EXERCISE: PULSE & BLOOD PRESSURE

Heart rate is usually determined by measuring the pulse, or

pressure wave, in an artery. During ventricular systole, blood
pressure increases and stretches the walls of arteries. When
the ventricle is in diastole, blood pressure decreases and the
arterial walls rebound to their relaxed diameter. This change
in vessel diameter is felt as a throb—a pulse—at various
pressure points on the body. The most commonly used
pressure point is the radial artery on the lateral forearm just
superior to the wrist (Figure 1). Other pressure points include
the common carotid artery in the neck and the popliteal
artery of the posterior knee. The number of pulses in a given
time interval indicates the number of cardiac cycles in that
interval. As you will see in this activity, arterial pulses are
related to changes in the volume of blood passing a given
point at a given time.

Figure 1. Pressure points along the systemic arteries

Blood pressure is a measure of the force the blood exerts on the walls of the systemic arteries (Figure 1).
Arterial pressure increases when the left ventricle contracts and pumps blood into the aorta. When the left
ventricle relaxes, less blood flows into the aorta and so arterial pressure decreases until the next ventricular
systole. Two pressures are therefore used to express blood pressure, a systolic pressure and a lower
diastolic pressure. Average blood pressure is considered to be 120/80 mm Hg (millimeters of mercury) for a
typical male and closer to 110/70 mm Hg for most females. Do not be surprised when you take your blood
pressure in the following exercise and discover it is not “average.” Cardiovascular physiology is a dynamic
mechanism, and pressures regularly change to adjust to the demands of the body.

Blood pressure is measured using an inflatable cuff called a sphygmomanometer (sfig-mō-ma-NOM-e-

terWatch the instructor demonstrate the proper placement of the cuff. It is wrapped around the arm just
superior to the elbow and then inflated to approximately 160-180 mm Hg to compress and block blood flow
in the brachial artery. A stethoscope is placed on the antecubital region, and pressure is gradually vented
from the cuff. Once pressure in the cuff is slightly less than the pressure in the brachial artery, blood spurts
through the artery and the turbulent flow makes sounds, called Korotkoff’s (kō-ROT-kofs) sounds, which
are audible through the stethoscope. The pressure on the gauge when the first sound is heard is recorded
as the systolic pressure. As more pressure is relieved from the cuff, blood flow becomes less turbulent and
quieter. The sounds fade when the cuff pressure matches the diastolic pressure of the artery.

Materials
Individual: Stockroom (per group): Instructor:
Latex or nitrile gloves Preserved heart
Watch or timer with seconds Sphygmomanometer
Methods

Measuring the Pulse

1. Have your subject relax for several minutes.
2. Locate your subject’s pulse in the right carotid artery. Use either your index finger alone or your
index and middle fingers to palpitate (feel) the pulse. Do not use your thumb for pulse
measurements (because there is a pressure point in the thumb and you might not be able to
distinguish your pulse from your subject’s).

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 EXERCISE: PULSE & BLOOD PRESSURE

3. Apply light pressure to the pressure point, and count the pulse rate for 15 seconds. Multiply this
number by 4 to obtain the rate per minute. Record your data in Table 1.
4. Obtain your subjects’ pulse rate from the right brachial, right radial and right dorsalis pedis arteries
and record your data in Table 1.

Measuring Blood Pressure

Part 1: Resting blood pressure
1. Choose a subject whose BP you will measure for both Parts 1 and 2. Have the subject sit
comfortably and relax for several minutes. If your subject is wearing a long-sleeved shirt, roll up the
right sleeve to expose the upper brachium. Clean the stethoscope earpieces with a sterile alcohol
wipe and dispose of the used wipe in a trash can.
2. The sphygmomanometer consists of a cuff connected to a pressure gauge by rubber tubing and a
rubber bulb used to inflate the cuff. A valve near the bulb closes or opens the cuff to hold or release
the air. Force all air out of the sphygmomanometer by compressing the cuff against a flat surface.
Loosely wrap the deflated cuff around your subject’s right arm so that the lower edge of the cuff is
just superior to the antecubital region of the elbow, as shown in Figure 37.3b.
3. If the cuff has orientation arrows, line up the arrows with the antecubitis; otherwise, position the
rubber tubing over the antecubital region. Tighten the cuff so it is snug against the arm.
4. Gently close the valve on the cuff, and squeeze the rubber bulb to inflate the cuff to approximately
160-180 mm Hg. Do not leave the cuff inflated for more than one minute, because the inflated cuff
prevents blood flow to the forearm, and the disruption in blood flow could lead to fainting.
5. Put the stethoscope earpieces in your ears. Place the bell below the cuff and over the brachial
artery at the antecubitis.
6. Carefully open the valve to the sphygmomanometer, and slowly deflate the cuff while listening for
Korotkoff’s sounds. When the first sound is heard, note the systolic pressure reading on the gauge.
7. Continue to vent pressure from the cuff and to listen with the stethoscope. When you hear the last
faint sound, note the diastolic pressure on the gauge, then open the pressure valve completely and
quickly finish deflating the cuff.
8. Record the systolic and diastolic pressure measurements in the “Resting” column of Table 2.
9. Take two more BP measurements while the subject is at rest (while sitting). Calculate the average
systole and average diastole and round them off to the whole number (without any decimal places).

Part 2: Effect of Posture on Blood Pressure

Changing posture changes the way in which gravity influences blood pressure. This is readily apparent when
standing on your head. In this section your subject will lie supine (laying down on the back) for
approximately five minutes to allow for cardiovascular adjustments. You will then determine blood
pressure and compare your findings with the pressures obtained in Part 1.
1. Ask your subject to lie on the table and relax for at least five minutes.
2. Wrap the sphygmomanometer around your subject’s right arm, determine the supine blood
pressure, and record it in the “Supine” column of Table 2. Take two more measurements while
subject is supine and calculate the average.
3. Next, ask your subject to stand up and remain still for five minutes. Take the blood pressure again,
and record the reading in the “Standing” column of Table 2. Take two more measurements while
subject is standing up and calculate the average.

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