Sphygmomanometer
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2008-07-16T13:27:25Z
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[[Image:BloodPressure.jpg|thumb|BP 126/70 [[mmHg]] as result on electronic sphygmomanometer]]
A '''sphygmomanometer''' ({{pron-en|ˌsfɪgmoʊməˈnɒmɪtər}}<ref>{{cite web |url=http://dictionary.reference.com/browse/sphygmomanometer |title=sphygmomanometer |work=Dictionary.com Unabridged (v 1.1) |publisher=[[Random House|Random House, Inc]] |accessdate=2008-06-20}}</ref>) or '''blood pressure meter''' is a device used to measure [[blood pressure]], comprising an inflatable [[cuff]] to restrict blood flow, and a [[mercury (element)|mercury]] or mechanical [[manometer]] to measure the pressure. It is always used in conjunction with a means to determine at what pressure blood flow is just starting, and at what pressure it is unimpeded. Manual sphygmomanometers are used in conjunction with a [[stethoscope]].
The word comes from the [[Greek language|Greek]] ''sphygmós'' (pulse), plus the scientific term [[manometer]] (pressure meter). The device was invented by [[Samuel Siegfried Karl Ritter von Basch]]. [[Scipione Riva-Rocci]], an [[Italy|Italian]] [[physician]], introduced a more easily used version in [[1896]]. [[Harvey Williams Cushing|Harvey Cushing]] discovered this device in 1901 and popularised it.
A sphygmomanometer usually consists of an inflatable cuff, a measuring unit (the [[mercury manometer]]), a tube to connect the two, and (in models that don't inflate automatically) an inflation bulb also connected by a tube to the cuff. The inflation bulb contains a one-way valve to prevent inadvertent leak of pressure while there is an adjustable screw valve for the operator to allow the pressure in the system to drop in a controlled manner.
==Operation==
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The cuff is normally placed around the upper right [[arm]], at roughly the same vertical height as the [[heart]] while the subject seated with the arm supported. The cuff is inflated until the [[artery]] is completely [[occlusion|occluded]]. Listening with a [[stethoscope]] to the [[brachial artery]] at the [[Elbow-joint|elbow]], the examiner slowly releases the pressure in the cuff. As the pressure in the cuffs falls, a "whooshing" or pounding sound is heard (see [[Korotkoff sounds]]) when bloodflow first starts again in the artery. The pressure at which this sound began is noted and recorded as the [[systolic blood pressure]]. The cuff pressure is further released until the sound can no longer be heard and this is recorded as the [[diastolic blood pressure]].
==Significance==
By observing the mercury in the column while releasing the air pressure with a control valve, one can read on the scale the values of the blood pressure in mm Hg. The peak pressure in the arteries during the [[cardiac cycle]] is the systolic pressure, and the lowest pressure (at the resting phase of the cardiac cycle) is the diastolic pressure. A stethoscope is used in the auscultatory method. Systolic pressure ( first phase) is identified with the first of the continuous Korotkoff sounds. Diastolic is identified at the moment the Korotkoff sounds disappear (fifth phase).
==Types==
[[Image:Sphygmomanometer.jpg|300px|Mechanical sphygmomanometer with aneroid manometer and stethoscope|thumb|Conventional (mechanical) sphygmomanometer with aneroid manometer and stethoscope]]
Blood pressure meters can be divided in several types:
* [[Digital]] non-portable with manual or automatic inflation. These are electronic, easy to operate and practical in noisy environments. Many have not been validated for all patient groups, and can give very inaccurate readings).They measure [[mean arterial pressure]], MAP, and use algorithms to calculate systolic and diastolic values. In this sense, they do not actually measure the blood pressure, but derive the readings. Digital oscillometric monitors are also confronted with “special conditions” for which they are not designed to be used : [[arteriosclerosis]], [[arrhythmia]], [[preeclampsia]], ''[[pulsus alternans]]'', and ''[[pulsus paradoxus]]''.
* Digital portable [[wrist]] blood pressure monitors with automatic inflation. These are more convenient for travel purposes.<ref>[http://seniorhealth.about.com/cs/healthproducts/tp/BP%20Monitors.htm Wrist blood pressure monitors]</ref>
* Digital portable [[finger]] blood pressure monitors with automatic inflation. Again these too are more portable and easy to operate. They are noted as being the smallest blood pressure monitors around.<ref>[http://seniorhealth.about.com/cs/healthproducts/tp/BP%20Monitors.htm Finger blood pressure monitors]</ref><ref>[http://www.thefreelibrary.com/World's+smallest+blood+pressure+monitor%3B+goes+where+you+go,+lets+your...-a018990857 Finger blood pressure monitor easiest for on the road]</ref>
* [[Manual]] (older fashioned, though more precise). Must be operated by a trained person. Mercury manometers are considered to be the "gold standard" of measurement because they do not go out of calibration. For this reason they are often required in clinical trials of pharmaceuticals and for clinical evaluations of determining blood pressure for high risk patients including pregnant women. [[Aneroid]], mechanical, types are in common use, but should be checked against a mercury manometer if they are suspected to be out of calibration.
[[Image:Clinical Mercury Manometer.jpg]]
==Patents==
{{Commonscat}}
* {{US patent|2560237}} : R. H. Miller : "''Sphygmomanometer''"
* {{US patent|6752764}}: Man S. Oh: "''Pocket sphygmomanometer''"
==References==
<references />
[[Category:Medical equipment]]
[[Category:Pressure gauges]]
[[Category:Physiological instruments]]
[[Category:Blood pressure]]
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