Blood Pressure Flashcards
What is the palpatory systolic blood pressure?
Gauge reading when the pulse is first felt…
When you slowly release pressure in blood pressure cuff how fast do you do it?
2-3 mm Hg per second
You inflate the cuff how high after pulse disappears?
20-30 mm Hg
What is the “auscultatory gap”?
transient period of silence of the Korotkoff sounds (as much as 10-15 mm Hg before they return)
What are Korotkoff sounds?
audible noises created by turbulent blood flow through the partially open lumen of the brachial artery
How many times do the quality and intensity of Korotkoff sounds change as the artery slowly opens?
4 times
Which part of stethoscope is better for low sounds?
bell
Where do you apply the bell?
over brachial artery in the anticubital fossa
What is auscultatory systolic BP?
first two consecutive pulsed, thud like sounds
What is the 1st or mid-diastolic pressure?
point at which the blowing sounds become softer and begin to fade
What is the end-diastolic pressure?
when the sounds completely stop
When sounds due to high cardiac output may be heard all the way through to 0 what do you use?
mid-diastolic pressure
What is the pulse pressure?
the pressure difference between the systolic & diastolic pressures.
Some studies show what about pulse pressure?
that it is a better indicator of heart disease than systolic/diastolic alone.
If blood pressure is taken in both arms there should be no more than what difference in the systolic pressures?
no more than 10 mm Hg difference
The right arm may be 5-10 points higher due to what?
Additional bifucation
What is this 5-10 point difference called?
Poiseuille’s Law
A larger difference between the arm pressures suggest what?
compression, obstruction, or aneuryism of an artery on the lower side
What could cause the compression?
mechanical or space taking lesion
What could cause the obstruction?
plaque, clots or dissecting aneurysms
Which blood pressures are greater?
leg BP’s are higher than arm BP’s
Why are leg BP’s higher than arm BP’s?
because of the greater muscle mass
If a young persons arm BP is higher than the leg BP, what do you suspect?
coarctation of the aorta
If an elderly persons arm BP is higher than the leg BP. what do you suspect?
stenosis
Systolic pressure should range from …
100-140 mm Hg
Diastolic pressure should range from ….
60-90 mm Hg
What increases the diastolic pressure?
increased peripheral (arterial) resistance
What tends to increase both systolic and diastolic pressure?
strong emotions (anxiety)
Pulse pressure should be
40 mm Hg
Wide pulse pressure means what?
there is additional arterial stretch with every heartbeat, therefore greater wear and tear on the arteries
Are all abnormal combinations significant?
yes
The average normal blood pressure is what?
120/80
Many physiologic variables influence blood pressure, readings therefore should what?
be taken on at least 3 different occasions
and attempt to eliminate those variables before declaring someone has abnormal blood pressue
What are some causes for inaccurate BP readings?
arm hyperextended, unsupported, or not at heart level
reinflating cuff too soon of before releasing all the pressure
wrong cuff size
auscultory gap can cause over/under estimation
What is the ideal width of the cuff?
1/3-1/2 the circumference of the arm
Why is high blood pressure so important?
extra wear and tear on blood vessels (esp. on the tiny vessels leading to the eyes, kidneys, heart, and brain)
What accounts for 92% of people with high blood pressure?
essential or idiopathic hypertension
What does it mean that 92% of ppl with high BP mean?
there is no single discernable pathology causing the hypertension
What can be some causes of hypertension?
obesity, sedentary, salt, smoking, atherosclerosis etc.
What accounts for 8% of ppl with hypertension?
secondary hypertension
What is secondary hypertension?
there is a discernable pathology causing subsequent hypertension
What tops the list of pathologies that cause hypertenstion?
renal diseases
After renal disease, what else can cause secondary hypertension?
adrenal disease, hyperthyroidism, coarctation of the aorta, polycythemia, preeclampsia
What is polycythemia?
increase in total red cell mass in the blood
What is prehypertension?
systolic pressure that is between 120-139
diastolic pressure that is between 80-89
What can ppl do themselves to lower BP?
life-style modifications, nutritional changes, and nutritional supplements
What percentage of adults in US and Canada have high BP?
25%
What percentage of HBP manifest in a mild form?
75%
What specific things can people do to lower BP?
slow breathing exercises concord grape juice sodium reduction weight loss program of moderate exercise eat more fresh fruits and veggies avoid smoking and excessive alcohol
What are the 3 stages of blood pressue? Managments?
stage 1 - 140-159, 90-99 (diuretics)
stage 2 - >160, >100 ( diuretics + meds)
stage 3 - > or = 180, > or = 100 (combo meds)
Most people are in which range?
stage 1
Has chiropractic been shown to lower blood pressure?
yes
What is optimum BP? Management?
What is prehypertension? Management?
120-139, 80-89 - decrease risky behavoirs
