Blood Pressure: ةلديصلا مسق / ةعماجلا ديشرلا ةيلك Physiology Lab. لا لصفلا / ةيناثلا ةلحرملا يناث Lab.

‫ الفصل الثاني‬/ ‫المرحلة الثانية‬ ‫ قسم الصيدلة‬/ ‫كلية الرشيد الجامعة‬
Lab. (1) Physiology Lab.
Blood Pressure
Is the pressure exerted by the blood against the vessel walls, the arterial blood
pressure being the most frequently measured pressure and most useful one.
Important Terms:
Systolic Blood Pressure: is the highest pressure in the artery produced by
the contraction phase (systole) of the heart. The normal value for a 20 year
old man is 120 mmHg.
Diastolic Blood Pressure: is the lowest pressure in the artery produced by

the relaxation phase (diastole) of the heart. The normal value for a 20 year old
man is 80 mmHg
Pulse Pressure: is the difference between the systolic and diastolic pressure.
The normal value is 40 mmHg
Mean Blood Pressure: is the average pressure during a complete heart cycle.
It is the average effective pressure forcing blood through the circulatory
system. It can be determined as follows:
Mean Blood Pressure (MBP) = Diastolic BP + 1/3(Systolic BP – Diastolic BP)
Normal value of MBP is 96 – 100 mmHg
The MBP is the function of two factors: (Cardiac output and total peripheral
resistance). The peripheral resistance depends on the diameter of the blood
vessel and the viscosity of blood.
MBP = Cardiac Output * Total Peripheral Resistance
Cardiac Output (CO) = Heart Rate (beat/min) * Stroke Volume (ml/beat)
General Factors Affecting Blood Pressure:

1. Age and gender: women upon aging have greater tendency to increase
BP than men, and also in general women tend to develop high blood
pressure than men. This could be due to reduced elasticity upon aging
and the other reason is due to the deposition of cholesterol and lipids on
the blood vessel walls
2. Habits: type of diet, smoking and drinking
3. Exercise: during exercise there is a sharp rise in the systolic blood
pressure that persists for several minutes
4. Gravity: the pressure in any vessel below the heart level is increased
and that in any vessel above the heart level is decreased by the effect of
gravity.
Maintenance of Systemic Blood Pressure:

Because blood pressure is so important, there are many physiological factors
and processes interact together to keep the PB within normal limits.
1. Venous Return: the amount of blood that returns to the heart by way of
the veins. Venous return is so important because the heart can pump
only the blood it receives. There are three mechanisms help promote
venous return:
- Constriction of veins: veins contains smooth muscles, which enables
them to constrict and force blood towards the heart
- The skeletal muscle pump: effective for deep veins of the legs. These
veins are surrounded by skeletal muscles that contract and relax
during walking. Contraction of the leg muscles squeezes the veins to
force blood towards the heart.
- The respiratory pump: affects the veins that pass through chest
cavity. The pressure changes of inhalation and exhalation alternately
expand and compress the veins and blood is returned to the heart
2. Heart rate and force: both increase during exercise, however, if the
heart is beating extremely rapidly then the ventricles will not fill
completely between beats and the cardiac output and blood pressure
will decrease
3. Peripheral resistance: the term refers to the resistance of the vessels
to the flow of blood.
4. Elasticity of the large arteries: normal elasticity, therefor, lowers
systolic BP, raises diastolic BP and maintains a normal pulse pressure.
The usual ratio of systolic to diastolic to pulse pressure is approximately
3:2:1.
5. Viscosity of the blood: is maintained by number of RBCs and plasma
proteins, mainly the albumin. Viscosity increases in cases of
polycythemia vera and heavy smoker peoples and this will lead to
increase BP. While the viscosity is reduced when there is a disorder
causing low production of RBCs as in case of anemia or decreased
albumin as in case of liver disease or kidney disease which will lead to
decreased BP.
6. Loss of blood:
7. Hormones: several hormones affect the BP and they are:
- Norepinephrine and epinephrine secreted by the adrenal medulla and
they cause vasoconstriction and increase heart rate in stress
situations resulting in increased BP
- Antidiuretic Hormone (ADH) secreted by the posterior pituitary gland
which increases water reabsorption by the kidneys
- Aldosterone secreted by the adrenal cortex, when there is a drop in
BP aldosterone stimulate the reabsorption of sodium (Na) from the
kidneys
- Atrial Natriuretic Peptide (ANP) secreted by the atria of the heart and
causes the secretion of sodium (Na) and water when there is a rise in
BP
Types of high Blood Pressure:

1. Primary hypertension:
More than 9 of 10 people with high blood pressure have what’s called
primary or essential hypertension. This means that there is no single
clear cause of it.
Although the exact cause of high blood pressure is not fully understood,
it is known that some factors to do with the life style can contribute, and
these are:
- Smoking
- Previous family history
- Obesity
- Drinking alcohol
- Lack of exercise
- Type of diet
2. Secondary hypertension:
About 1 in 20 people with high blood pressure have secondary
hypertension. This means the condition can be linked to a recognized
cause; it may be a symptom of another underlying disease of factor such
as:
- Kidney disease
- Endocrine disease
- Narrowing of the aorta
- Steroid medicines
- The contraceptive pills
- Pregnancy which can cause pre-eclampsia
Objective of the Experiment:

Measurement of blood pressure provides information on the heart pumping
efficiency and the condition of the systemic blood vessels. In general, the
systolic BP indicates the contraction of the heart whereas the diastolic BP
indicates the condition of the systemic blood vessels.
Materials required: (Auscultatory Method)

1. A device called sphygmomanometer for measuring BP and it consists of
the followings:
- Inflatable rubber bag (Cuff)
- Rubber bulb for introducing air into the Cuff
- Mercury manometer for the measurement of the pressure in the Cuff
2. A stethoscope
Procedure:
Blood pressure may be measured either directly or indirectly
• Direct method:
A cannula is inserted into the artery and the direct head-on pressure
of the blood is measured with a transducer or mercury manometer
• Indirect method:
There are two ways of measuring blood pressure:
A. Palpatory Method:
This is an old and less accurate method, in which one simply
palpates or feels the pulse as pressure is applied externally to the
artery. A major disadvantage of this method is that it cannot
measure the diastolic BP.
B. Auscultatory Method:
It is called that way because blood pressure is recorded by the
detection of sounds. The procedure is as follows:
- Have the subject seated with her/his arm rested on the table. Wrap
the pressure Cuff around the bare upper arm, making sure that the
inflatable bag within the Cuff is placed over the inside of the arm
where it can exert pressure on the brachial artery.
- Wrap the end of the Cuff around the arm and tuck it into the last turn.
Close the valve of the bulb.
- Place the stethoscope bell below the Cuff and over the brachial artery
where it branches into the radial and ulnar arteries.
- Place the stethoscope ear piece in your ears. With no air in the Cuff
sounds can be heard.
- Inflate the Cuff so the pressure is above diastolic (80 – 90 mmHg)
and you will be able to hear the spurting of blood through the
partially occluded artery. Increase the Cuff pressure to around 160
mmHg; this pressure should be above the systolic pressure so that
the artery is completely collapsed and no sounds are heard
- Open the valve and begin slowly to lower the pressure in the Cuff. As
the pressure decreases you will be able to hear four phases of sound
changes; these were first reported by Korotkoff in 1905 and are
called korotkoff sounds, which are:
1) Phase 1: appearance of fairly sharp thudding sound that
increase in intensity in the next 10 mmHg of drop in pressure.
The pressure when the sound first appears is the systolic
pressure.
2) Phase 2: the sound become a softer murmur during the next 10
– 15 mmHg of drop in pressure
3) Phase 3: the sounds become louder again and have a sharper
thudding quality during the next 10 – 15 mmHg of drop in
pressure
4) Phase 4: the sound suddenly becomes muffled and reduced in
intensity. The pressure at this point is termed diastolic
pressure. This muffled sound continues for another drop in
pressure for 5 mmHg, after which all sounds disappears. The
point where the sound ceases completely is called the end of
diastolic pressure.
The Auscultatory Method of Blood Pressure Measurement

Blood Pressure: ةلديصلا مسق / ةعماجلا ديشرلا ةيلك Physiology Lab. لا لصفلا / ةيناثلا ةلحرملا يناث Lab.

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Blood Pressure: ةلديصلا مسق / ةعماجلا ديشرلا ةيلك Physiology Lab. لا لصفلا / ةيناثلا ةلحرملا يناث Lab.

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‫ الفصل الثاني‬/ ‫المرحلة الثانية‬ ‫ قسم الصيدلة‬/ ‫كلية الرشيد الجامعة‬

Lab. (1) Physiology Lab.

Diastolic Blood Pressure: is the lowest pressure in the artery produced by

General Factors Affecting Blood Pressure:

Maintenance of Systemic Blood Pressure:

Types of high Blood Pressure:

Objective of the Experiment:

Materials required: (Auscultatory Method)

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