Auscultatory Method

Group 2: Briones, Botones,

Cabading

Blood pressure
Is the force/pressure of the blood
pushing againsts the walls of the
arteries
With each hearbeat, blood is
being pumped out into our
arteries and throughout the
body,

Blood Pressure
The laminar flow that normally
occurs in arteries produces little
vibration of the arterial wall and
therefore no sounds. However,
when
an
artery
is
partially
constricted, blood flow becomes
turbulent, causing the artery to
vibrate and produce sounds.

Blood Pressure
When measuring blood pressure using the
auscultation method, turbulent blood flow will
occur when the cuff pressure is greater than
the diastolic pressure and less than the systolic
pressure. The "tapping" sounds associated
with the turbulent flow are known asKorotkoff
sounds. Remember that these sounds are not
to be confused with the heart sounds produced
by the opening and closing of the heart valves.

Blood Pressure
Bernoullis
Principle

Systolic vs Diastolic
120/80 = top number is the systolic
pressure and the bottom is the
diastolic
Systolic pressure is the pressure on
the arteries as the heart contracts
and pumps blood
Diastolic pressure is the pressure on
the arteries when the heart is at rest
in between heartbeats

Auscultatory Method
Also known as the Riva Rocci
Korotkoff or manual method for
blood pressure measurement
Is the LISTENING of Korotkoff
sounds in the brachial artery
Healthcare provider uses a
sphygmomanometer

Korotkoff Sounds
Tapping sounds heard with a
sthethoscope as the cuff is deflated
Classified into five different phases
(K-1, K-2, K-3, K-4, K-5)

Procedure
1. Let the subject rest for 3 minutes and
determine the blood pressure. Apply
stethoscope at antecubital fossa over
the brachial artery (medial side of the
arm)
2. Inflate the bag with rubber bulb at a
pressure higher than the expected
systolic pressure and no sound
audible through the stethoscope

Procedure
3. Deflate the bag slowly and 2 to 4
mmHg per heartbeat. Note the Korotkoff
sound which is a clear faint tapping
sound over the brachial artery. The first
tapping sound heard simultaneously
with the manometric reading is systolic
pressure and disapperance of the lass
Korotkoff sound is the diastolic pressure.
Expressin mmHg.

Results
110/75 mmHg

POSSIBLE SOURCES OF
ERRORS
Errors in blood pressure readings:
Thecuff is not of the proper size: if the cuff is too small
the blood pressure readings may be artefactually high. If the
cuff is too big, the readings may be artefactually low.
The cuff ispositioned too loosely: the blood pressure
may be artefactually high.
The centre of the cuffbladder is not positioned over the
brachial artery.

POSSIBLE SOURCES OF
ERRORS
The cuff isinflated slowly: a slow inflation causes venous
congestion, which in turn causes the Korotkoff sounds to be faint;
this results in false readings with the systolic value being too low
and the diastolic reading too high.
If the cuff isre-inflated immediately afteran initial reading
(trying to re-check the reading): a rapid re-inflation could cause
venous distension, the Korotkoff sounds become more muffled.
The initial Korotkoff sound may be missed so the systolic reading
would be falsely low, and the diastolic reading would be falsely
high because the last Korotkoff sounds could not be heard.

CONCLUSION
The auscultatory method has been the
standard method of determining BP for
over 100 years and relies on the
observer to detect the audible sounds
(Korotkoff sounds) that occur during
constricted blood flow. Proper training of
observers, positioning of the patient, and
selection of cuff size are all essential.