{"id":326,"date":"2010-12-02T13:36:10","date_gmt":"2010-12-02T13:36:10","guid":{"rendered":"https:\/\/cloverock.info\/mockosce23\/new\/palpation-of-the-arteries\/"},"modified":"2023-01-11T23:05:09","modified_gmt":"2023-01-11T23:05:09","slug":"palpation-of-the-arteries","status":"publish","type":"post","link":"https:\/\/www.qpercom.com\/sim\/index.php\/the-cardiovascular-examination\/periphical-circulation\/palpation-of-the-arteries\/","title":{"rendered":"Palpation of the arteries"},"content":{"rendered":"<p>Palpation of the aorta takes place in the same way as deep palpation of the abdomen; palpation of the other arteries can best be done using the three middlemost fingertips. Be aware that sometimes one\u2019s own pulse is felt. If in doubt, simultaneously palpate the patient\u2019s carotid artery or auscultate the heart. Take care not to press too hard as, it is very easy to occlude particularly the small arteries in particular!<\/p>\n<p>When palpating the arteries note:<\/p>\n<ul>\n<li>Size of pulses:<br \/>\n+ present, \u00b1 weakly present, &#8211; absent<br \/>\n<em>Absent or weak pulses can be indicative of stenosis of the blood vessel or stenosis of a blood vessel closer to the heart which supplies blood to the examined blood vessel. Inability to palpate a dorsal pedal artery does not necessarily signify the presence of pathology. In 10 to 15% of cases the artery is anatomically absent.<\/em><\/li>\n<li>Character of the pulse wave<br \/>\n<em>Please refer to the characteristics of the pulse wave as described under the heart examination.<\/em><\/li>\n<li>Direction of the pulses<br \/>\n<em>Normally there are transmitted pulses that are only felt on the upstroke and the downstroke. In the case of aneurysm formation (concentric dilatation of a vessel) pulsations can be felt in all directions and are termed expansile pulsations.<\/em><\/li>\n<li>Condition of the blood vessel<br \/>\n<em>Normally the peripheral blood vessels are supple and can be easily compressed. In the case of extensive arteriosclerosis, however, the blood vessel can feel tough and hard.<\/em><\/li>\n<li>Diameter of the blood vessel<br \/>\n<em>In the case of aneurysm formation the diameter can be markedly increased.<\/em><\/li>\n<\/ul>\n<p><strong>Individual arteries<\/strong><\/p>\n<p><em><strong>Common carotid artery<\/strong><\/em> [Figure 25]<\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/116865714?dnt=1&amp;app_id=122963\" width=\"640\" height=\"480\" frameborder=\"0\" allow=\"autoplay; fullscreen; picture-in-picture\" allowfullscreen><\/iframe><br \/>\nPalpate both sides at the height of the caudal part of the anterior edge of the sternocleidomastoid muscle. Do not press too hard or palpate both sides at the same time!<\/p>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-313\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-25.jpg\" alt=\"\" width=\"400\" height=\"300\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-25.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-25-300x225.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 25: Common carotid artery<\/span><\/span><\/p>\n<p><em><strong>Subclavian artery<\/strong><\/em> [Figure 26]<br \/>\nPalpate in the supraclavicular space in the caudal direction under the clavicle.<\/p>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-314\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-26.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-26.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-26-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 26: Subclavian artery<\/span><\/span><\/p>\n<p><strong>Upper extremities<\/strong><\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/116865700?dnt=1&amp;app_id=122963\" width=\"640\" height=\"480\" frameborder=\"0\" allow=\"autoplay; fullscreen; picture-in-picture\" allowfullscreen><\/iframe><\/p>\n<p><em><strong>Axillary artery<\/strong><\/em> [Figure 27]<br \/>\nPalpate (high) in the armpit, posterior to the attachment of the pectoralis major muscle, towards the humerus. As circulatory disorders of the lower extremities are far more common than those of the upper extremities, the subclavian artery, axillary artery, brachial artery and ulnar artery are not routinely palpated.<\/p>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-315\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-27.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-27.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-27-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 27: Axillary artery<\/span><\/span><\/p>\n<p><em><strong>Brachial artery<\/strong><\/em> [Figure 28]<br \/>\nPalpate along the direction of the medial bicipital groove, between the thickest part of the muscle of the biceps and triceps towards the humerus and\/or the elbow crease.<\/p>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-316\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-28.jpg\" alt=\"\" width=\"400\" height=\"300\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-28.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-28-300x225.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 28: Brachial artery<\/span><\/span><\/p>\n<p><em><strong>Radial artery<\/strong><\/em> [Figure 29]<br \/>\nPalpate on the ventroradial (thumb) side of the wrist, somewhat proximally to the radial styloid process.<\/p>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-317\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-29.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-29.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-29-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 29: Radial artery<\/span><\/span><\/p>\n<p><em><strong>Ulnar artery<\/strong><\/em> [Figure 30]<br \/>\nPalpate on the ventral ulnar (little finger) side of the wrist at the height of the ulnar styloid process.<\/p>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-318\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-30.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-30.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-30-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 30: Ulnar artery<\/span><\/span><\/p>\n<p><strong>Abdomen<\/strong><\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/116865669?dnt=1&amp;app_id=122963\" width=\"640\" height=\"480\" frameborder=\"0\" allow=\"autoplay; fullscreen; picture-in-picture\" allowfullscreen><\/iframe><\/p>\n<p><em><strong>Abdominal aorta<\/strong><\/em> [Figure 31]<br \/>\nPalpate deep in the epigastrium when the abdominal muscles are relaxed.<\/p>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-319\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-31.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-31.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-31-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 31: Abdominal aorta<\/span><\/span><\/p>\n<p><em><strong>Femoral artery<\/strong><\/em> [Figure 32]<br \/>\nPalpate medially in the groin fold with the fingers pointing straight down and parallel to the groin fold. If necessary, once its position has been determined the femoral artery can subsequently be palpated lengthwise.<\/p>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-320\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-32.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-32.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-32-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 32: Femoral artery<\/span><\/span><\/p>\n<p><strong>Lower extremities<\/strong><\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/116865694?dnt=1&amp;app_id=122963\" width=\"640\" height=\"480\" frameborder=\"0\" allow=\"autoplay; fullscreen; picture-in-picture\" allowfullscreen><\/iframe><\/p>\n<p><em><strong>Popliteal artery<\/strong><\/em><br \/>\n<em>In supine position:<\/em> [Figure 33]<br \/>\nBend patient\u2019s knee at a 45-degree angle and palpate between the fingertips of both hands in the direction of the tibial plateau (in which the thumbs rest on the dorsal edge of the tibial plateau).<\/p>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-321\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-33.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-33.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-33-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 33: Popliteal artery &#8211; In supine position<\/span><\/span><\/p>\n<p><em>In prone position:<\/em> [Figure 34]<br \/>\nBend patient\u2019s knee at a 45-degree angle; allow it to rest against your shoulder and feel again in the direction of the tibial plateau.<\/p>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-322\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-34.jpg\" alt=\"\" width=\"400\" height=\"300\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-34.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-34-300x225.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 34: Popliteal artery &#8211; In prone position<\/span><\/span><\/p>\n<p><em><strong>Posterior tibial artery<\/strong><\/em> [Figure 35]<br \/>\nPalpate under and behind the medial malleolus (= tibial malleolus, inner ankle).<\/p>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-323\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-35.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-35.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-35-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 35: Posterior tibial artery<\/span><\/span><\/p>\n<p><em><strong>Dorsal pedal artery<\/strong><\/em> [Figure 36]<br \/>\nPalpate the dorsum of the foot just laterally to the tendon of the extensor hallucis longus muscle.<\/p>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-324\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-36.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-36.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-36-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 36: Dorsal pedal artery<\/span><\/span><\/p>\n<p><em><strong>Chart &#8211; intensity of pulsations<\/strong><\/em> [Figure 37]<br \/>\nThe intensity of the pulsations can be presented in a chart.<br \/>\nThe arteries of the upper extremities have not been included in the overview.<\/p>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-325\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-37.jpg\" alt=\"\" width=\"400\" height=\"300\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-37.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-37-300x225.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 37: Chart &#8211; intensity of pulsations<\/span><\/span><\/p>\n<p>+&nbsp;&nbsp;&nbsp; = present<br \/>\n+\/-&nbsp; = weakly present<br \/>\n&#8211;&nbsp;&nbsp;&nbsp;&nbsp; = absent<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Palpation of the aorta takes place in the same way as deep palpation of the abdomen; palpation of the other arteries can best be done using the three middlemost fingertips. Be aware that sometimes one\u2019s own pulse is felt. If in doubt, simultaneously palpate the patient\u2019s carotid artery or auscultate the heart. Take care not [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[31],"tags":[120],"class_list":["post-326","post","type-post","status-publish","format-standard","hentry","category-periphical-circulation","tag-the-cardiovascular-examination"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Palpation of the arteries - Qpercom | Skills in Medicine<\/title>\n<meta name=\"description\" content=\"Online Mock OSCEs with examiners, patient actors, instant results and personalised feedback. 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