Vital Signs II - Respiration and Blood Pressure - Gulf Medical University - PDF

AT ATF 202 L3 Vital signs II Nithin Raj MSc AT February 11, 2025 www.gmu.ac.ae College of Health Respiration  Respiration Respiration is movement of air between lungs and atmospher...

AT ATF 202 L3 Vital signs II Nithin Raj MSc AT February 11, 2025 www.gmu.ac.ae College of Health Respiration  Respiration Respiration is movement of air between lungs and atmosphere Types of respiration External respiration refers to the interchange of oxygen and carbon dioxide between the alveoli of the lungs and pulmonary blood. Internal respiration, it is the interchange of these same gases between the circulating blood and the cells of the body tissues. Respiratory (breathing ) cycle Breathing cycle consist of Two phases:  Inspiration (Inhalation)  Expiration (Exhalation)  breathing time = 5 seconds  inspiratory time = 2 seconds  Expiratory time = 3 seconds  respiratory rate (RR) per minute = = 12 breath/min Mechanism of inspiration (steps ) 1. Contraction of inspiratory muscle (external intercostal muscle),contraction of diaphragm lead to increase vertical diameter 2. Increase the chest volume 3. Decrease the pressure in lungs 4. Now the atmospheric pressure more than lungs pressure so the air move from atmosphere to lungs external intercostal muscle diaphragm Mechanism of expiration 1. The expiration is passive process by relaxation the inspiratory muscles of lung and chest 2. lungs pressure increase 3. Now the pressure in the lungs is more than atmospheric pressure so the air move from lungs to atmosphere  Measuring Blood pressure ATF II February 11, 2025 www.gmu.ac.ae College of Health  Blood pressure Blood pressure (BP) definition Is the force that blood exert against blood vessel walls. The pumping action of the heart generates blood flow. Blood pressure results when that blood flow (BF) is met by resistance(R) from vessel walls (BP= BF+R) Blood pressure is expressed in millimeters of mercury (mmHg) 9  Measuring Blood pressure Direct method Indirect method (intra arterial cannula) Palpatory method Auscultatory method 10 Direct method transducer  Blood pressure Graph mmHg Systolic pressure 120 Pulse Mean pressure pressure 80 Diastolic pressure 40 Time  Measuring Blood pressure Components of blood pressure Graph:- 1. Systolic pressure 2. Dicrotic notch 3. Diastole pressure 4. Pulse pressure 5. Mean arterial pressure 13  Measuring Blood pressure Systolic pressure Systolic pressure is maximum pressure exerted by the blood against the artery wall It is the result of ventricular systole or contraction It is normally about 120 mmHg (average) Range (100 – 140) mmHg 14  Measuring Blood pressure Dicrotic notch The dicrotic notch represents interruption of smooth flow due to the brief backflow of blood that closes the aortic semilunar valve when ventricles relax. 15  Measuring Blood pressure Diastole pressure Diastole pressure is the lowest pressure in artery It is the result of ventricular diastole or relaxation It is normally about 80 mmHg Range (60 – 90) mmHg 16  Measuring Blood pressure Pulse pressure Pulse pressure is difference between systole and diastole pressure Pulse pressure = systole pressure - diastole pressure 40 mmHg = 120 mmHg - 80 mmHg 17  Measuring Blood pressure Mean arterial pressure (MAP) Mean arterial pressure is calculated “average” pressure in arteries. MAP = diastole pressure + 1/3 Pulse pressure 93 mmHg = 80 mmHg + 40/3 18  Measuring Blood pressure Direct method Indirect method (intra arterial cannula) Palpatory method Auscultatory method Auscultatory method  140 Auscultatory method 120 Mercury 100 monometer 90 80 Sphygmomanometer 60 40 20 stethoscope pump cuff 21 Diastolic Systolic pressure pressure 150 140 120 100 90 80 60 40 stethoscope 20 10 150 140 120 100 90 80 60 40 20 10  Palpatory method 140 pulse disappears (A) 120 Mercury 100 monometer 90 80 60 pulse reappears (B) 40 20 A + B Systolic pressure = 2 cuff 24 Reference Morgan and Mikhail's clinical anesthesiology 6th edition 2018, ISBN: 9781-25-983443-1 The anesthesia technologist's manual Emily Guimaraes, Matthew Davis, Glenn Woodworth, Jeffrey R. Kirsch Second edition. | Philadelphia: Wolters Kluwer,