Meaning of the Pulse:
The ventricles pump blood into the articles regularly about 70 to 80 times a minutes. The force of the ventricular contraction starts a wave of increased pressure which begins at the heart and travels along the arteries. This wave is called the pulse. It can be felt in the arteries that are relatively close to the surface, particularly if the vessel can be pressed down against a bone.
At the wrist the radial artery passes over the bone on the thumb side of the forearm, and the pulse is most commonly obtained there. Other vessels sometimes used for obtaining the pulse include the carotid artery in the neck and the dorsalis pedis on the top of the foot.
Normally, the pulse rate is the same as the heart rate. Only if a heartbeat is abnormally weak, or if the artery is obstructed, may the beat not be detected as a pulse. In checking the pulse of another person, it is important to use the second or third fingers. If you use your thumb, you may find that you are getting your own pulse. When taking a pulse, it is important to gauge the strength as well as the regularity and the rate.
Various factors may influence the pulse rate.
Just a few are enumerated below:
1. The pulse is somewhat faster in smaller people and usually is slightly faster in women than men.
2. In a newborn infant the rate may be from 120 to 140 beats per minute. As the child grows, the rate tends to become slower.
3. Muscular activity influences the pulse rate. During sleep the pulse may slow down to 60 a minute. While during strenuous exercise the rate may go up to well over 100 a minute. If a person is in good condition, the pulse does not remain rapid despite a continuation of exercise.
4. Emotional disturbances may increase the pulse rate.
5. In many infections, the pulse rate increases with the increase in temperature.
6. An excessive amount of secretion from the thyroid gland may cause a rapid pulse. The pulse rate may serve as a partial guide for the person who must take thyroid extract.
Blood pressure and its determination.
Since the pressure inside the blood vessels varies with the condition of the heart and the arteries as well as with other factors, the measurement of blood pressure together with careful interpretation may prove a valuable guide in the care and evaluation of a person’s health. The pressure decreases as the blood flows from the arteries into capillaries and finally into veins. Ordinarily, measurements are made of arterial pressure only. The instrument used is called a sphygmomanometer (sfig-mo-mah-nom-e-ter).
The two measurements made are of:
1. The systolic pressure, which occurs during heart muscle contraction and averages around 120, expressed in millimeters of mercury (mm hg).
2. The diastolic pressure, which occur during relaxation of the heart muscle and averages around 80 mm hg.
The sphygmomanometer is essentially a graduated column of mercury connected to an inflatable cuff. The cuff is wrapped around the patient’s upper arm and is inflated with air until the brachial artery is compressed and the blood flow cut off. Then, listening with a stethoscope, the doctor or nurse slowly lets air out of the cuff until the cuff is equal to the systolic pressure; and this pressure is read off the mercury column. Then, more air is let out until a characteristic muffled sound indicates the point at which the diastolic pressure is to be read. Considerable practice is required to insure an accurate reading.
Abnormal blood pressure
Lower than normal blood pressure is called hypotension (hi-po-ten-shun). However, they are variations in normal pressure levels, and what be a low pressure for one person might be a normal or even a high pressure for some one else.
For this reason, hypotension is best evaluated in terms of how well the body tissues are being supplied with blood. For instance, a person whose systolic pressure is consistently below his normal range may experience episodes of fainting because of inadequate blood flow to the brain. The sudden lowering of blood pressure below a person’s normal level is one symptom of shock. It may occur also in certain chronic diseases as well as in heart block.
Hypertension (hi-per-ten-shun), which is high blood pressure, has received a great deal of attention. Often it occurs temporarily as a result of excitement of conditions including the following:
1. Kidney disease and uremia or other toxic conditions.
2. Endocrine disorders such as hyperthyroidism and acromegaly.
3. Artery disease including the so-called hardening of the artery wall.
4. Tumors of the central potion of the adrenal (suprarenal) gland.
Hypertension that has no apparent medical cause is called essential hypertension. This condition is fairly common and is seen as a cause of strokes, heart failure or kidney damage. Treatment is begun with young patients when the diastolic pressure is over 90mm hg.
An excess of a hormone produced in the kidney called rennin seems to play a role in the severity of this kind of hypertension. Drugs may be given to block excessive rennin production and to prevent fluid retention. General health measures such as weight control and avoidance of alcohol and cigarette consumption plus adequate exercise are all beneficial.
Although stress has been placed on the systolic blood pressure, in many cases the diastolic blood pressure, is even more important. The condition of small arteries may have more effect on the diastolic pressure at any rate. The determination of what really constitutes hypertension depends on each person normal range. As previously noted, a pressure that is normal for one individual may be abnormal for another.
Causes and risk factors.
The cause is generally unknown, but the risk of the development of hypertension increases with stress, smoking, obesity, a high salt, high saturated fat diet and the lack of exercise and fitness. Also there are hereditary factors in many cases. Preventative measures include avoidance of the risk factors outlined above.
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