Blood Pressure - Physical Examination

Blood Pressure

Blood pressure is the force or pressure of blood against the walls of blood vessels as it flows through them.

It depends on the following factors:

1.        Force of the heart beat

2.        Elasticity of the blood vessel wall

3.        Volume of blood in circulation

4.        Dilatation on concentration of the small arteries and capillaries

Variation in Blood pressure:

__________Fear

____________ Worry

_______________ Emotions

_____________________ Exercise

Hyper tension – high blood pressure 140/90 mmHg

Hypo tension – low blood pressure 90/60 mmHg

Types of Blood pressure Monitoring Equipment

1.        Sphygmomanometer: It includes a pressure manometer, unify cuff inflatable rubber bladder and a pressure bulb with a release valve that inflates the bladder.

2.        Electronic Blood pressure device: Many different types of electronic BP machines are available to determine BP automatically. They relay on an electronic sensor to detect the vibrations caused by the rush of blood through an artery.

3.        Self-measurement of blood pressure: Electronic monitoring device allows individuals to measure their own BPs in their home with the rush of button.

4.        Dial type of BP apparatus: It is lighter and useful for home visits. There is no mercury or glass. But this type may be not as accurate as the sphygmomanometer.

A stethoscope should be used with the BP apparatus in order to listen to the sounds of the brachial pulse and determine the BP reading.

Method of taking the Blood Pressure

1.        Explain the procedure to the patient and have him seated by a table or lying with the arm supported and relaxed.

2.        Place the centre of the cuff of the BP apparatus over the brachial artery and wrap it smoothly and firmly around the patient’s arm 5cm just above elbow. Junk the end neatly.

3.        Find the brachial pulse with the fingers and place the stethoscope over it.

4.        Close the sinew valve and inflate the cuff until the pulse disappears and above that about 20 mm mercury

5.        Open the valve slowly and listen for the first sound while watching the manometer reading. The first sound given the systolic reading. As air escapes, the sounds become louder and cleaner.

6.        Continue to let air out slowly. As you listen the sounds suddenly become dull and at this point take the Diastolic reading.

7.        Allow all the air to escape and the mercury to all to zero

8.        Repeat the procedure, if there is any doubt about the reading

9.        Record the reading the systolic pressure in always written over the Diastolic pressure eg. 120/80 mmHg

10.   Remove the cuff from the patient’s arm, roll and replace in the box.