how to measure abp
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How to Measure ABP
Dr. Nisreen MansourDepartment of Physiology
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Dr. Nisreen Mansour
Blood Flow;Laminar Flow Vs. Turbulent Flow
• Normal laminar flow produces no sounds
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Dr. Nisreen Mansour
Arterial Blood Pressure
• ABP; Is the lateral force exerted by the column of blood on the lateral walls of arteries
• ABP is expresses as systolic over diastolic• Systolic BP; is the maximum pressure caused by
the ejected blood during peak of ventricular systole; normally 90-140 mm Hg
• Diastolic BP; is the lowest pressure at the end of ventricular diastole; normally 60-90 mm Hg
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Dr. Nisreen Mansour
Systolic BP
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Dr. Nisreen Mansour
Diastolic BP
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Dr. Nisreen Mansour
• Mean Arterial Blood Pressure (MAP)
is the average perfusing pressure during cardiac cycle
MAP = diastolic +1/3 pulse pressure
= 93 mm Hg
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Dr. Nisreen Mansour
Arterial Pressure Wave
• Diacrotic notch is caused by sudden closure of aortic valve causing sudden drop of aortic pressure
Diacrotic notch
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Dr. Nisreen Mansour
Arterial Blood Pressure
• Average ABP = 120/80 mm Hg• However, there are physiological variation:• Age• Sex• Race• Meals• Posture• Emotion• Exercise• Sleep
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Dr. Nisreen Mansour
How To Measure ABP
• Indirect
• Usually in Brachial artery
• Using Syphygmomanometer
• 2 methods;Palpation methodAuscultation Method
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Dr. Nisreen Mansour
How To Measure ABP; Palpation Method
• Gives a rough idea about value of systolic BP; HOW?
Apply the cuff to upper arm Your middle 3 fingers of one hand feeling radial
pulse Using the other hand, inflate the cuff till pulse
disappears Slowly deflate the with your eyes at the
manometer; the value at which u feel the pulse again is the Systolic BP
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Dr. Nisreen Mansour
How To Measure ABP; Auscultatory Method
• With the cuff still around the upper arm (NOTICE THAT CUBITAL FOSSA MUST BE CLEAR)
• Place the stethoscope on anatomical site of brachial artery (medial side of antecubital fossa, u can feel its pulse)
• Raise the pressure in the manometer by about 10-20 mm Hg above the value that u measured by palpation method before
• Start to deflate very slowly (by 2mm Hg) until u hear sound; Korotkov’s sounds
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Dr. Nisreen Mansour
How To Measure ABP; Auscultatory Method
• The 1st appearance of sounds indicates systolic BP
• The intensity of sound increases (blowing) as the pressure in cuff is decreased (Turbulent flow)
• Sound is muffled gradually then disappears indicating Diastolic BP
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Dr. Nisreen Mansour
How To Measure ABP; Auscultatory Method
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Dr. Nisreen Mansour
How To Measure ABP; Auscultatory Method
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Dr. Nisreen Mansour
Arterial Pulse
• Where u can feel arterial pulsation?
• Arterial pulse is the expansion of arterial wall by the ejected blood during systole causing sudden increase in aortic pressure that is transmitted as pressure wave to systemic arteries
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Dr. Nisreen Mansour
Pulse
• The strength of pulse is determined by the pulse pressure
• Pulse Pressure = Systolic BP –Diastolic BP = = 120-80 = 40 mm Hg
• PP is affected by stroke volumecompliance of arteries
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Dr. Nisreen Mansour
Pulse
• Significant because it gives an idea about:
• Heart rate
• Certain CV diseases:Water hammer pulsePulsus alternans
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Dr. Nisreen Mansour
THANK U