Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Everything that you are ever going to want to know about running shoes: Running Shoes Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
  2. Have you considered the Critical Thinking and Skeptical Boot Camp, for taking it to the next level? See here for more.
    Dismiss Notice
  3. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.


Discussion in 'General Issues and Discussion Forum' started by len stevens, Jan 6, 2016.

  1. len stevens

    len stevens Member

    Members do not see these Ads. Sign Up.
    hi folks. new on here so hope question is the sort of thing you talk about.
    We use the tri , bi and mono classification of pulse all the time to indicate the state of Patient's peripheral circulation at various points but something bothers me about this. As I understand it the 1st part is the forward flow from the contracting ventricle, the second the rebound from the arterioles or capillary beds and the 3rd is due to the elasticity of the aorta. sending out another forward pulse. If I am correct in this assumption then that 3rd aorta pulse either happens or it doesn't. I don't see how it can happen in one leg but not the other. This would mean that it would be impossible to have triphasic at one pulse and monophasic at another which is clearly not the case.
    Please explain in simple language to a simpleton!
    Many thanks
  2. Ben Lovett

    Ben Lovett Active Member

    Hi Len,

    Interesting question. I don't think the answer is very simple and would seem to lie in the physics of fluid flow dynamics in elastic verses inelastic vessels.

    My (simple) understanding of it would be that inelastic vessels offer greater resistance to flow than elastic vessels - if you push a bolus off fluid down an inelastic vessel local pressure will increase, pushing back against the driving force; hence we have elastic arteries. As each phase has progressively less power than the last the tri and then bi phasic wave forms will be attenuated sooner than the initial systolic wave. This effect will be more severe in sclerotic vessels and particularly those with a stenosis. Additionally we don't have a simple single vessel system; there are multiple branches (arterioles) each offering their own different and variable resistance to flow and thus influencing the wave form in the pedal pulses. Both of these effects will tend to lead to different wave forms presenting in different legs or arteries.

    For more on this try here


    and here


  3. len stevens

    len stevens Member

    Thanks Ben,
    That Hashimoto study is fascinating. Will have to read it a couple more times to really get it though. Interesting that there are so many factors that affect the pulse in different ways. Also interesting that it seems that even now it is not fully understood even by the experts (which gives me hope)! But I definitely have more of a handle on it now. Thanks once again.
  4. Ben Lovett

    Ben Lovett Active Member


Share This Page