1. Blood Pressure

2. Blood pressure is the pressure exerted by circulating blood upon the walls of blood vessels, and is one of the principal vital signs. During each heartbeat, BP varies between a maximum (systolic) and a minimum (diastolic) pressure.

3. Invasive Non-Invasive Blood Pressure Palpatory Method Auscultatory Method Oscillometric Method Extravascular Sensor Intravascular Sensor

4. Indirect Methods in Blood Pressure Measurements

5. General Facts Indirect measurement = non-invasive measurement Brachial artery is the most common measurement site Close to heart Convenient measurement The most common indirect methods are auscultation and oscillometry

6. General Facts An occlusive cuff is placed on arm and inflated to P > SP. Then the cuff is deflated gradually cuff The cuff should be placed at the heart level in order to minimize the hydrostatic effects

7. Palpatory Method When the cuff is deflated, there is a palpable pulse in the wrist. P = BP +) The blood pressure can be measured in noisy environment too ADVANTAGES -) Only the systolic pressure can be measured (not DP) DISADVANTAGES -) The technique does not give accurate results for infants and hypotensive patients cuff +) Technique does not require much equipment

8. Auscultatory Method The Korotkoff sounds are ausculted with a stethoscope Pulse waves that propagate through the brachial artery, generate Korotkoff sounds. There are 5 distinct phases in the Korotkoff sounds, which define SP and DP

9. When cuff pressure is between than 120 and 80 mm Hg: Blood flow through the vessel is turbulent whenever blood pressure exceeds cuff pressure. Intermittent sounds are heard as blood pressure fluctuates throughout the cardiac cycle.