• It is a wave generated at the base of Aorta& spreading along the arterial wall to the

peripheral arteries.

• Wave is generated due to pumping of blood by heart.
• Pulse is not due to blood flow in the vessel.

Sites of pulse examination

• Superficial Temporal Artery
• Facial Artery (Anterior border of Masseter muscle)
• Carotid (Medial to Sternocleidomastoid muscle)
• Apical
• Brachial artery
• Radial artery
• Femoral artery(Inguinal region)
• Popliteal artery(Behind knees)
• Posterior Tibial artery
• Dorsalis pedis artery(1st Intertarsal space)

Temporal: The site is above and lateral to the eye where the temporal artery passes over the temporal bone of the head. It is one of two terminal branches of the external carotid artery. It supplies the temporalis muscle and the scalp and, as a donor artery, it supplies vascularity to the temporoparietal fascia.

Facial artery: It supplies the muscles and skin of the face. It has a crucial function in maintaining these areas, and provides them with oxygen and nutrients. The facial artery is one of the eight branches of the external carotid artery.It is also known as the external maxillary artery.

• Carotid: At the side of the neck where the carotid artery runs between the trachea and the sternocleidomastoid muscle. an artery on each side of the neck which divides into the external carotid artery and internal carotid artery
• External carotid artery, an artery on each side of the head and neck supplying blood to the face, scalp, skull, neck and meninges
• Internal carotid artery, an artery on each side of the head and neck supplying blood to the brain

Apical: At the apex of the heart. It can be found in the left center of your chest, just below the nipple. This position roughly corresponds to the lower (pointed) end of your heart.& is located at the fourth intercostal space at the left midclavicular line.

Brachial: The brachial pulse can be located by feeling the bicep tendon in the area of the antecubital fossa.palpated on the anterior aspect of the elbow by gently pressing the artery against the underlying bone with the middle and index fingers.

Radial:Use the tip of the index and third fingers of your other hand to feel the pulse in radial artery between your wrist bone and the tendon on the thumb side of  wrist. Apply just enough pressure so you can feel each beat.

Femoral: Is felt at the groin just below the inguinal ligament midway between the anterior superior iliac spine and the symphysis pubis. located along the crease midway between the pubic bone and the anterior iliac crest. Use the tips of your 2nd, 3rd and 4th fingers. If there is a lot of subcutaneous fat, you will need to push firmly.

Popliteal: Is rather difficult to feel as it lies deep behind the knee. The knee is flexed to 40degrees with the heel resting on the bed, so that the muscles around the popliteal fossa are relaxed .The clinician places his fingers over the lower part of popliteal fossa &the fingers are moved sideways to feel the pulsation of the popliteal artery against the posterior aspect of the tibial condyles.This artery can also be palpated by turning the patient into prone position and by feeling the artery with the finger tips after flexing the knee passively with another hand.

Posterior tibial: Is felt just brhind the medial malleolus midway between it and the tendo achillis.

Anterior tibial artery:Is felt in the midway anteriorly between the two malleoli against the lower end of tibia just above the ankle joint and just lateral to the tendon of the extensor halluces longus which is made prominent by asking the patient to extend his great toe.

Dorsalis pedis:Is felt just lateral to the tendon of the extensor halluces longus.It is absent in 10% of cases. Where the dorsalis pedis artery passes over the bones of the foot, on an imaginary line drawn from the middle of the ankle to the space between the big and second toes.