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Lab. no.

13:

Measurment
of Blood
Pressure in
Man

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Measurment of BP indirectly:
In man, indirect method is usually employed
by Sphygmomanometer.

This is of three types:


1. Ordinary mercury sphygmomanometer.
2. Electronic sphygmomanometer.
3. Aneroid sphygmomanometer.

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The Sphygmomanometer:

It consists of a rubber bag connected


to a manometer.
The rubber bag can be inflated by a
bulb attached to it. A valve is provided
near the bulb to allow the release of
air from the bag. The rubber bag is
enclosed in a cloth cuff.
Note that in the manometer scale, one
small division represents (2 mm. Hg).
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Procedure:
Allow the subject to relax for
5 min. Expose the upper arm
and wrap the cuff around it
so that the lower edge of the
cuff is at least 2.5 cm above
the elbow.

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The palpatory method:
Feel the radial pulse with the left
hand and with the right hand raise the
pressure in the sphygmomanometer
till the pulse disappears. Raise the
pressure 20 mm further. Now lower the
pressure slowly by slightly opening the
release valve and take the reading on
the manometer when the pulse is just
palpable.

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The palpatory method: (cont.)
This is the reading of systolic blood
pressure (SBP). Diastolic blood pressure
(DBP) cannot be recorded by this
method. SBP recorded by this method
is 5–10 mm Hg. less than that recorded
by the auscultatory method.

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The auscultatory method:
Palpate the brachial artery over the
elbow and place the chest- piece of the
stethoscope over it firmly but without
undue pressure. The chest-piece
should not rub against the cuff or the
tubing of the sphygmomanometer.

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The auscultatory method: (cont.)
Raise the pressure to the top of the
mercury manometer, or if palpatory
method has been used, to 30 mm
above the SBP by that method. No
sounds would be heard in the
stethoscope. Release the pressure so
that mercury falls at a uniform rate of
2–3 mm/sec. Note the level when
Korotkoff sounds begin to be heard
for the first time.
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The auscultatory method: (cont.)
These are faint tapping sounds that
coincide with the frequency of the
heart beats. This level is SBP. Lower
the pressure further and take the
reading when the sounds become
muffled. This is DBP. If the pressure is
lowered 5–10 mm further, the sounds
disappear completely. Now release the
pressure all at once.

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The auscultatory method: (cont.)
For the beginners it may be difficult to
appreciate when the sounds become
muffled, hence the level at which the
sounds disappear may be taken as the
DBP. The whole procedure should not
be unduly prolonged since prolonged
obstruction to the blood flow in the
limb produces a rise of blood pressure
all over the body.

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Korotkoff sounds:
Are thought to be due to the blood
jetting through the partly occluded
vessel, the jet causes turbulence of the
blood flow in the open vessel beyond
the cuff and this sets up the vibrations
heard through the stethoscope.

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Normal Blood Pressure values:
-In healthy adults:
SBP = 100 –140 mm Hg.
DBP = 60 –90 mm Hg.
-In children it approximates to the lower
figure in each case (100 SBP/60 DBP) mm
Hg.
-In the elderly it reaches or even exceeds the
higher figures (140 SBP/90 DBP) mm Hg.
-The difference between SBP and DBP is
pulse pressure (= 30–60 mm Hg).

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pulse pressure:
=The difference between SBP and DBP.

Normal pulse pressure=


pressure 30–60 mm Hg.

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