Question

(a) It is possible to measure a patient’s heart rate by either palpating their peripheral pulse, by observing their ECG, or by listening for the lub-dup through a stethoscope. However, patients with atherosclerosis of the femoral artery may not have a pulse in the popliteal artery or dorsalis pedis of the foot. Does this mean that they will also lack a heart beat (lub-dup) or QRS complex? Explain the relationship between a heart beat, pulse, and QRS complex. (B) Why is there a delay between systole of the ECG and the resulting pulse felt in the finger (R-Pulse)?

Answer 1

b)When you listen to the heart sounds, you are hearing the flow of blood which stops abruptly when a heart valve closes. This produces the "lub-dub" sounds. 1st heart sound (when the Mitral Valve closes) as the ventricle contracts (systole) and then 2nd heart sound (when the Aortic Valve closes) and the ventricle starts to fill again (diastole)
The pulse is the wave of pressure you can feel through the artery walls. This denotes systole.
The ECG's QRS complex is the electrical signal that tells the Ventricles to contract. You can see that the QRS occurs right at the beginning of systole and triggers Isovolumetric contraction.
So the QRS on the ECG, the pulse wave you can feel (ie. the rise in aortic pressure) and the 1st heart sound all signify SYSTOLE.
there a delay between systole of the ECG and the resulting pulse felt in the finger (R-Pulse) because it takes a little bit of time for the pressure to transmit through the body, as the finger is not on the heart (if it was there would be no delay)