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QUINCKE'S PULSE

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) .