How to Take Blood Pressure Blood Pressure Cuff Placement
Okay so now we want to talk about the placement of the blood pressure cuff, and the placement of the stethoscope. So in general, you want to be a couple of inches, or a couple of centimeters actually, above the elbow crease. You don't want any clothes constricting around the blood pressure cuff. Go ahead and close that off, so now we have that. And the next part is placement of the stethoscope. One important aspect is to make sure that the ear pieces you can see are angled, and you want to make sure those angles are pointing forward when.
Regulating Arterial Blood Pressure
One of the things that we know about hypertension is, first of all, it affects one out of every three adults. It's an epidemic in our country and it's one of the major concerns for institutes like NIH and the American Heart Association. It's primarily two disease models. Hypertension, which is higher blood pressure. And lower blood pressure, which is orthostatic intolerance. For someone who has really low blood pressure, they may have trouble standing up with this. So with the micronography technique we're taking a tungsten microelectrode and we're inserting it into the peroneal nerve.
And this right now is the gold standard for assessing sympathetic traffic. It's the only method out there where we can get direct signals of sympathetic traffic. When we're probing for a sympathetic nerve we're listening for what we call an insertion burst. That insertion burst will give us an indication that we're actually in the nerve. Now we still have to make tiny microadjustments sometimes in order to get there because we're actually recording from multiple fibers. And what we're interested in is, individuals who are more prone to fainting have lower.
Sympathetic tone, lower sympathetic traffic, and, or, they have a reduced ability to increase sympathetic traffic. So on one scale, one side of the spectrum we're looking at fainting and orthostatic intolerance. On the other side of the scale, someone who has a high sympathetic traffic, outflow, and tone, often is associated with hypertension. And so we look at these patients and try to characterize their activity levels, and then we expose them to various types of intervention. So one intervention is getting more sleep, other interventions are physical activity. One that we just completed was looking at the effects of the Omega3 fatty acids,.
This is how you find anatomical positions for your pulses. First the carotid, on either side. Next the brachial. The brachial can be located by going to the antecubital fossa, splitting it in half, taking the inside medial half and splitting it in half again. Brachial artery. The next is a radial. The radial bone closest to the thumb. Just on the inside. Next, stand up will be the femoral. The femoral will be identified at the connection between the torso and the legs. The midway point right here. Turn around. Popliteal. Back of the.
Leg inside the medial half similar to that of the brachial artery. Have a seat. Finally two of the probably more difficult ones. First the dorsalis pedis. First identify the big toe, the tendon coming up the big toe and the first toe. Go into that groove into the point where they meet and go a couple fingers up. And that is the dorsalis pedis. The posterior tibal is on the inside portion of the ankle. Right here. Practice these pulses often and on as many friends and family as you can to get use to this. It is an acquired skill that.
Interpreting Central Venous Pressure Waveforms by James DiNardo, MD, for OPENPediatrics
Interpreting Central Venous Pressure Waveforms, by Dr. James DiNardo. Hi. My name is Jim DiNardo. I'm a Professor of Anesthesia at Harvard Medical School and one of the Cardiac ICU attendings to your Children's Hospital Boston. I'm going to talk now about our central venous pressure trace and the kind of information that we can get from a central venous pressure trace, and also about how a central venous pressure trace is generated and what implications that has. So again, it's important to remember that when we're measuring a CVP, we are in fact.
Measuring a pressure in the central circulation, so in the superior vena cava or in the right atrium, depending on where the tip of the catheter is. But in fact, what's happening is this pressure is a consequence physiologically of volume changes in the superior vena cava or the right atrium in the setting of the compliance of those two systems. What we see here when we look at a CVP trace, we see a volume moving in and out of the right atrium or the superior vena cava being represented as a pressure here. This pressure we're.
Going to talk about this trace as one bead of the central venous pressure. You can see that there's a couple of waves here. So this first wave on the upstroke here is known as the A wave. And you can see that is actually occurring we can see with the simultaneous A line trace as a late event in diastole. So here is end diastole in the arterial blood pressure traced right before the onset of systole. And if we look up here at the EKG, that same.
Interval corresponds with the atrial contraction of the EKG. So this is an end diastolic event. And what this represents this is the pressure generated in the right atrium or the superior vena cava when the atrium contracts in a late diastole. And that is the pressure that's generated. And that pressure is a consequence of the volume of blood that's moving into the atrium and the compliance of the atrium. So you can imagine a circumstance where, if you have a very compliant right atrium, even if you have a lot of volume moving in with the atrial contraction, the A wave is not.
RX TN Auscultation
Now, for our patient we are going to listen to heart and lung sounds. We're going to go ahead and start with lung sounds. So, we're going to take our stethoscope and we're going to try to listen to the lobes of the lung to see if there is an issue with a specific lobe. So, what we would do is we're going to take and we're going to listen in four places. We're going to listen in the left upper, right upper, left lower, and right lower. Now, listening to the heart, we're going to listen right here, just like where.
How To Measure Blood Pressure
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Pulse Wave Velocity Technique UDETMA
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