The arterial pulse is the expansion of an artery resulting from the heart’s ejection of blood into the aorta, transmitting this wave throughout the arterial system. This palpable wave moves away from the heart through vessels, serving as a useful clinical tool. The femoral pulse refers to the heartbeat felt over the femoral artery, a large blood vessel transporting oxygenated blood to the lower extremities and part of the abdominal wall. It is considered one of the central pulses in the body, along with the carotid pulse.
How to Locate the Femoral Pulse
To locate the femoral pulse, focus on the crease of the groin where the leg joins the abdomen. This pulse point is found midway between two bony landmarks: the pubic symphysis (the front of the pelvis) and the anterior superior iliac spine (the prominent hip bone). Lying down can make it easier to access this area.
Using the tips of two or three fingers, apply firm but not excessive pressure in the crease, slightly below the inguinal ligament that runs between the bony landmarks. If there is significant subcutaneous fat, a deeper palpation may be necessary to feel the pulse. You should feel a rhythmic throb or pulsation.
Clinical Importance of Checking the Femoral Pulse
Checking the femoral pulse is medically significant, providing a direct indication of blood circulation to the lower extremities and reflecting overall cardiovascular status. It is frequently assessed in emergencies, such as during cardiopulmonary resuscitation (CPR), to determine circulation when other pulses are difficult to detect. While the carotid pulse is often the primary choice for adult CPR, studies have explored the femoral pulse as an alternative, sometimes providing earlier and more effective information.
The femoral artery also serves as a common access point for medical procedures, including cardiac catheterization. Its superficial location and large size make it suitable for inserting catheters to diagnose and treat heart conditions. Assessing the femoral pulse can also help evaluate for conditions like coarctation of the aorta, which causes a palpable delay between radial and femoral pulses.
What Abnormal Femoral Pulses Indicate
Abnormalities in the femoral pulse can provide important clues about underlying health conditions. A weak or absent femoral pulse suggests reduced blood flow to the lower limbs. This can be a sign of Peripheral Artery Disease (PAD), where plaque buildup narrows arteries, or an acute event like a blood clot (thrombus or embolus) occluding the artery. Severe low blood pressure, such as in cardiogenic shock where the heart cannot pump sufficient blood, can also lead to a weak or undetectable pulse.
Conversely, a strong or bounding femoral pulse, sometimes called a hyperkinetic pulse, indicates an increased volume of blood ejected from the heart with each beat. This can occur in conditions that cause a hyperdynamic state, such as fever, anxiety, or hyperthyroidism. Certain heart conditions, like severe aortic regurgitation (where the aortic valve does not close completely), can also result in a bounding pulse due to increased blood pressure and volume. Any perceived abnormality should prompt evaluation by a healthcare professional to determine the cause.