Temperatures
Normal Body temperature
-Oral 36,5 – 37,2 (place thermometer after shaking and sterilization under tongue for 3 min)
--Fever > 37,5 Subnormal 1c
4- Relapsing Fevers for few days with brucelleosis
interval of normal
temperature
5- low grade Prolonged fever 41,1 Heat stroke, enciphilitis,
Respiratory rate
Normal 12 -20 min
Pulse : resp. ratio 4 :1
rate = tachypnea : causes of acute dyspnea and
fever
rate = bradypnea ( RC inhibition by morphine)
Rhythm: see chest
pulse
Radial (semi pronated hand to avoid stretch brachial
artery by fascia in cubital fossa).
Carotid ( ant. To sternomastoid at angle of jaw)
Subclavians ( at middle and lat. 1/3 of clavicle)
Brachilais (med. To biceps tendon)
Femoral (mid inguinal point)
Popliteal (popliteal fossa)
Pos. tibialis (behind med. Malleolus)
Dorsalis pedis (lat ext. hallucis)
Pulse
Rate:
Normal 60 :100 beats / min
100 tachycardia ( thyrotoxicosis)
Rhythm
Normal : Regular
Irregular : a) regular irregular
b) irregular irregular
Pulse deficit
If pulse is irregular.
Apical pulse rate as detected by stethoscope S1 >radial
pulse.
Cause :- ventricular contraction opens cusp without
peripheral transmission of blood.
AF Pulse deficit > 10 beats / min
Extrasystols 60mmHg}
(volume)
Causes of small volume (weak pulse)
1- Filling: pericardial effusion, constrictive
pericarditis.
2- Pumping: shocks, HF, myocardial infarction.
Obstruction: pulmonary hypertension.
Causes of big volume (wide pulse).
Prominent arterial pulsation = hyper dynamic
circulation.
1- atherosclerosis, anemia, AV fistula.
2- Beri beri, heart block, brady carida, pregnancy,
hypertension.
Thyrotoxicosis
Causes of variable volume
1- Arrhythemia : AF, multiple extrasystoles
2- pulses altenans.
3- partial heartblock.
Arrhythemia
AF Multiple PMPs
rate 120 -150 / min normal
Rhythm No 4 regular beats 4 regular beats
Pulse deficit >10 /min 10 mm Hg)
Causes:
1- normal but 115
Hypotension
BP UL 10 -20 mm Hg because :-
1- arteries in LL are direct continuity with aorta.
2- Gravity
3- bulk muscles.
In AR Systolic BP in LL is 60 diastolic pressure < 60.