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Quincke's pulse (QP) is often best demonstrated in the
capillary beds of fingernails. With a light held on the
pad of the finger, gentle pressure is applied to the
distal nail. If the pulse pressure (PP) is wide,
alternating filling and blanching of the capillary bed
can be seen.
At rest, the normal PP (systolic pressure minus
diastolic pressure) is about 30-40 mm Hg.
Conditions that widen the PP by elevating systolic
pressures are numerous, and include exercise, anxiety,
thyrotoxicosis, pain and hypertension.
Aortic insufficiency (AI) widens PP by increasing
systolic pressure while simultaneously lowering
diastolic pressure; this can result in PP of >140 mm
Hg. Evidence of PP widening can include QP, systolic
nodding of the head (Demuse's sign), systolic pulsing
of the uvula (Mayer's sign), a bounding radial pulse
(Corrigan's pulse), a "pistol-shot" sound over the
femoral arteries (Traube's sign), and a to-and-fro
murmur over the lightly compressed femoral arteries
(Duroziez's sign) .