Pulse Points: Locations and Corresponding Arteries — A Comprehensive Guide

Nine Common Pulse Sites

Pulse Site	Location	Artery	Clinical Use
Temporal	Anterior to ear, above zygomatic arch	Superficial temporal	Fever, temporal arteritis
Carotid	Anterior to sternocleidomastoid, at thyroid cartilage level	Common carotid	CPR, shock, rapid assessment
Brachial	Medial antecubital fossa, medial to biceps tendon	Brachial	BP measurement, infant CPR
Radial	Lateral wrist, distal to radius styloid	Radial	Routine vital signs, Allen's test
Femoral	Mid-inguinal point, below inguinal ligament	Femoral	Cardiac arrest, shock, cath access
Popliteal	Popliteal fossa, knee slightly flexed	Popliteal	Peripheral vascular exam, knee surgery
Posterior Tibial	Posterior to medial malleolus	Posterior tibial	PVD assessment, diabetic foot
Dorsalis Pedis	Dorsum of foot, lateral to extensor hallucis longus tendon	Dorsalis pedis	PVD assessment, diabetic foot
Apical	5th ICS, midclavicular line (apex beat)	Left ventricle (palpated)	Heart rate, rhythm, contractility; pediatric

Assessment Technique

• Use pads of index + middle fingers (never thumb).
• Apply light pressure — occluding artery eliminates pulse.
• Count 30 sec ×2 (regular) or 60 sec (irregular).
• Grade: 0 (absent), 1+ (weak), 2+ (normal), 3+ (bounding), 4+ (aneurysmal).
• Compare bilateral symmetry.

Clinical Significance

• Rate/rhythm: arrhythmias, blocks.
• Strength: shock (weak), aortic regurgitation (bounding), aortic stenosis (parvus et tardus).
• Symmetry: coarctation (radial-femoral delay), subclavian steal, dissection.
• Character: pulsus paradoxus (tamponade, asthma), pulsus alternans (severe LV dysfunction).