1、Biology 2021: Human Anatomy and Physiology Lab Guide 4. Human Cardiovascular Physiology-Auscultating Heart Sounds; Heart Sounds (Biopac Lesson 17); and Blood Pressure (Biopac Lesson 16) Objectives: 1. To define systole, diastole, cardiac cycle, pulse, pulse deficit, blood pressure, and Korotkoff sou
2、nds. 2. To indicate the normal length of the cardiac cycle, the relative pressure changes occurring within the atria and ventricles during the cardiac cycle, and the timing of valve closure. 3. To use the stethoscope to auscultate the heart sounds and to relate heart sounds to cardiac cycle events.
3、4. To describe the clinical significance of heart sounds and murmurs. 5. To demonstrate the thoracic locations where the first and second heart sounds are most accurately auscultated. 6. To determine a subjects blood pressure with a sphygmomanometer and relate it to events of the cardiac cycle. 7. T
4、o use Biopac to record ECG, heart sounds, and blood pressure 8. To relate measures of hemodynamics to circulatory system health and fitness Exercise 33A: Human Cardiovascular Physiology-Blood Pressure and Pulse Determinations Activity 1: Auscultating Heart Sounds, pp. 333-346 The term heart sounds r
5、efers to the sounds made by the closing of the atrioventricular (AV) and semilunar (SL) valves of the heart, lub and dup, respectively. Refer to figure 33A.1a, p. 334, in your lab manual (or figure 18.20, p. 697, in the text) to see the points in the cardiac cycle when the heart sounds occur. Abnorm
6、al heart sounds are called murmurs and often indicate problems with a heart valve. Your lab instructor will demonstrate the procedure for auscultating heart sounds. Then, find an agreeable male subject in the lab to allow you to auscultate his heart. Female lab partners may wish to auscultate each o
7、thers heart sounds in the privacy of the womens lavatory in the atrium portion of the building. Estimate the time intervals between the first and second heart sounds and the second and first. Relocate the stethoscope to the various locations on the thorax illustrated in Figure 33A.2, p. 336, to ausc
8、ultate the individual valves. Biopac Lesson 17: Heart Sounds Open the Biopac program and select L017-HS-1. The procedure is very similar to the ECG lab except a stethoscope will be recording heart sounds at the same time as the ECG is being recorded. The stethoscope monitors the vibrations (sounds)
9、caused by the closing of the AV and SL valves during the cardiac cycle. You will collect data for each of the four valves by placing the stethoscope on four different thoracic locations. These are the steps you will take: 1. Setup Attach the ECG electrodes as illustrated in the posters at the comput
10、er stations. The transducers are already plugged in and ready to go. Click on the Biopac icon on the computer desktop to start Biopac. A menu of Lessons will appear. Select Lesson 17: Heart Sounds (L017-HS-1). Type in your (folder) name. If you have a folder on this computer station, a window should
11、 appear with the message “A folder with this name already exists. Would you like to use it or create a new folder?“ Choose Use it. 2. Calibration Click on Calibrate to test the transducers. Read the prompt and click on OK. One person in the group should lightly tap the stethoscope diaphragm twice. W
12、hen the calibration is completed you should see two “sound recordings“ in Channel 3 and a typical ECG recorded on channel 4. If the calibration looks good, then proceed to Step 3 (Record). If the calibration looks wrong, click Redo. 3. Record data In this procedure one person in the lab group will a
13、ssist the subject in placing the stethoscope in the four different locations illustrated on the posters in lab corresponding to the Aortic (A), Pulmonary (P), Tricuspid (T), and Mitral (M) valves and then listen to the heart sounds and describe them to a second assistant. The second assistant will t
14、ype the first assistants description of the heart sounds into the pop up box which will appear by clicking on the Note Sounds button at the upper left of the screen. Click Record to collect heart sounds data for the four positions. If the recording is not good click on Redo to repeat it. When you ha
15、ve successfully collected the heart sounds data for each valve, click Done to proceed to data analysis. A dialogue box will appear and ask if you are sure you have completed the data recording. Choose Yes. At this point a menu box will appear and ask “What would you like to do now?“ You may proceed
16、to analyze the data you just collected by choosing “Analyze Current Data File“ or if you want to collect the data for all the members in your group first, you can choose “Record from Another Subject“ and repeat #3. 4. Data Analysis If you did not proceed directly to “Analyze Current Data File“ from
17、step 3 you will start Biopac and select Review Saved Data from the Lessons menu. Open your folder in the “Data Files“ folder, and then open the lesson 17 data file you created earlier. Recall that channel 3 refers to the stethoscope data and channel 4 to the ECG recording.Select CH4 (ECG) as the fir
18、st measurement box and select delta T from the drop down menu as the measurement to be made in that box. Select Channel 3 (Stethoscope) as the second measurement box and select delta T as the measurement to be made in that box. Use the magnifying glass tool to zoom 4-5 cardiac cycles into view. Use
19、the I-beam to highlight from the peak of an R-wave to the 1st heart sound. Paste this measurement into your journal and annotate this measurement as the “delay between R-wave and first heart sound.“ Using the same measurement box settings, highlight the interval from the peak of the T-wave to the 2n
20、d heart sound. Paste this measurement into your journal and annotate it as the “delay between T-wave and second heart sound.“ Print a representative section (3 or 4 cardiac cycles) of your heart sounds and ECG chart and attach it to your lab report. Print your data journal and attach it as well. Les
21、son 17-Heart Sounds File name: students name Thursday, January 30, 2003 02:24:26 PM First recording segment: Recorded heart sounds while subject is sitting up, in a relaxed state. Notes for Aortic position (A in figure): faint delay from r wave to first heart sound deltaT(3) = 0.11000 sec deltaT(4)
22、= 0.11000 sec delay from t wave to second heart sound deltaT(3) = 0.14000 sec deltaT(4) = 0.14000 sec Notes for Pulmonic position (P in figure): faint delay from r wave to first heart sound deltaT(3) = 0.16000 sec deltaT(4) = 0.16000 sec delay from t wave to second heart sound deltaT(3) = 0.12000 se
23、c deltaT(4) = 0.12000 sec Notes for Tricuspid position (T in figure): louder delay from r wave to first heart sound deltaT(3) = 0.09000 sec deltaT(4) = 0.09000 sec delay from t wave to second heart sound deltaT(3) = 0.11000 sec deltaT(4) = 0.11000 sec Notes for Mitral position (M in figure): louder
24、delay from r wave to first heart sound deltaT(3) = 0.07000 sec deltaT(4) = 0.07000 sec delay from t wave to second heart sound deltaT(3) = 0.13000 sec deltaT(4) = 0.13000 sec Second recording segment: Record heart sounds while subject is sitting up, recovering from moderate exerciseWe will skip the
25、second recording segment.Label P, QRS, and T waves on your ECG and Heart sound 1 and Heart sound 2 on the printed graph with the stethoscope recording. On the back of your graph describe the mechanical events to which each of these labeled events correspond. Refer to Figure 33A.1, p. 334, in you lab
26、 manual for a reference that summarizes the events occurring in the heart during the cardiac cycle.Activity 2: Palpating Superficial Pulse Points Palpate on your lab partner the superficial pulse points illustrated in figure 33A.3, p. 337, of your lab manual with the possible exception of the femora
27、l artery in the groin.Activity 3: Measuring the Pulse Using a Plethysmograph and Biopac Skip: We did this last week. Activity 4: Taking Apical PulseAs described in lab manual. Apical pulse, the actual number of heart beats determined by auscultation at the apex of the heart, can be compared to radia
28、l pulse, the number of heart beats determined by palpation of the radial artery, to determine a pulse deficit. Large pulse deficits may indicate that the heart is pumping with insufficient force to push blood into the arterial tree where it can be palpated. Record the 3 results (apical pulse, radial
29、 pulse, and pulse deficit) in your lab manual and write them in on the Data Journal printout from L017-HS-1. Activity 5: Using a Sphygmomanometer to Measure Arterial Blood Pressure Indirectly Biopac Lesson 16: Blood Pressure Open the Biopac program and select L016-BP-1. The procedure is very similar
30、 to the Lesson 17 above except a sphygmomanometer will be recording blood pressure at the same time as the ECG and Korotkoff sounds are being recorded. Korotkoff sounds - There are five sounds which are heard as the blood pressure in the sphygmomanometer cuff is released during the measurement of ar
31、terial pressure; these are described as: Korotkoff I is a sharp thud Korotkoff II is a loud blowing sound Korotkoff III is a soft thud Korotkoff IV is a soft blowing sound Korotkoff V is silenceThe Biopac program will display ECG, blood pressure, and the Korotkoff sounds simultaneously to help you b
32、etter understand the anatomical and physiological basis of blood pressure measurement. See pp. 339-340 of the lab manual for additional explanation of blood pressure measurement using a sphygmomanometer. Identify the components of the sphygmomanometer used to determine blood pressure: pressure cuff,
33、 pressure gauge, inflation bulb, adjustment screw. Define: systolic pressure, diastolic pressure, pulse pressure, and Korotkoff sounds. These are the steps to follow in Biopac: 1. Setup Attach the ECG electrodes as illustrated in the posters at the computer stations. Keep these electrodes attached u
34、ntil you have completed the second Biopac experiment. The transducers are already plugged in and ready to go. Click on the Biopac icon on the computer desktop to start Biopac. A menu of Lessons will appear. Select Lesson 16: Blood Pressure (L016-BP-1). Type in your (folder) name. If you have a folde
35、r on this computer station a window should appear with the message “A folder with this name already exists. Would you like to use it or create a new folder?“ Choose Use it. 2. Calibration Fold the cuff on itself with the velcro seal made and lay it on the counter. Click on Calibrate to test the tran
36、sducers. Inflate the cuff to 100 mm Hg. Read the prompt and click on OK. When prompted, deflate the cuff to 40 mm Hg. Read the prompt and click on OK. When you click OK the calibration recording will begin. One person in the group should lightly tap the stethoscope diaphragm twice. When the calibrat
37、ion is completed you should see a constant 40 mm Hg pressure recorded on channel 1 (red line), two “sound recordings“ in Channel 3 (green line), and a typical ECG recorded on channel 4 (blue line). If the calibration looks good, then proceed to Step 3 (Record). If the calibration looks wrong, click
38、Redo. 3. Record data In this procedure one person in the lab group will assist the subject in placing the pressure cuff and stethoscope and will listen for the Korotkoff sounds. A second assistant will work on the computer to run the Biopac program. This Biopac program is set up to expect two measur
39、ements from the left arm while sitting up, two measurements from the right arm while sitting up, two measurements from the left arm while lying down, and two measurements from the right arm after exercise. First deflate the blood pressure cuff completely. Place it on the subjects arm. To save time,
40、we will only do one measurement on the left arm while sitting up, one measurement on the right arm while sitting up, and one measurement from the right arm after exercise. (You may do all of the steps if you like, but they are not required.) To make the program “think“ you are following the expected
41、 protocol, do the following:Remember, if any part of the recording is not good you can click on Redo to repeat it. Click on Record to collect the blood pressure on the left arm while sitting up. Click on Resume and Suspend for the second recording. Switch the pressure cuff to the left arm and click
42、on Resume to collect the blood pressure data for the right arm while sitting up. Click on Suspend when you have completed this measurement. Click on Resume and Suspend two more times to fool the program into “thinking“ you have done all but the last step. Click on Resume one more time and then click
43、 on Done to proceed to data analysis. A dialogue box will appear and ask if you are sure you have completed the data recording. Choose Yes. At this point a menu box will appear and ask “What would you like to do now?“ You may proceed to analyze the data you just collected by choosing “Analyze Curren
44、t Data File“ or, if you want to collect the data for all the members in your group first, you can choose “Record from Another Subject“ and repeat #3. 4. Data Analysis If you did not proceed directly to “Analyze Current Data File“ from step 3 you will start Biopac and select Review Saved Data from th
45、e Lessons menu. Open your folder in the “Data Files“ folder, and then open the lesson 16 data file you created earlier (L016-BP-1). Recall that channel 1 refers to cuff pressure, channel 3 refers to the stethoscope data, and channel 4 to the ECG recording.Select CH1 (Cuff Pressure) as the first meas
46、urement box and select MAX as the measurement to be made in that box. Select CH1 (Cuff Pressure) as the second measurement box and select MIN as the measurement to be made in that box. Select CH4 (ECG) as the third measurement box and select BPM as the measurement to be made in that box. Use the mag
47、nifying glass tool to zoom the portion of the graph from just before the first Korotkoff sound to just after the last Korotkoff sound into view. Select the Select the I-Beam measurement button and highlight the interval on the graph from the first to the last Korotkoff sound. Paste these measurement
48、s of the heart rate during the blood pressure measurement into your journal and annotate as needed. Example: Lesson 16-Indirect Blood Pressure File name: students name Thursday, January 30, 2003 02:30:22 PM First procedure: Subject has cuff on LEFT arm, and is sitting up at rest. Max(1) = 117.65024
49、mmHg Min(1) = 82.73907 mmHg BPM(4) = 15.36098 BPM Second procedure: Repeat of the first procedure on right arm, sitting at rest. Print the graph in landscape format of your blood pressure for the left arm while sitting. Print your data journal and attach it as well. Label P, QRS, and T waves on your ECG and the first and last Korotkoff sounds on the graph. Report the blood pressure measurements for this graph (systolic/diastolic)
