1. make sure the artery is completely closed

1.     
Describe what the Korotkoff sounds
are, and how they are relevant in blood pressure measurement.

Korotkoff
sounds are arterial sounds that are observe while taking blood pressure with a
sphygmomanometer over the brachial artery in the antecubital fossa which is the
triangular area on the anterior view of the elbow. These sounds appear and
disappear as the blood pressure cuff is inflated and deflated by hand.  The systolic blood pressure is recorded when the
first Korotkoff sound is first heard and the diastolic blood pressure is measured
when the last Korotkoff sound is just barely audible , this method has been
used for years and is an very accurate way of listening and measuring blood
pressure. When the cuff itself is tightened it cuts of the blood supply and
closes the artery, then when slowly released you will start to hear the sounds
via stethoscope from the artery opening up and then fade out when the artery is
fully open. They are relevant sounds as they help clearly identify pressure of
the heart I the initial systolic and then diastolic phase of the heart and the
pressure or the blood against the arterial walls.

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2.     
Describe how blood pressure is
measured using a sphygmomanometer and a stethoscope.

A
sphygmomanometer is a device that is used to visually see and measure the two readings
from a blood pressure measurement being the systolic and diastolic measurement.
Its pumped up  and inflating the cuff
simultaneously the dial counter hand will also rise , this should be pumped
over any possible reading to make sure the artery is completely closed to
around 200mmHg
(millimetres of mercury). Then the cuff wrapped around the
patients arm should be deflated using the air release value on the other end of
the inflation bulb.

When the cuff’s pressure equals the arterial
systolic pressure the blood begins to flow through the arm cuff creating blood
flow turbulence and korotkoff sounds, initial being the systolic pressure. Then
by using a stethoscope these sounds are heard and the cuff’s pressure is
recorded. The blood flow sounds will continue until the cuff’s pressure falls
below the arterial diastolic pressure. The pressure when the blood flow sounds
stop indicates the diastolic pressure. Systolic and diastolic pressures on
average should fall around 120 over 80.

 

3.     
Describe the terms auscultation and
palpation with reference to blood pressure measurements    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3087253/

 

Auscultation
of heart is the clinical procedure of listening to cardiac sounds. Auscultation of heart may reveal problems with the heart
murmurs which are related to heart valve abnormalities. Cardiac auscultation is
performed over five locations on the chest anterior wall. Aortic Valve area, pulmonic
area, Erb’s Point, tricuspid and mitral valve area, all used to listen to
different lengths and durations pitches of sounds to identify possible defects
such as leaky valves called murmurs in all of the 5 different areas. As with any defect , blood pressure
can drop or rise according to the hearts auscultations, for example if there is
a serious defect or leaky valve, blood pressure could rise or lower making it
difficult to complete tasks such as siting up quickly or walking up stairs and
the heats is not functioning on full capacity . Most common method for
measuring blood pressure is palpatory but only systolic pressure can be
measured with this method. The palpatory method of measuring diastolic blood
pressure is via the radial pulse (the pulse at the radial artery in the wrist),
its palpated with the fingers of the left hand. 
The number of beats in 30 seconds is counted, and the heart rate in
beats per minute is recorded.

 

 

4.      Describe how
you would classify hypertension

 

Hypertensive
heart disease refers to heart conditions caused by high blood pressure. Such as
the thickening or narrowing of the arteries causing high blood pressure

The
heart working under increased pressure causes some different heart disorders.
Hypertensive heart disease includes heart failure, thickening of the heart
muscle, coronary artery disease, and other conditions. Coronary arteries
transport blood to your heart muscle. When high blood pressure causes the blood
vessels to become narrow, blood flow to the heart can slow or stop. This condition
is known as coronary heart disease (CHD), also called coronary artery disease. Hypertensive
heart disease can cause serious health problems. It’s the leading cause of
death from high blood pressure.

 

5.      Describe what
is meant by ‘white coat hypertension’ and ‘postural hypotension’.

 

Postural
hypotension also known as Orthostatic hypotension , is a form of low blood
pressure that happens when you stand up from lying down just from sitting.
Orthostatic hypotension can make you feel dizzy or lightheaded, and maybe even
faint. Most Orthostatic hypotension is mild and last for less than a few
minutes but some cases can be long-lasting can indicate more-serious problems.
Acute Orthostatic hypotension is usually caused by something obvious, such as dehydration
or lengthy bed rest, and is easily treated.

White
coat hypertension comes from the references to the white coats traditionally
worn by doctors or people in hospitals taking blood pressure measurements on
the patients . The white coat effect means that your blood pressure is higher
when it is taken in a medical setting than it is when taken at home.  On average, when your blood pressure is taken
at home the top (systolic) number can be around 10mmHg lower than it would be
if taken by a doctor and 5mmHg lower on the bottom (diastolic) number.  Most of us tend to feel more tense in medical
settings than we do in surroundings that are familiar to us, although we do not
always notice it. The white coat effect can influence some peoples’ blood
pressure more than others.  If you are
very anxious your systolic blood pressure can rise by as much as 30mmHg.  This can make it more difficult for your
doctor to get an accurate measurement of your blood pressure.

 

 

6.     
Describe how your blood pressure
fluctuates during the cardiac cycle, and any changes that occur between day and
night.

 

Blood pressure changes are directly linked to changes in cardiac output.
So a larger cardiac output means that a larger volume of blood is being forced
out of the heart and into the aorta. Cardiac output referring to the amount of
blood in litres pumped out of the heart per minute. It is calculated by taking
the stroke volume , being the the amount of blood in millilitres pumped out
into the circulation by the left ventricle each time it contracts, and
multiplying it by the number of times the heart beats a minute. This will give
a cardiac output in ml/min. Most adults have about 5 litres of blood in their
circulatory system. A major drop in blood volume causes blood pressure to drop.
The reverse is also true. If blood volume increases, for example if the body
retains too much water, then blood pressure rises. The blood volume is regulated
by the renal system. In a dehydrated person, any water that arrives at the
kidneys in the blood will be retained and returned to the blood. In a well
hydrated person, any excess water will be eliminated by the kidney. Blood
pressure does change during the day and night. When someone wakes up, it
typically is somewhat higher than it is after we’ve had a chance to sit down
and eat. Blood pressure is also higher first thing in the morning because once someone
has got up form sleeping all night from a lying position, many of us get a
sudden rush of adrenaline, and that adrenaline tends to raise one’s blood
pressure and heart rate. Blood pressure is normally lower at night while you’re sleeping.
Your blood pressure starts to rise a few hours before you wake up. Your blood
pressure continues to rise during the day, usually peaking in the middle of the
afternoon. Then in the late afternoon and evening, your blood pressure begins
dropping again. Having an abnormal blood pressure pattern, such as high blood
pressure during the night or early in the morning, can mean that you have a
health problem.