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On inspection the clinician looks for signs of: trauma; previous surgery ()muscle wasting/muscle asymmetry; edema (swelling) erythema (redness); ulcers – arterial ulcers tend to be on the borders / sides of the foot, neuropathic ulcers on the plantar surface of the foot, venous ulcers tend on be on the medial aspect of the leg superior to the medial malleolus.
The first pulse closest to the wrist is the cun (inch, 寸) position, the second guan (gate, 關), and the third pulse position furthest away from the wrist is the chi (foot, 尺). There are two main systems of diagnostic interpretation of pulse findings utilised in the Chinese medicine system.
In medicine, the pulse is the rhythmic throbbing of each artery in response to the cardiac cycle (heartbeat). [1] The pulse may be palpated in any place that allows an artery to be compressed near the surface of the body, such as at the neck (carotid artery), wrist (radial artery or ulnar artery), at the groin (femoral artery), behind the knee (popliteal artery), near the ankle joint ...
The PAT signal is a form of pulse wave amplitude measured by incorporating both a unified pressure field and a specific isosbestic wavelength.Applying a uniform pressure field around the measured surface releases arterial wall motion restriction, magnifies the dynamic range of the recorded signal, and prevents the distention of the veins distal to the site of pressure application.
The pulses should be palpated, first the radial pulse commenting on rate and rhythm then the brachial pulse commenting on character and finally the carotid pulse again for character. The pulses may be: Bounding as in large pulse pressure found in aortic regurgitation or CO 2 retention.
A Wiggers diagram modified from [1]. A Wiggers diagram, named after its developer, Carl Wiggers, is a unique diagram that has been used in teaching cardiac physiology for more than a century.
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In a normal subject the pressure at the ankle is slightly higher than at the elbow (there is reflection of the pulse pressure from the vascular bed of the feet, whereas at the elbow the artery continues on some distance to the wrist). [citation needed] The ABPI is the ratio of the highest ankle to brachial artery pressure.