# CV LAB Circulation in Human Subjects

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2 Blood Pressure Measurements Systolic/Diastolic Pulse Pressure at Pressures Rate which oscillation (mm Hg) (per min) begins (mm Hg) Comparison of methods Auscultatory 1 / Auscultatory 2 / Auscultatory 3 / Mean / Palpatory 1 Palpatory 2 Palpatory 3 Mean Body positions Supine 1 / Supine 2 / Supine 3 / Mean / Standing 1 / Standing 2 / Standing 3 / Standing 4 / Mean (2,3,4) /

3 4. Effects of Exercise on Blood Pressure and Pulse Rate: (One subject per table). After measurement of blood pressure and pulse rate in the control state (quiet standing), the subject performs 30 deep knee bends in 30 seconds, with the blood pressure cuff wrapped around his upper arm but disconnected from the manometer. Immediately at the end of the exercise, connect the cuff to the manometer, and determine blood pressure and pulse rate as soon as possible. Repeat these measurements (Note the time of measurement) until the values return to control levels. Using the control data and the first measurement obtained immediately after exercise, calculate the effects of exercise on stroke volume, cardiac output and total peripheral resistance by using the following assumptions: (a) the control cardiac index (cardiac output per unit body surface area) is 3.3 L/min/m 2, (b) the effect of exercise on stroke volume is proportional to its effect on pulse pressure, and (c) the mean arterial pressure equals [diastolic pressure + (pulse pressure/3)]. Calculation of Cardiac Output, Stroke Volume and Total Peripheral Resistance Control Exercise Measured Data Systolic pressure (SP, mm Hg) Diastolic pressure (DP, mm Hg) Pulse rate (HR, per min) Body surface area 1 (SA,M 2 : estimate from hgt./wt.) Calculated results Pulse pressure (PP = SP-DP, mm HG) Control cardiac output (CO c = 3.3 SA, L/min) Control stroke volume (SV c = CO c /HR c, ml) Exercise Stroke volume (SV E = SV c x PP E /PP c, ml) Exercise Cardiac output (CO E = SV E x HR E, L/min) Mean Arterial Pressure [MAP = DP + (PP/3), mm Hg] Total peripheral resistance (TPR=MAP/CO, mm Hg-sec/ml) Hemodynamic Effects of Exercise (percent of control): 100 HR E /HR c = % 100 SV E /SV c = % 100 CO E /CO c = % 100 MAP E /MAP c = % 100 TPR E /TPR c = % 1 Surface Area (cm 2 ) = Wt X Ht X Weight (Wt) is in kilograms, and height (Ht) is in centimeters. From DuBois and DuBois. Arch. Internal. Med. 17:865, 1916

4 Part II: Cold pressor test: Record blood pressure and pulse rate from right arm to 1 min intervals until a stable reading is obtained. Continue the recording and perform the cold pressure test by placing left hand and lower forearm in a basin containing equal parts of water and ice for 2 min. After removal of the hand from the basin, continue the recording for 3 more min. What is the effect of cold pressure test on blood pressure and heart rate? Control 1 min (in ice) 2 min (in ice) 3 min 4 min 5 min Blood Pressure (systolic/diastolic ) Pulse Rate (/min) Part III: Study of Skin 1.The Red Reaction. Draw a blunt instrument firmly across the forearm. The lighter flush of an arteriolar flare may be seen peripheral to the red reaction. 2.The Triple Response. Draw a blunt instrument 6 to 7 times over the same area of the skin. Look for local vasodilation, the flare, and local edema. 3.Veins. Examine the veins of the hand and then allow the hands to hang at the side. Note the size of the veins. What is the effect on the veins of opening and closing the fist several times? Raise the hand slowly from the subject s side. At what level do the veins collapse? What is the effect on the veins of the forearm and hand of applying a blood pressure cuff to the arm inflated to a pressure of 40 mm Hg for 3 to 5 minutes?

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