B.Sc. (Hons) Zoology Prof.

Anita Kamra Verma

Life Sustaining Systems
Sem IV

Aim
The main purpose of conducting this experiment is to study the common method used for
measuring the blood pressure of an individual.
Materials Required
Stethoscope, Blood pressure cuff, sphygmomanometer or Digital Blood Pressure monitor.
Measurement of Blood Pressure with a Sphygmomanometer
What is a Sphygmomanometer?
A sphygmomanometer is a word derived from the Greek word sphygmos which means
beating of the heart or the pulse. By adding two words sphygmos + manometer, a word
sphygmomanometer was formed.
A sphygmomanometer is a device that measures blood pressure. It is composed of an
inflatable rubber cuff, which is wrapped around the arm. A measuring device indicates the
cuff's pressure. A bulb inflates the cuff and a valve releases pressure. A stethoscope is used to
listen to arterial blood flow sounds.

Mercury sphygmomanometer Stethoscope

Mercury sphygmomanometers are manual operated, providing blood pressure reading.

Mercury sphygmomanometer requires the help of stethoscope to measure the Blood Pressure
of the arteries.

Parts of a Sphygmomanometer
Bladder: It is an inflatable bag that, when filled, squeezes the arms to block the artery.
Cuff: The cuff has an inflatable rubber bladder that is cloaked around the upper arm. A
pressure meter indicates the cuff's pressure.
Valve: The deflation valve allows for controlled deflation of the cuff and it’s critical for
accurate measurement. An end check valve prevents air from escaping.
Bulb: A small, handheld air pump inflates the blood pressure inside the cuff.

Manometer: It is the portion of the sphygmomanometer that measures the blood pressure in
mmHg. This aneroid gauge contains a watch-like movement that measures the air pressure
B.Sc. (Hons) Zoology Prof. Anita Kamra Verma
Life Sustaining Systems
Sem IV
applied to the cuff. Within the gauge, there is a series of diaphragms (of copper or beryllium)
that expands when air is filled and contains gears that transform the linear motion of
diaphragms, turning the needle on a dial calibrated in mmHg.

Blood Pressure
Blood pressure is the force created by the blood circulation through the circulatory system.
There is a fluctuation of blood pressure and it depends on our lifestyle, eating patterns, BMI
– body mass index, family history and many other factors. As the heart beats, blood forced
through the arteries cause a rise in pressure, called systolic pressure, followed by a decrease
in pressure as the heart's ventricles prepare for another beat. This low pressure is called the
diastolic pressure.
The systolic pressure is a higher value that represents the pressure in the vessel when the
heart is contracting (i.e. pulse flow)
The diastolic pressure is a lower value that represents the pressure in the vessel when the
heart is relaxing
Based on the reading, the blood pressure is of two types.
High blood pressure or Hypertension mainly occurs when there is an increase or rise in blood
pressure from its normal to unhealthy levels.
Low blood pressure or Hypotension mainly occurs when there is a decrease or drop in blood
pressure from its normal levels. Moreover, the exact causes of varying blood pressure are not
clear. Along with the causes, the symptoms and treatment of blood pressure vary.

How to Measure Blood Pressure with a Sphygmomanometer?

Procedure
1. Allow the patient to relax for 15 to 20 minutes before taking their readings.
2. To begin blood pressure measurement, use a blood pressure cuff of the correct size.
The length of the cuff's bladder should be at least equal to 80% of the circumference
of the upper arm.
3. Wrap the blood pressure cuff evenly around the patient’s arm above the antecubital
fossa for an accurate reading.
4. Now place the bell of the stethoscope over the brachial artery.
5. Lightly press the stethoscope's bell over the brachial artery just below the cuff's edge.
Some health care workers have difficulty using the bell in the ante-cubital fossa.
6. Once, after everything is set, start pumping the cuff bulb gradually and listen to the
pulse sounds. Keep on checking the reading in the Sphygmomanometer.
7. Continue to expand the cuff up to the point where the pulse sound is no longer felt.
This reading is recorded as the diastolic pressure. Listen with the stethoscope and
simultaneously observe the dial or mercury gauge. The first knocking sound, is the
subject's systolic pressure. When the knocking sound disappears, that is the diastolic
pressure (such as 120/80).
B.Sc. (Hons) Zoology Prof. Anita Kamra Verma
Life Sustaining Systems
Sem IV
8. Record the pressure in both arms and note the difference; also record the subject's
position (supine), which arm was used, and the cuff size (small, standard or large adult
cuff).
9. If the subject's pressure is elevated, measure blood pressure two additional times,
waiting a few minutes between measurements.
10. Now slowly reduce the cuff until the pulse sounds are felt. This reading is recorded as
the systolic pressure.

Measuring Blood pressure using a Sphygmomanometer

 Blood pressure is measured in arteries using a sphygmomanometer (veins do not have

sufficient pressure to be easily detected)
 The sphygmomanometer is a blood pressure cuff that cuts off circulation to a region
(typically the brachial artery in the arm
 The pressure of the cuff is slowly released until a pulse can be audibly detected with a
stethoscope (systolic pressure)
B.Sc. (Hons) Zoology Prof. Anita Kamra Verma
Life Sustaining Systems
Sem IV
 The pressure continues to be released from the cuff until a pulse can no longer be
audibly detected (diastolic pressure)
 A normal blood pressure for a healthy adult is approximately 120 / 80 mmHg

The sphygmomanometer cuff is inflated to well above expected systolic pressure. As the valve
is opened, cuff pressure (slowly) decreases. When the cuff's pressure equals the arterial
systolic pressure, blood begins to flow past the cuff, creating blood flow turbulence and
audible sounds. 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 are commonly stated as systolic 'over' diastolic. For
example, 120 over 80. Blood flow sounds are called Korotkoff sounds.
In some patients the Korotkoff sounds disappear as the systolic pressure is bled down. After
an interval, the Korotkoff sounds reappear. This interval is referred to as the "auscultatory
gap" This pathophysiologic occurrence can lead to a marked under-estimation of systolic
pressure if the cuff pressure is not elevated enough. It is for this reason that the rapid inflation
of the blood pressure cuff to 180 mmHg was recommended above.
The "auscultatory gap" is felt to be associated with carotid atherosclerosis and a decrease in
arterial compliance in patients with increased blood pressure.

Note: If you are using the new Digital Blood Pressure monitor, then there is no more use of
the stethoscope. As this single device can measure the blood pressure, pulse rate and provide
accurate results instantly with one-touch operation.

Result
Note the measurements of both systolic and diastolic blood pressure obtained and calculate
the accurate blood pressure of an individual. Normal Blood Pressure is 120/80 mm of Hg.

Conclusion
According to the National Institutes of Health, the normal blood pressure of a healthy
individual is measured to be 120 – 140 / 70 – 90 mm Hg along with the normal pulse rate 60 –
80 per min.
The normal range of systolic blood pressure should be between 90 – 120 mm Hg. Systolic
blood pressure is the reading recorded when the pressure is exerted on the arteries and blood
vessels while the heart is beating.
The normal range of diastolic blood pressure should be between 60 – 80 mm Hg. Diastolic
blood pressure is the reading recorded when the pressure is exerted on the walls of arteries
around the body in between heartbeats when the heart is relaxed.

Types of a Sphygmomanometer
B.Sc. (Hons) Zoology Prof. Anita Kamra Verma
Life Sustaining Systems
Sem IV
Different types of sphygmomanometers are available. Digital sphygmomanometers are
automated, providing blood pressure reading without needing someone to operate the cuff
or listen to the blood flow sounds. However, digital types are less accurate. Some healthcare
providers use digital for screening but use manual sphygmomanometers to validate readings
in some situations. Manual sphygmomanometers consist of aneroid (dial) and mercury
(column) devices. Operating these aneroid and mercury sphygmomanometers is nearly the
same, except that aneroid devices require periodic calibration.

There are three types of sphygmomanometers that are used to gauge human blood.
1. Mercury Sphygmomanometer
The mercury sphygmomanometer is considered the “gold standard” among all other types of
devices representing the classic and time-tested method of assessing blood pressure.
The device consists of an inflatable bladder along with a column of mercury. Varying
pressures cause different levels of mercury in the column. Once the column is made,
recalibration is not required to take place to their exactness.

2. Aneroid Sphygmomanometer
The aneroid sphygmomanometer is a device that stands on the stans or walls, consists of a
spring device and metal membrane that translates the signals from the cuff and operates a
needle in the gauge. The absence of a liquid provides mobility, as this device can be moved
easily from one location to another. Since these devices require calibration checks that’s why
they provide imprecise results. The needle has to be kept to zero before its use. The accurate
results are possible by frequent calibrations.

3. Digital Sphygmomanometer
When you want to measure the blood pressure at your home effortlessly, the diastolic and
systolic blood pressure, the digital sphygmomanometer comes out to be handy without
preparations. You just need to connect the node of the rubber inside the hole of the monitor
and cloak the cuff around your upper arm, as you click on the button, it would evaluate your
bp and heart rate by means of oscillometric detection. The monitor has an audio device inbuilt
to tell you the results in accordance with the WHO standards. The best part of having such a
device is, it is portable and has expediency, it can be charged and we can also see the average
results.
Precautions

1. Aneroid and digital manometers may require periodic calibration.

2. Use a larger cuff on obese or heavily muscled subjects.
3. Use a smaller cuff for pediatric patients.
4. For pediatric patients a lower blood pressure may indicate the presence of hypertension.
5. Don't place the cuff over clothing.
6. Flex and support the subject's arm.
B.Sc. (Hons) Zoology Prof. Anita Kamra Verma
Life Sustaining Systems
Sem IV
Q.1.What is Blood pressure?
Blood pressure is the force of blood against the arteries. The reading of blood pleasure is
given by two numbers- systolic pressure and the diastolic pressure.

Q.2.What is Systolic Blood Pressure?

The amount of pressure exerted on the arteries and blood vessels is called Systolic Blood
Pressure. The systolic Blood Pressure increases with the individual’s age. The normal range
of systolic blood pressure should be 90 – 120 mm Hg.

Q.3.What is Diastolic blood pressure?

The amount of pressure exerted on the walls of the arteries is called diastolic Blood Pressure.
The diastolic Blood Pressure decreases with the individual’s age. The normal range of
diastolic blood pressure should be 60 – 80 mm Hg.

Q.4.What is Hypotension?
Hypotension is also called as low blood pressure. It is the sign of an underlying disease,
where the reading on the sphygmomanometer falls below 90/60 mm Hg- 90 mm Hg systolic
or 60 mm Hg diastolic.

Q.5.What is Hypertension?
Hypertension is also called as high blood pressure. It is a serious, chronic health problem
related to the rise in the blood pressure, where the reading on the sphygmomanometer
raises more than 140/90 mm Hg- 140 mm Hg systolic or 90 mm Hg diastolic.