Important Concepts Associated with the Measurement of Blood Pressure BP is one of the principal vital signs Classification of hypertension (elevated blood pressure) in adults BP Classification Systolic/Diastolic Values Normal 119/79 or less Prehypertension 120/80 to 139/89 Stage 1 Hypertension 140/90 to 159/99 Stage 2 Hypertension 160/100 or higher Left heart QRS Electrocardiogram P Atrial SYSTOLE Pressure (mm Hg) P 2nd “Lup” = closing of L AV valve or Mitral valve (1st heart sound) Dicrotic notch “Dup” = closing of Aortic valve (2nd heart sound) Aorta Left ventricle Atrial systole Ventricular volume (ml) Review of aortic pressure: T 1st Heart sounds Left atrium EDV = End Diastolic Volume ESV = End Systolic Volume EDV SV SV = Stroke Volume ESV Atrioventricular valves Aortic and pulmonary valves Open Closed Open Closed Open Closed Ventricular SYSTOLE Ventricular DIASTOLE Blood Pressure (BP) when measured with a sphygmomanometer mostly closely approximates aortic pressure. Superficial temporal artery Facial artery Common carotid artery Brachial artery Radial artery Femoral artery Popliteal artery Posterior tibial artery Dorsalis pedis artery More practically, blood pressure (BP) is a measure of pressure in the brachial artery (a vessel located a small distance from the aorta). The dots here represent pressure points located throughout the body. Blood Pressure (BP) Force exerted by circulating blood on the walls of the brachial artery (if measured traditionally) Force exerted against walls of a blood vessel when the heart contracts (systole) Systolic Blood Pressure Force exerted against walls of a blood vessel when the heart relaxes (diastole) Diastolic Blood Pressure Average blood pressure or mean arterial pressure (MAP) is determined by obtaining both systolic and diastolic values of the blood vessel. (point of this exercise) Where does your blood pressure fall? And YOU think you have stress! Left heart QRS Electrocardiogram P Pressure (mm Hg) Atrioventricular valves Aortic and pulmonary valves P 2nd “Lup” = closing of L AV valve or Mitral valve (1st heart sound) Dicrotic notch “Dup” = closing of Aortic valve (2nd heart sound) Aorta Left ventricle Atrial systole Ventricular volume (ml) Other concepts to review: T 1st Heart sounds Left atrium EDV = End Diastolic Volume ESV = End Systolic Volume EDV SV SV = Stroke Volume ESV Open Closed Open Closed Open Closed Ventricular SYSTOLE Ventricular DIASTOLE Cardiac Output can be calculated with a quick and easy mathematical formula (using the above information). Volume of blood pumped out by a ventricle with each heart beat Stroke Volume (SV) Number of beats per minute Heart Rate (HR) Graph showing the change in volume (mL) of blood in one “chamber” during a heart beat EDV diastole systole diastole What is the volume of blood at the end of diastole? Graph showing the change in volume (mL) of blood during one heart beat ESV diastole systole diastole What is the volume of blood at the end of systole? Graph showing the change in volume (mL) of blood during one heart beat SV diastole systole diastole Therefore, what is the stroke volume? Volume of blood (mL) pumped by each ventricle in one minute (min) Cardiac Output (CO) Cardiac Output (CO) is Heart Rate (HR) x Stroke Volume (SV) Example: What would be the cardiac output of an individual at rest (60 beats/min) and with no obvious heart condition (use the stroke volume already given)? Answer: CO (mL/min) = HR (60 beats/min) SV (70 mL/beat) = 4,200 mL/min or 4.20 L/min This means that over the course of one hour, one heart chamber at rest could eject over 240 liters of blood. That’s over 63 gallons! Sixty-three gallons for a little over six and a half days … this could fill a 10,000 gallon (small size) swimming pool. With continuous exercise (120 beats per minute), that time could be cut in half (about 3 days)! *1 Liter = 0.264172051 US Gallons Measuring Blood Pressure (BP) Click below if you have a username & password at MyA&Pplace.com Interactive Physiology Exercise (In order to make this work, an access code log-in is required.) Steps: Click on Tutorials > Interactive Physiology > Chapter 19 > Cardiovascular System > Measuring Blood Pressure (The plan here will be to complete all steps and the quizzes/worksheets in lab class.)