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BP at Rest

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Sreedeep Teja
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54 views

BP at Rest

Uploaded by

Sreedeep Teja
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Recording of Blood Pressure

at Rest
RECORDING OF BLOOD
PRESSURE
It provides valuable information about the cardiovascular system
By 2 methods: Direct method
Indirect method

Direct method: BP is measured directly by placing a cannula in


the lumen of the artery and connecting it to pressure transducer.
It is used in
1- experimental animals
2- In human beings- In critically ill patient by arterial
catheterization
Indirect method:
It is used In humans.

It is measured by sphygmomanometer

3 methods: Palpatory method


Oscillatory method
Auscultatory method
AIM: Recording of arterial blood pressure
at rest
PRINCIPLE: Air pressure in rubber cuff is
balanced against pressure in brachial artery
APPARATUS
1. Stethoscope 2. Sphygmomanometer
MERCURY SPHYGMOMANOMETER

“Sphygmo” means pulse, “manos” means thin, and


“metron” refers to measure.
It has following parts:
a. Mercury manometer. It has 2 limbs.
One limb is reservoir for mercury .
Another limb is graduated in mm from 0 to 300,
with each division of 2 mm.
A stopcock between the two limbs, when closed
prevents mercury from entering glass tube.
b. The cuff (rubber bag; Riva Rocci cuff)
It consist of an inflatable rubber bag, 24 cm × 12
cm, which is fitted with 2 rubber tubes—one
connecting it to the mercury reservoir and the
other to a rubber bulb (air pump).
The width of the bag should be 20% more than
diameter of the arm.
Different size of cuff is used in different age
groups
c. Air pump (rubber bulb).
It has a one-way valve at one end, and a leak-valve
with a screw, at the other.
The cuff is inflated by turning the screw clockwise,
and compressing the bulb.
PALPATORY METHOD
Procedure:
The subject should take
rest for 5 minutes and
may be supine or sitting.
Expose the arm upto
shoulder, Place the cuff
around it, with the center
of the bag lying over
brachial artery, keeping
its lower edge about 2-3
cm above the cubital
fossa.
Sphygmomanometer must be at the
level of the heart.
Palpate radial artery .
 Inflate cuff slowly until pulse
disappear; note the reading then raise
pressure another 10–20 mm Hg.
Open the leak valve and reduce the
pressure gradually in steps of 2–4
mmHg.
Note the reading when pulse just
reappears.
This is the systolic pressure.
Repeat procedure in the other arm
Advantages
It gives rough indication of systolic BP before
recording by auscultatory method.
it avoids auscultatory gap that may be seen in
auscultatory method.
Disadvantages
Diastolic pressure cannot be measured.
AUSCULTATORY
METHOD
Auscultatory Method
1. Record the systolic pressure by the palpatory method
2. Raise the pressure to 20 mmHg above it
3. Place diaphragm of the stethoscope on the brachial artery
in the cubital fossa (medial to tendon of biceps)
4. Lower the pressure gradually
5. We hear different phases of sounds called Korotkoff
sounds.
6. First we hear a clear tapping sound. This is the systolic
blood pressure.
7. When sounds stops, it is the diastolic pressure
8. Repeat procedure in the other arm
Advantages:
Gives the accurate systolic blood pressure.
It also measures diastolic blood pressure.

Disadvantages:
It may miss auscultatory gap therefore it is
preceded by the palpatory method
Auscultatory gap
In severely hypertensive patients,
after appearance of sounds,
occasionally it disappears and then
reappears and finally disappears at
the level of diastolic pressure.
The period of 1st disappearance of
sound is called as silent or
auscultatory gap.
Therefore blood pressure is
recorded first by palpatory method
followed by auscultatory method.
If BP is directly measured by
auscultaory method, this gap may
be missed and systolic value may
be recorded as lower than actual.
PROFORMA
Name:
Age:
Gender:
Address:
Occupation:

Right arm Left arm


Palpatory Method
Systolic BP
Auscultatory Method
Systolic BP
Diastolic BP
Mean arterial pressure
Pulse Pressure

Inference: The blood pressure of the subject is within normal range


QUESTIONS AND
ANSWERS
1) Define blood pressure
ANS- It is the lateral pressure exerted by the column of blood on the
walls of the arteries
2) Define systolic and diastolic bp, what is the normal range
ANS- Systolic BP- The maximum pressure produced during the
cardiac cycle, recorded in systole. Normal range- 100-140mmHg
Diastolic BP- The minimum pressure recorded during the cardiac
cycle, recorded in diastole. Normal range- 60-90mmHg
3) What is pulse pressure and its significance
ANS- It is the difference between systolic and diastolic blood
pressure. Significance- It is the pressure that maintains normal
pulsatile nature of the flow of blood.
Eg- If DBP=80mmHg, SBP=120mmHg, THEN PP= 120-
80=40mmHg
4) What is mean arterial pressure, how do you calculate it, mention
its significance
ANS-It is the average pressure produced during the cardiac cycle.
MAP= DBP + 1/3 PP
Eg- If DBP=80mmHg, SBP=120mmHg, THEN PP= 120-
80=40mmHg
MAP= 80 +13.3 = 93.3mmHg
Significance- It helps in forward movement of blood in blood
vessels. It determines tissue perfusion
6) What are Korotkoff sounds
When the pressure in cuff is progressively lowered, the sound undergo a series of
changes. These are called Korotkoff sounds
It show the following phases:
Phase I: clear tapping sounds - this is the systolic blood pressure
Phase II: the softening of sounds and the addition of a swishing sound
•Phase III: return of tapping sounds, as in phase I, but with an increase in intensity 
•Phase IV: the muffling of sounds, with soft and blowing quality
•Phase V: the complete disappearance of sounds - this is diastolic blood pressure
5) How does BP recorded in femoral artery differ from
brachial
ANS-Patient lies face downwards, cuff is applied above
knee and auscultation carried out over popliteal artery.
Usually pressure is higher in lower limbs than upper
limbs.
Low pressure in femoral artery then arms is seen in
coarctation of aorta.
Thank you

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