RHYTHMICAL

EXCITATION OF THE
HEART
Superior
posterolateral wall of
the right atrium
60-100 beats per
minute
Self excitation
(Automatocity)
Bachmanns bundle
Anterior internodal tract
Middle internodal tract
Posterior internodal tract
 To prevent cardiac
impulses to travel
rapidly from atria
to ventricles
40-60 beats per
minute
Posterior wall of
the right atrium;
behind the
tricuspid valve

Total delay of 0.16

second
 Very large fibers

High level of
permeability
(rapid beats per
20-40
transmission)
minute

Inability of the
action potentials
for retrograde
transmission
 HEART RATE
Posterior
The brachial
Popliteal tibial
EXAMINATION OF THE
The ThePULSE
artery dorsalis
temporal
artery,
artery, located on
Thelies
The deep
common
pedis in the
radial
theTheartery
locatedfemoral
medial
biceps-triceps
is of
above
side
the artery
artery
carotid
and
anterior ankle
artery isisis
joint,
behind just
is
felt
the
furrow onto the the
overPimenta's
medialin to the
usually
deep
palpable
knee,
Point, ear
medial in
and
side
where
in
at the
the the
the
of
3
the
outer
inguinal
arm
neck border
popliteal
nearligament
groove
near fossa,
the theof
overlies
fingers
the
elbow. radius the
are placed
and
midway
found
at between between
by
anterior
the midpoint the
of
temporal
lateral
holding to
the anterior
bone,
the the
animaginary line
border
one first
of
It coursesthe
tendon of
two the
few
toward
of
superior
bent
drawn knee.
between iliac the
the midline
sternocleidoma
tendons on of the
the
the
bony normally
spine flexor
prominence
and carpi
antecubital fossa,the of
stoid
medial
the
pubic muscle
medial
tortuous
The
where knee side
radialis
tubercle
it is is of
usually
maleolus, and the
the
PALPATIONinsertion
bent
just dorsum
atof the
arteries
medial to theof
 EXAMINATION OF THE CARDIAC
RATE

AUSCULTATION
 RESTING HEART RATE
is the heart pumping the lowest
amount of blood you need because
youre not exercising.

60-100 beats per minute (ADULTS)

a heart rate lower than 60

doesntnecessarily signal a medical
problem (beta blockers, athletes)
 How Other Factors
Affect Heart Rate
Air temperature

Body position

Body size

Medications
 MODERATELY HARD PHYSICAL
INTENSE ACTIVITY
ACTIVITIES

Maximum heart rate is about

220 minus your age.
 If there is a difference between the
auscultated apical and palpated arterial
rates, it is termed a pulse deficit

The ECG is the gold standard for heart

rate, as not all electrical events
produce an audible mechanical event,
especially at high heart rates.
Thank
You!