Over the next few weeks, we’ll be diving head first into the anatomical explanations for some of the routine procedures you may have experienced when visiting the doctor. ?⚕️ Let’s start by looking at what happens when you have your pulse taken. ?
There are a number of different parts of the body where the pulse can be taken. For example, in the upper limb ? the pulse can be measured at the wrist, or in the lower limb? on the front of the foot. Let’s take a look at the pulse points in the head in a little more detail.
It’s important to note that we can feel a pulse in each of these locations because an artery is running close to the skin and is easily compressed against a hard structure below. ☠️
In the head there are three pulse points (labelled above). They are:
- The carotid pulse – along the anterior border of the sternocleidomastoid muscle, the common carotid artery can be located and pushed against the thyroid cartilage.
- The facial pulse – as the facial artery passes over the angle of the mandible a pulse can be felt. See if you can find this one on yourself, it can sometimes be difficult to locate.
- The temporal pulse – in front of the ear, the superficial temporal artery can be compressed against the temporal bone.
Each time the heart beats ❤️ blood is forced into the periphery in ‘waves’? which causes the pressure of blood in the vessels increase. Because it is elastic, this increase in pressure makes the vessel expand. It is these increases in blood pressure, called the systolic pressure, which can be felt when someone takes your pulse. This means someone can measure the rate at which your heart is beating by taking your pulse ⏱️
As well as the heart rate, a clinician can also appreciate the rhythm of your heart – if it is beating regularly. Additionally they can even make a rudimentary assessment of the functionality of your heart – if the pulse is weak, the heart might not be pumping blood efficiently. This non-invasive method of assessment can tell us quite a lot about the old ticker!
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Heart rate; Heart beat The pulse is the number of heartbeats per minute. The carotid arteries take oxygenated blood from the
heart to the brain. The pulse from the carotids may be felt on either side of thefront of the neck just below the angle of the jaw. This rhythmic beat is caused by varying volumes of blood being pushed out of the heart toward the extremities.
Arteries carry oxygenated blood away from the heart to the tissues of the body. Veins carry blood depleted of oxygen from the same tissues back to the heart. The arteries are the vessels with the pulse, a rhythmic pushing of the blood in the heart followed by a refilling of the heart chamber. To determine heart rate, one counts the beats at a pulse point like the inside of the wrist for 10 seconds, and multiplies this number by 6. This is the per-minute total.
To measure the pulse at the wrist, place the index and middle finger over the underside of the opposite wrist, below the base of the thumb. Press firmly with flat fingers until you feel the pulse in the radial artery.
To measure the pulse on the neck, place the index and middle finger just to the side of the Adam's apple, in the soft hollow area. This pulse is felt in the common carotid artery.
How to take your pulse. 1. Place the tips of your index and middle finger on the inside of your wrist below the base of your thumb. 2. Press lightly. You will feel the blood pulsing beneath your fingers. 3. Use a watch or clock with a second hand. Count the beats you feel for 1 minute. Or count the beats for 30 seconds and multiply by 2. This is also called your pulse rate.
How the Test is Performed
The pulse can be measured at areas where an artery passes close to the skin. These areas include the:
- Back of the knees
- Groin
- Neck
- Temple
- Top or inner side of the foot
- Wrist
To measure the pulse at your wrist, place your index and middle finger over the underside of your opposite wrist, below the base of the thumb. Press with flat fingers until you feel the pulse.
To measure the pulse on the neck, place the index and middle fingers just to the side of the Adam's apple, in the soft, hollow area. Press gently until you locate the pulse.
Note: Sit or lie down before taking the neck pulse. The neck arteries in some people are sensitive to pressure. Fainting or slowing of the heartbeat can result. Also, do not take the pulses on both sides of the neck at the same time. Doing so can slow the flow of blood to the head and lead to fainting.
Once you find the pulse, count the beats for 1 full minute. Or, count the beats for 30 seconds and multiply by 2. This will give the beats per minute.
How to Prepare for the Test
To determine the resting heart rate, you must have been resting for at least 10 minutes. Take the exercise heart rate while you are exercising.
How the Test will Feel
There is a slight pressure from the fingers.
Why the Test is Performed
Measuring the pulse gives important information about your health. Any change from your normal heart rate can indicate a health problem. Fast pulse may signal an infection or dehydration. In emergency situations, the pulse rate can help determine if the person's heart is pumping.
Pulse measurement has other uses as well. During or immediately after exercise, the pulse rate gives information about your fitness level and health.
Normal Results
For resting heart rate:
- Newborns 0 to 1 month old: 70 to 190 beats per minute
- Infants 1 to 11 months old: 80 to 160 beats per minute
- Children 1 to 2 years old: 80 to 130 beats per minute
- Children 3 to 4 years old: 80 to 120 beats per minute
- Children 5 to 6 years old: 75 to 115 beats per minute
- Children 7 to 9 years old: 70 to 110 beats per minute
- Children 10 years and older, and adults (including seniors): 60 to 100 beats per minute
- Well-trained athletes: 40 to 60 beats per minute
What Abnormal Results Mean
Resting heart rates that are continually high (tachycardia) may mean a problem. Talk to your health care provider about this. Also discuss resting heart rates that are below the normal values (bradycardia).
A pulse that is very firm (bounding pulse) and that lasts for more than a few minutes should be checked by your provider as well. An irregular pulse can also indicate a problem.
A pulse that is hard to locate may mean blockages in the artery. These blockages are common in people with diabetes or hardening of the artery from high cholesterol. Your provider may order a test known as a Doppler study to check the blockages.
References
Bernstein D. History and physical examination in cardiac evaluation. In: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 449.
Schriger DL. Approach to the patient with abnormal vital signs. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 7.
Version Info
Last reviewed on: 1/16/2021
Reviewed by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 09/30/2021.