blood pressure (BP)

Etymology: AS, blod + L, premere, to press

the pressure exerted by the circulating volume of blood on the walls of the arteries and veins and on the
chambers of the heart. Blood pressure is regulated by the homeostatic mechanisms of the body by the
volume of the blood, the lumen of the arteries and arterioles, and the force of cardiac contraction. In the
aorta and large arteries of a healthy young adult, blood pressure is approximately 120 mm Hg during
systole and 70 mm Hg during diastole. See also hypertension, hypotension.
method The indirect blood pressure is most often measured by auscultation, using an aneroid or mercury
sphygmomanometer, a stethoscope, and a blood pressure cuff. With the upper arm at the level of the
heart, the cuff is placed around the upper arm and inflated to a pressure greater than the systolic
pressure, occluding the brachial artery. The diaphragm of the stethoscope is placed over the artery in the
antecubital space, and the pressure in the cuff is slowly released. No sound is heard until the cuff
pressure falls below the systolic pressure in the artery; at that point a pulse is heard. As the cuff pressure
continues to fall slowly, the pulse continues, first becoming louder, then dull and muffled. These sounds,
called sounds of Korotkoff are produced by turbulence of the blood flowing through a vessel that is
partially occluded as the arterial pressure falls to the low pressure of diastole. When the cuff pressure is
less than the diastolic pressure, no pulse is heard. Thus the cuff pressure at which the first sound is heard
is the systolic blood pressure, indicative of the pressure in the large arteries during systole; the cuff
pressure at which the sounds stop is the diastolic blood pressure, indicative of the pressure in the arteries
during diastole. A variation of this method involves the use of palpation in place of auscultation in the
antecubital space to determine the systolic pressure (the pressure at which a pulse is first palpated).
Another variation uses a transducer in the cuff to translate changes in ultrasound frequency caused by
blood movement within the artery to audible sounds. Blood pressure may be monitored directly by means
of a strain gauge or mercury manometer after a cannula has been placed in an artery. The flush method
is used when blood pressure is difficult to measure by other methods. The cuff is applied, and complete
capillary emptying is performed, usually with an elastic bandage. The cuff is inflated, the elastic bandage
is removed, and the earliest discernible flush is observed as the cuff is deflated. This method measures
mean blood pressure.
interventions The intervals at which the patient's blood pressure is to be taken are specified. The
pressure in both arms is taken the first time the procedure is performed; persistent major differences
between the two readings is indicative of a vascular occlusion. Alternatively, the blood pressure may be
taken using the thigh and the popliteal space when the leg is at the level of the heart. The width of the cuff
should be one third to one half the circumference of the limb used. Thus, a larger cuff is required for a
large patient or for any patient if the pressure is taken at the thigh.
outcome criteria Any factor that increases peripheral resistance or cardiac output increases the blood
pressure. Therefore, it is important to obtain a blood pressure reading when the patient is at rest.
Increased peripheral resistance usually increases the diastolic pressure, and increased cardiac output
tends to increase the systolic pressure. Blood pressure increases with age, primarily as a result of the
decreased distensibility of the veins. As a person grows older, an increase in systolic pressure precedes
an increase in diastolic pressure.
Mosby's Medical Dictionary, 8th edition. 2009, Elsevier

http://medical-dictionary.thefreedictionary.com/blood+pressure

Blood Pressure
Pressure is exerted by the blood on the walls of the blood vessels and mainly arteries.
Blood pressure is measured on the radial artery by using a sphygmomanometer
(inflatable rubber cuff that is applied to the arm and connected to a graduated scale,
enabling the determination of blood pressure by increasing and releasing the pressure
in the cuff), stethoscope, and blood pressure cuff.

It is measured in millimeters of mercury either as a fraction with the numerator being the
maximum pressure (systolic) that the heart pumps blood into the left ventricle of the
heart. The denominator being the minimum pressure (diastolic) that the heart pumps
blood or as a whole number that represents the first value only.

Procedures
To begin taking the patients blood pressure, use a blood pressure cuff. The length of
the cuff's bladder should be at least equal to about 80% of the circumference of the
upper arm.
Wrap the cuff around the upper arm with the cuff's lower edge one inch above the
antecubital fossa.
Gently press the stethoscope over the brachial artery below the cuff's edge.
Rapidly inflate the cuff to 180mmHg. Release air from the cuff at a moderate rate which
is about 3mm/sec.
Use the stethoscope to listen as you observe the sphygmomanometer. The first
knocking sound is the patients systolic pressure. When the knocking sound disappears,
that is the diastolic pressure.
Record the pressure in both arms and take note of the differences

Changes made to Blood Pressure definition

The original medical definition included an overwhelming about of information

that included words I was not familiar with. In order to simplify the definition and make it
easier to understand, I had to summarize the medical definition and include only the
important bits of information and simple procedures.
I noticed while reading the medical definition that all of the words were bunched
together. There was no separation between the different procedures and detailed
explanations regarding blood pressure. This made it harder to follow along with and
comprehend the correct way to take someones blood pressure. In my definition, I
made sure to separate the definition from the proper procedures. For the procedures I
broke it down to six bulletin points so that it would be quicker and easier to identify the
steps. Also, to make it easier to understand, I included a picture of a diagram that has
instructions on how to take someones blood pressure step by step. As far as sentence
structure goes, I tried to use only simple and compound sentences in my definition.
The medical definition used words and descriptions that are not commonly used
by people who are not in or familiar with the medical field and its extensive terminology.
To fix this problem I printed off a copy of the medical definition, read through it, and
highlighted all of the important pieces that stuck out to me. Then I went back over the
context and used a thesaurus to find a more common word to replace the confusing
medical terms that were given. If for some reason I could not find a word that could be
simplified, like sphygmomanometer, I made sure to include the definition following the
word. By doing this I hope that the audience will be able to understand my definition of
blood pressure better and be able to follow the procedures of efficiently. For example,
instead of saying The indirect blood pressure is most often measured by auscultation,
using an aneroid or mercury sphygmomanometer, a stethoscope, and a blood pressure
cuff, I wrote, Blood pressure is measured on the radial artery by using a
sphygmomanometer, stethoscope, and blood pressure cuff.
I hope that the changes I made in order to write my definition will help the
audience understand what blood pressure is and the procedures to take it more clearly
than the medical definition. By sticking to two types of sentence structures, more
common medical terms, illustrative examples, and a list of simplified procedures these
should help the reader have a better understanding and be able to apply their new
knowledge if a situation ever requires it.