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