Anatomy 2 Lab Practical 1- Exercise 32: Blood Pressure

To determine a subject's apical and radial pulses.

- apical pulse - radial pulse

To investigate the effects of exercise on blood pressure, pulse, and cardiovascular fitness.

- charts in need to know

Radial Pulse

- in the groove of the wrist on the thumb side - if patient has been active, wait 5-10 min for it to get back to baseline - if rate is regular, count the number of pulses within in 30 seconds, and multiply that number by 2 to get their heart rate - if patient has irregular heartbeat, you have to count for the full minute to get a more accurate number - have elbow bent 90 degrees and rest hand on thigh - take 2 pads of your finger and put on groove

To define the following terms:

-systole -diastole -cardiac cycle

Measurement of Arterial Blood Pressure

1. To determine blood pressure, locate the pulse of the brachial artery. This can be done by placing 2 fingers on the medial side of the biceps brachia muscle near the antecubital fossa. 2. Place the blood pressure cuff around the arm at the level of the heart. Make sure the inflatable portion of the cuff is on the anterior medial side. 3. Place the diaphragm of the stethoscope on the place where you located the brachial pulse, and rest his forearm on the counter. You should NOT hear any sound at this time. 4. Hold on to the rubber squeeze bulb with the attached rubber tubing leading away from you. Turn the metal dial clockwise until it is closed. You can now begin to inflate the cuff. 5. Pump the cuff up to about 80 mmHg. Look at the mercury in the glass tube or the dial on an aneroid instrument. If the mercury needle bounce up and down a little, then listen closely for the sounds in the stethoscope. If you do not hear any sound, then inflate the mercury or the dial on the aneroid instrument to 100 or 120 mmHg. If you see the mercury or needle pulsing, listen again for the sound. Make sure the diaphragm of the stethoscope is in the right place. 6. Once you are sure you have heard the pulse sound, remove the cuff and pace it on the other arm. Excessive constriction of the arm may elevate your partner's blood pressure. 7. Inflate the cuff on the other arm, but make sure you exceed the level where you see motion in the needle or pulsing in the mercury (usually around 150 mmHg.) Do not leave the cuff inflated for a long period. 8. Release the knob slowly, so that the mercury or needle slowly begins to descent. 9. Record the number when the first sound is heard. This sound represents the systolic pressure of the ventricles, which is the pressure the heart generates that exceeds the pressure of the cuff. The sound may muffle a bit and then come in strong. 10. Continue to let air out of the cuff slowly until the sound starts to muffle. Listen very carefully until the sound completely disappears. The exact level at which the sound disappears is the diastolic pressure. 11. Record the level of blood pressure as the systolic pressure over the diastolic pressure.

Effect of position on blood pressure and heart rate (measured as pulse)

1. take a "baseline" reading of pulse and blood pressure with the patient sitting quietly. Repeat these measurements and record BOTH readings. 2. let the subject decline (lay down) for 2-3 minutes, then record BP and pulse. 3. Have the subject stand, and IMMEDIATELY record blood pressure and pulse. Measure again after 2-3 minutes. 4. Allow the patient to remain standing for 2-3 minutes, then record blood pressure and pulse rate again. 5. Repeat steps 2-4.

Effect of a cold stimulus on blood pressure and heart rate.

1. take one baseline reading of pulse and BP, while the patient is sitting quietly. 2. Place the subject's non-cuffed hand in a bucket of ice water (~ 5 C). Record the pulse and blood pressure at 1 minute intervals for 3 minutes.

Effects of exercise on blood pressure and heart rate (measured as pulse)

1. take one baseline reading of pulse and BP, while the patient is sitting quietly. 2. have the patient do an exercise for 5 minutes. 3. At the end of the 5 minutes of exercise, BP and pulse rate should be recorded at 1 minute intervals for 3 minutes.

Cardiac Cycle

A complete heartbeat consisting of contraction and relaxation of both atria and both ventricles

To use a stethoscope to auscultate heart sounds, and to relate heart sounds to events in the cardiac cycle.

Assume a blood pressure of 120/80. Normal arterial flow with no pressure on the brachial artery. No sound is heard in the stethoscope. Cuff inflated to beyond systolic pressure. Brachial artery is closed and no sound is heard. Release of pressure from the sphygmomanometer just less than blood pressure. Blood rushes into brachial artery and makes a rhythmic "whooshing" sound. Sound increases as pressure is lessened. Sound disappears at 80 mmHg because blood is no longer constricted. Pressure when sound disappears is known as diastolic pressure.

Did you notice a change in BP and HR when the subject stood after reclining for several minutes? How can you explain this change?

Blood pressure increases upon standing, then decreases. Heart rate increases then decreases.

What change did you observe in BP and HR that resulted from exposure to the cold?

Cold should increase BP; some subjects may be particularly sensitive to cold stimuli, and have much greater increase in BP.

When did you observe the greatest changes in BP and HR? Can you explain these changes?

Right after exercise- BP and HR then decline as subject returns to baseline.

Heart Rate vs Blood Pressure

While your blood pressure is the force of your blood moving through your blood vessels, your heart rate is the number of times your heart beats per minute.

Systole

contraction phase of the heartbeat

Diastole

relaxation phase of the heartbeat

Apical Pulse

want pulse to be between 60-100 bpm for adults - found where the apex of the heart is (bottom) - having patient laying down - left side- sternal notch- 5th intercostal space at the midclavicular line - listen for one full minute and count the pulses