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Ulnar Artery Pulse

Exams and Signs

Historical Overview

  • Taking a patient’s ulnar artery pulse is useful for evaluating neurovascular injuries and for determining normal heart function. If a patient has undiagnosed irregular pulse rates, s/he should see a primary care provider.
  • Doppler can be used to record arterial perfusion patterns to the hand.1

Description

  • A healthy ulnar artery pulse should be between 60 and 100 beats per minute (bpm). 
  • Frequently, the ulnar artery is obscured, requiring effective wrist relaxation.2
  • Pulse volume recordings (PVR) measure flow through the ulnar artery. PVR is an effective screening tool to determine whether hemodynamically significant vascular disease has caused alterations in digital flow patterns.3

Pathophysiology

  • Deviations from normal, triphasic wave patterns arise from diseased arteries.1

Instructions

  1. Use a Doppler to monitor the ulnar artery pulse
  2. Observe whether the pulse is in the range of 60–100 bpm 
  3. Observe whether the pulse is steady
  4. Take the ulnar artery pulse in the contralateral hand

Variations

  • Check the pulse at the dorsal branch of the ulnar artery and the radial artery. 
  • In some cases, it is difficult to feel the ulnar artery because of an aberrant location. In these situations, the Allen test should be used.4

Related Signs and Tests

  • Radial artery pulse
  • Allen test
  • Cold stressor test

Additional Information

Presentation Photos and Related Diagrams
  • Palpating Ulnar Artery pulse at the wrist.
    Palpating Ulnar Artery pulse at the wrist.
  • Palpating Ulnar Artery pulse at the wrist.
    Palpating Ulnar Artery pulse at the wrist.
Definition of Positive Result
  • A positive result occurs when the patient’s ulnar artery pulse is irregular or outside the normal range of 60–100 bpm.  
Definition of Negative Result
  • A negative result occurs when the patient’s ulnar artery pulse is steady and inside the normal range of 60–100 bpm.  
Comments and Pearls
  • To achieve an accurate pulse reading, check that the patient is in a relaxed state. 
  • In patients with diabetes, calcified vessels can result in falsely high pressure measurements.1
  • Caffeine intake may also affect pulse rate.
  • Often, the Allen test is necessary to determine if a non-palpable ulnar artery is absent or only obscured.2
Diagnoses Associated with Exams and Signs
Videos
Palpating Ulnar Pulse
Doppler Assessment of Ulnar Pulse
References
  1. Culp R, Jacoby S.  Musculoskeletal Examination of the Elbow, Wrist and Hand: Making the Complex Simple. New Jersey: SLACK Incorporated, 2012.
  2. Loscalzo J, Creager MA, Dzau VJ eds. Vascular Medicine: A Textbook of Vascular Biology and Diseases. 2nd edition. Boston: Little, Brown and Company, 1996.
  3. Kleinert JM, Gupta A. Pulse volume recording. Hand Clin. 1993;9(1):13-46. PMID: 8444970
  4. Abramson, DI. Vascular Disorders of the Extremities. 2nd edition. New York: Harper and Row, 1974.
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