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Blood pressure is the pressure that the blood exerts against the walls of the arteries as it passes through them. Pulse refers to the periodic ejection of blood from the heart's left ventricle into the aorta. The left ventricle, or chamber, receives blood from the left atrium, another of the heart's chambers. By contracting, the left ventricle drives the blood into the aorta, a central artery through which blood is relayed into the arteries of all limbs and organs except the lungs. Pulse, transmitted though the arteries as a repeated pressure wave, is the mechanism that moves blood through the body.

The high and low points of this pressure wave are measured with the sphygmomanometer, or blood pressure monitor, and are expressed numerically in millimeters of mercury. The higher number, systolic pressure, measures the maximum pressure exerted on arteries and the heart muscle; the lower figure, diastolic pressure, measures the minimum pressure exerted. The reading of the two measurements indicates how hard the human system is working. All physicians consider a patient's blood pressure when determining general health or diagnosing disease.

The blood pressure monitor is used in conjunction with a stethoscope. After fastening the constricting band, or cuff, around one of the patient's arms above the elbow, the clinician inflates the cuff by pumping air into it with a rubber squeeze bulb until the mercury column or the needle of the gauge (also known as an aneroid dial) stops moving, usually at a point between 150 and 200 millimeters of mercury. The stethoscope is then placed over the brachial artery, on the inside of the arm at the elbow, while air is slowly released from the system via a small valve attached to the bulb. The technician watches carefully as the air escapes and the pressure indicator correspondingly declines. The point on the gauge at which the pulse can first be heard through the stethoscope indicates systolic pressure, and the gauge's reading when the sound disappears indicates diastolic pressure. Normal pressures vary with the individual, but systolic pressure typically ranges between 110 and 140, while diastolic runs from 65 to 80. Pressure above normal levels predisposes the patient to such health problems as heart disease, stroke, and kidney failure.

Many early attempts at measuring blood pressure involved attaching an instrument directly to one of the patient's arteries, a painful and dangerous practice. The first sphygmomanometer to use an inflated armband was developed in 1876 by Samuel Siegfried von Basch. Twenty years later, the Italian physician Scipione Riva-Rocci developed a more accurate device that soon replaced von Basch's instrument. Riva-Rocci's design was much like today's monitor, but its operating procedure allowed for measuring blood pressure only while the heart was contracted. In 1905, the measurement procedure was further refined by Nikolai Korotkoff, who added the use of a stethoscope to detect pulse rate, thereby enabling doctors to measure blood pressure while the heart was relaxed as well. Korotkoff suspected that both pressure readings were important, and today we realize that certain indications, such as a rise in the systolic with a stable or falling diastolic pressure, may suggest brain damage.

Source: www.encyclopedia.com
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