PRESSURE

BLOOD PRESSURE MEASUREMENT

• INDIRECT METHOD
• DIRECT METHOD
 INDIRECT METHOD
• SYSTOLIC PRESSURE-120mm Hg
• DIASTOLIC PRESSURE-80 mm Hg
• KOROTKOFF SOUND(SP>CP)
• MUFFLING(KS disappeared at some point)
• AUSCULTATION(Hearing)
INDIRECT METHOD
PRESSURE MEASUREMENT
 DIRECT METHOD
• CATHETER TIP PROBE
• FLUID FILLED PROBE
DIRECT METHOD
CARDIAC OUTPUT MEASUREMENT
• FICK’S METHOD
• INDICATOR DILUTION METHOD
• THERMO DILUTION METHOD
• IMPEDANCE CHANGE
 Measurement of cardiac output
• Practical considerations
– dye recirculates in the CVS
– estimate of first transit time is facilitated by
plotting log concentration
– Dye must be non-toxic and not immediately
absorbed eg indocyanine green
– Injected into pulmonary artery
– Measured in brachial artery
– Like the Fick method, is invasive, &
discontinuous
FICK’S METHOD
FICK’S METHOD
• I=CaQ-CvQ
• Q=I/Ca-Cv
• Q=CARDIAC OUTPUT
• Ca=CONCENTRATION OF BLOOD PRESSURE IN
ARTERIAL BLOOD(OUTGOING BLOOD)
• Cv=CONCENTRATION OF BLOOD PRESSURE IN
VENOUS BLOOD(INCOMING BLOOD)
 Indicator dilution method

inject bolus Sample dye

of dye concentration
Concentration (g/L)

0 Time (min) 0.5

Measurement of cardiac output

Concentration (g/L)
time of passage (t) = 0.5 min

~
average conc (X) = 2 mg/L

0 Time (min) 0.5

• Amount of dye added = 5 mg

• Average dye concentration = 2 mg/L
• Therefore the volume that diluted the dye = 5mg = 2.5 L
2 mg/L
• Time it took to go past = 0.5 min
• ie flow rate = 2.5 L = 5 L/min
0.5 min
• General equation:
mass of dye (Q g)
Flow rate = ~
average dye conc (X g/L) x time of passage (t min)
THERMO DILUTION METHOD
IMPEDANCE CHANGE
 SPIROMETER
• Spirometry is the measurement of the flow
and volume of air entering and leaving the
lungs
• Test of pulmonary function (PFT)
• Indicator of health status or disease
• Exercise fitness
• Apparatus used to measure static & dynamic
lung volumes/capacities using a closed system
• Registers the amount and rate of air moved
into or out of the lungs
• 2 main types;
1. Volume: records the amount of air
exhaled or inhaled within a certain time
2. Flow: measures how fast the air flows in
or out as the volume of air inhaled or exhaled
increases
 CLASSES
HAND HELD TYPE CLOSED CHAMBER
TYPES-WATER SEALED SPIROMETER
TYPES-WEDGE SPIROMETER
TYPES-ULTRASONIC SPIROMETER
 PLETHYSMOGRAPHY
• Plethymography is a non-invasive diagnostic
treatment used for screening and patient
follow-ups with various arterial and venous
pathologies.
• This treatment is concerned with the
measurement of volume and volume
displacement of blood.
 TYPES
PHOTO PLETHYSMOGRAPHY BODY PLETHYSMOGRAPHY
GSR
Erythrocyte Sedimentation Rate
(ESR)
 ESR
• The erythrocyte sedimentation rate (ESR)
is a nonspecific measurement used to
detect and monitor an inflammatory
response to tissue injury in which there is
a change in the plasma concentration of
several proteins.
• The ESR is affected by three factors:
erythrocytes, plasma composition, and
mechanical/technical factors.
• Normal values:
– Adult male 0-15 mm/hr
– Adult female 0-20 mm/hr
 Significance of the ESR

• The ESR represents a nonspecific response to

tissue damage and inflammation and denotes the
presence of disease, but not its severity.
• It primarily reflects changes in the plasma
proteins that accompany most the acute and
chronic infections, tumors, and degenerative
diseases. It may be used to follow the progress
of certain diseases such as tuberculosis and
rheumatoid arthritis.
• An elevated ESR may be found in:
1. Pregnancy (after the third month).
2. Acute and chronic infections.
3. Rheumatic fever.
4. Rheumatoid arthritis.
5. Myocardial infection.
6. Nephrosis.
7. Acute hepatitis.
8. Menstruation.
9. Tuberculosis.
10. Hypothyroidism.
11. Hyperthyroidism.
• Adults over 60 years of age frequently have a
slightly higher ESR value due primarily to
decreased concentrations of plasma albumin.
• A decreased ESR will be present in:
1. Polycythemia.
2. Congestive heart failure.
3. Hypofibrinogenemia.
4. The presence of red blood cell abnormalities
(poikilocytosis, spherocytes, and sickle cells).
FINGER TIP OXIMETER
Pulse oximeter
Pulse oximeter
BLOCK DIAGRAM