulse rates. The pulse rate also temporarily increases with fever, PAIN, and anxiety.


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The cardiovascular system

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