blood pressure and pulse determination

normal heart beat

75 beats per minute

heart rate

# of beats per minute

abnormal venous pressure

-Decreased cardiac output -Increased blood volume -Venous constriction -Changing from standing to supine body posture -Forced expiration -Muscle contraction

normal blood pressure

120/80-140/90

Lub

1st sound: AV valves slam shut: Ventricles have just been filled; atria have been emptied: beginning of systole

Dub

2nd sound: Semilunar valves slam shut: atria and ventricles are filling with blood: beginning of ventricle diastole

semilunar valves open

As the ventricles continue to contract, the ventricular pressure exceeds the arterial pressures causing the semilunar valves open. when aortic semilunar valve pressure reaches 80.

ventricular systole

Av valves close when ventricular pressure > atrial pressure

congestive heart failure

CHF: CO is low that blood circulation inadequate to meet tissue needs: weakened myocardium

pulse deficit

VALUE OBTAINED FROM AN APICAL PULSE (BEATS/MIN) AND THAT FROM AN ARTERIAL PULSE TAKEN ELSEWHERE ON THE BODY.

stroke volume

EDV - ESV=

systolic sound

FIRST SOUND HEARD UNDER PRESSURE. AS THE PRESSURE IS RELEASED AND THE ARTERY CAN NO LONGER STAY CLOSED, AS BLOOD BEGINS TO FLOW THROUGH THE VIBRATIONS MAKE THIS FIRST SOUND.

ventricular systole

Highest Heart Pressure

Aortic Valve Area

Second right intercostal space (ICS), right sternal border

preload, contractility, after load

What affects SV?

2nd right intercostal space

Where to hear closure of the aortic semilunar valve

tachycardia

abnormally fast heart rate > 100 beats per min

Apical pulse

actual counting of heartbeats: stethoscope at apex: bicuspid valve

apical

actual counting of heartbeats: stethoscope at apex: bicuspid valve

both av and sv valves close

after atria and ventricular systole: Isovolumetric contraction & relaxation

stroke volume

amount of blood heart pumps with each beat

cardiac output

amount of blood that heart pumps in one minute

venous return

ant of blood returning to heart: most important factor stretching cardiac muscle

P wave

depolarization of SA node: atrial depolarization: wave of repolarization has gone thru atrium:

increase

arteriosclerosis increases or decreases blood pressure

systole

av valves close; ventricular pressure exceeds arteries; sv open

murmur

blood back flow after valve closes: swooshing sound

sounds of Korotkoff

blood flow produces vibrations in blood and tissues that can be heard with stethoscope

collateral blood flow

blood vessels that spontaneously grow to compensate for lack of adequate flow to an organ: can prevent ischemia

pulmonary obstruction

bluish tint

isovolumetric relaxation phase

both valves closed: heart practically empty; ventricles relax and repolarize; early diastole

isovolumetric contraction phase

both valves closed: ventricles have max capacity: ventricular systole

arterial bleeding

bright red: spurting

CO=HR x SV

cardiac output equation

increase

cold temp increases or decreased blood pressure

PNS

decreases rate

ectopic focus

defective SA node: abnormal pacemaker

preload

degree of stretch of cardiac muscle cells before they contract

disappearance of sound

diastolic blood pressure

pulse pressure

difference between systolic and diastolic pressure: greatest in aorta, declines in muscular arteries and non existent in arterioles

decreases ventricular relaxation

effects of rapid heart rate

EDV

end diastolic volume: amount of blood in ventricles after diastole: affected by length of ventricular diastole and venous pressure

ESV

end systolic volume: affected by arterial BP and force of ventricular contraction

increases systolic readings

exercise does what to blood pressure

apical pulse

faster than radial b/c of time delay

increase

fright, anger, exercise and standing do what to heart rate

regurgitation

heard as a swishing sound

stenosis

heard as high pitched sound

bradycardia

heart slower than 60 beats per minute; desirable for endurance training

decrease

heat increases or decreases blood pressure

reclining/standing

highest and lowest position for blood pressure

increase

if EDV increases, what does SV do?

increase

if ESV decreases what does SV do?

increased blood pressure

increased blood viscosity

increase

increased cardiac output increases or decreases blood pressure

decrease

increased diameter of the arterioles and hemorrhage increases or decreases blood pressure

increase

increased pulse rate increases or decreases blood pressure

SNS

increases rate and force

high pulse pressure

indicate recent exercise, stiffness of major arteries aortic regurgitation, hyperthyroidism

low pulse pressure

indicates blood loss, CHF, shock or error

skin color

indicator of circulatory dynamics

arrhythmias

irregular heart rythyms

pulmonary congestion

left side fails: blood back up in lungs

congestive heart failure

left side heart failure

diastole

low pressure; passive flow thru atria and ventricles; sv closed, av open

ventricular diastole

lowest heart pressure

diastolic pressure

lowest level of arterial pressure during ventricular relaxation

decrease

lying down and digesting do what to heart rate

dicrotic notch

momentary increase in aortic pressure that occurs when the semi lunar valves snap shut

cardiac cycle

one complete heartbeat: complete round of systole and diastole: electrical events, valve activity, heart sounds, chamber contractions and changes in pressure

hemorrhage

pale, cold, moist skin

extrasystole

premature contraction: ectopic focus sets high rate

blood pressure

pressure exerted by blood against the walls of blood vessels: measured in reference to systemic arterial BP in large arteries to heart

systolic pressure

pressure exerted on arterial walls during ventricular contraction

pulse

pressure surges in an artery occurring during each contraction and relaxation of the left ventricle

pulse rate

pressure surges per minute measured by regularity, amplitude and tension

radial

pulse at wrist

hyporreactors

raise/drop diastolic/systolic pressure from 0-22 points

hyperreactors

raise/drop of 23 or more points

fibriliation

rapid irregular contractions:

peripheral congestion

right side fails: blood pools in body organs: Edema

ventricular ejection

systolic pressure is

pulse pressure

systolic pressure minus diastolic pressure, indicates actual working pressure

dark red and oozing

venous bleeding

systole

ventricular contraction: .3 seconds

Ventricular systole

ventricular contraction: ventricular pressure exceeds atrial pressure: closes AV valves:

QRS wave

ventricular depolarization/ atrial repolarization

diastole

ventricular relaxation

diastole

ventricular relaxation: .4 seconds

T wave

ventricular repolarization

carotid artery

what artery has the greatest amplitude and pressure reading

alternate contraction and relaxation of the myocardium and opening and closing of the heart valves

what factors promote blood movement through the heart?

AV valves open

what happens when the ventricles relax and atrial pressure exceeds ventricular pressure

semilunar valves open

what happens when ventricular pressure > pressure in the arteries

bicuspid valve

what valve is at the fifth intercostal space in line with mid clavicle

heart block

when AV node does not conduct current: more P than QRS waves

diastole of heart and atrial systole

when are semilunar valves closed

atrial systole

when atrial pressure > ventricular pressure: AV valves are pushed open and blood flows into the ventricles

fifth intercostal space

where to hear closure of the tricuspid valve

veins are further from heart

why is venous pressure lower