Hand Surgery Source

Radial Pulse

Test, Exam and Signs

Historical Overview

  • Taking patients radial pulse is useful to examine neurovascular injuries and to determine if their heart is functioning properly.  If patients have undiagnosed irregular pulse rates, they should see a primary care physician.

Description

  • The radial pulse test monitors the neurovascular health of the patient. Pulse volume recordings (PVR) measure flow through an artery. A healthy pulse should be in the range of 60–100 beats per minute (bpm). 

Pathophysiology

  • Deviations from normal triphasic wave patterns arise from diseased arteries.

Instructions

  1. Use a Doppler to monitor the radial pulse
  2. Observe whether the pulse is in the range of 60–100 bpm
  3. Observe whether the pulse is steady

Variations

  • Check the pulse at the dorsal branch of the radial artery and the ulnar artery 

Related Signs and Tests

  • Ulnar pulse
  • Allen’s test 
Additional Information
Presentation Photos and Related Diagrams
  • Palpating Radial Artery pulse at wrist
    Palpating Radial Artery pulse at wrist
  • Palpating dorsal branch of Radial Artery pulse in dorsal first web space.
    Palpating dorsal branch of Radial Artery pulse in dorsal first web space.
Definition of Positive Result
  • A positive result occurs when the patient’s radial pulse is irregular or outside the range of 60–100 bpm. 
Definition of Negative Result
  • A negative result occurs when the patient’s radial pulse is steady and inside the range of 60–100 bpm. 
Comments and Pearls
  • To achieve an accurate pulse reading, check that the patient is in a relaxed state.
  • Caffeine intake may also affect pulse rate.
Diagnoses Associated with Tests, Exams and Signs
Video
Examination of Radial and Ulnar Pulses by Doppler
References
  1. Culp R, Jacoby S.  Musculoskeletal Examination of the Elbow, Wrist and Hand: Making the Complex Simple.  New Jersey: SLACK Incorporated, 2012.
  2. Kleinert JM, Gupta A. Pulse volume recording. Hand Clin  1993; 9(1):13-46. PMID: 8444970
  3. Kleinert JM, Fleming SG, Abel CS, et al. Radial and ulnar artery dominance in normal digits. J Hand Surg Am 1989;14(3):504-8. PMID: 2738336