Name: Study group:
This text was supported by project FRMU no. MUNI/FR/1552/2015 (Faculty of Medicine, Masaryk University).
Protocol
Estimation of pressure
Procedures
1. Non-invasive methods of blood pressure measurement
Measure blood pressure in three persons. The blood pressure of each person will be measured
by palpatory, auscultatory and oscillometric methods. Check the counted values in the graph.
Palpatory (Riva-Rocci) method
1. The sphygmographic cuff is placed on the naked upper arm of the examined
person tightly, but don’t strangulate the arm. The lower margin of the cuff has to
be placed 2.5 cm above the elbow region (the width of the cuff is 12.5 cm for
adults).
2. The radial artery is palpated at the wrist of the same arm. The cuff is inflated to a
pressure of 20–23 kPa (150–170 mmHg) using the rubber bulb the valve of which
is closed. If the pulse is still palpable at this pressure, increase the cuff pressure by
another 4–5 kPa (30–40 mmHg).
3. Opening slightly the valve, let the air slowly escape from the cuff. The first
pulsation felt on the radial artery during the decrease of cuff pressure means that
blood is just starting to flow through the compressed artery. At this moment, the
cuff pressure is equal to the systolic pressure.
Auscultatory (Korotkow) method
2. The arm cuff is inflated to a higher pressure than is the supposed systolic pressure,
and the stethoscope is applied over the brachial artery at the elbow region of an
extended arm.
3. In opening slightly the valve, one allows the air to escape slowly from the cuff (2–
3 mmHg) and observes the pressure indication on the manometer. Listen to the
Korotkow sounds.
Five phases are distinguished: weak sounds – sounds – intensive sounds – sudden
change of loudness – cessation of sounds. the first sounds heard over the artery mean a
beginning arterial flow during the maximal BP and the cuff pressure read at this
moment is thus the SBP. During a further slow decrease of cuff pressure the sounds of
the oscillating arterial wall increase in intensity and after a certain maximum loudness
attenuate a little. At a certain pressure the sounds, as yet distinctly audible, become
almost inaudible if the pressure is slightly reduced (sudden change of loudness) and at
a further decrease in pressure they disappear. At the moment of sudden lowering of
loudness, which is caused by cessation of oscillations of the arterial wall, the cuff
pressure is equal to DBP. Repeat the BP measurement at rest about 5 times, using both
methods, register all results, and calculate the mean.
Name: Study group:
This text was supported by project FRMU no. MUNI/FR/1552/2015 (Faculty of Medicine, Masaryk University).
Oscillomeric measurement
During the measurement the experimental person sits calmly and does not speak.
Wrap the cuff around the naked arm of the experimental subject (the green coloured
band is positioned 2–3 cm above the elbow on the inner side). Lay the arm on a table
so that the cuff is approximately at heart level (below heart level the blood pressure
measurement would be artificially high, while above the heart level it would be
artificially low). Switch on the unit by pressing the O/I button.
Wait until the heart symbol appears on the display. According to the type of
instrument either push the START button or inflate the cuff using the rubber bulb. The
instrument measures blood pressure and pulse, then the values are displayed. The
arrow symbol announces the end of the measurement. If the measurement has
finished, switch the device off by pressing the O/I button.
2. Changes of blood pressure after work load
1. After a few minutes of sitting at rest the SBP and DBP is measured.
2. Then the examined subject performs 30 deep squats at a frequency of one squat per second.
Then we measure SBP, DBP and heart rate by automatic device in sitting position each
minute until initial values are reached. During squatting the cuff is left on the arm, only the
manometer is disconnected.
Name: Study group:
This text was supported by project FRMU no. MUNI/FR/1552/2015 (Faculty of Medicine, Masaryk University).
Results
1. Non-invasive methods of measuring blood pressure
Bloodpressure[mmHg]
200
180
160
140
120
100
80
60
40
SBP
bypalpatorymethod
SBPandDBPby
auscultatorymethod
SBPandDBP
oscillometricmethod
SBP
bypalpatorymethod
SBPandDBPby
auscultatorymethod
SBPandDBP
oscillometricmethod
SBP
bypalpatorymethod
SBPandDBPby
auscultatorymethod
SBPandDBP
oscillometricmethod
person 1 person 2 person 3
Graph 1: Blood pressure estimated by palpatory method (Riva-Rocci), auscultatory method (Korotkow) and
oscillometric method in three persons. Mark values of systolic (SBP) and diastolic (DBP) blood pressure.
Which method of blood pressure measurement is the less exact? Why?
…………………………………………………………………………………………………
…………………………………………………………………………………………………
Which method enables measuring diastolic blood pressure? (2 words)
…………………………………………………………………………………………………
Which values of blood pressure (SBP, DBP, MAP) are really measured by the oscillometric
method and which values are counted?
…………………………………………………………………………………………………..
Which variables of cardiovascular system define mean arterial blood pressure? (3 variables)
…………………………………………………………………………………………………..
Name: Study group:
This text was supported by project FRMU no. MUNI/FR/1552/2015 (Faculty of Medicine, Masaryk University).
2. Changes of blood pressure after work loadBloodpressure[mmHg]
200
180
160
140
120
100
80
60
40
Resting
values
0 minute
after
squatting
1 minute
after
squatting
2 minutes
after
squatting
3 minutes
after
squatting
4 minutes
after
squatting
5 minutes
after
squatting
Graph 2: Blood pressure changes at rest and after squatting. Mark values of systolic (SBP) and diastolic (DBP)
blood pressure.
Describe changes of SBP, DBP and heart rate measured after physical activity.
……………………………………………………………………………………………….
……………………………………………………………………………………………….
Why is the SBP change greater than DBP change? (Explain in the context of cardiac output
and total peripheral resistance changes induced by activity)
…………………………………………………………………………………………………
…………………………………………………………………………………………………
Why does peripheral resistance decrease after physical activity? Which mechanism regulates
blood flow in skeletal muscles?
…………………………………………………………………………………………………..
…………………………………………………………………………………………………..
Name: Study group:
This text was supported by project FRMU no. MUNI/FR/1552/2015 (Faculty of Medicine, Masaryk University).
Conclusion
Summarize blood pressure changes observed under various physiological conditions.
…………………………………………………………………………………………………..
…………………………………………………………………………………………………..
…………………………………………………………………………………………………..