Anatomy and Physiology (Lab)

Shane Valerie C. Diez

THE PULSE AND BLOOD PRESSURE Different Sites of Pulse

A. THE PULSE
• For every blood ejected from LV is
subjected to great pressure
• Between ejections, blood pressure is
lowered, arterial walls bounce back to
the original diameter
• Pressure waves is also called pulse
Pulse
• is used to determine about the
function of CVS
• High pressure of the blood ejected
from the heart.
o When the ventricles contract
the blood goes to the aorta
(High in pressure, b/c largest
artery) you can feel the pulse B. BLOOD PRESSURE
pounding on the surface of the • Force that keeps the blood circulating
body continuously even between heartbeat
• Blood flow that is in high pressure that • Measure of the forced blood exerted
bunces back on the surface of the against the walls of blood vessel
artery that is close to the body • Measured for an artery in the arm at
• Rhythmic bulging of artery walls with the same height as the heart
each heartbeat • Gravity has a significant effect on blood
Pulse Rate – count the waves per minute
pressure
How to determine:
• Blood pressure for a healthy 20-yearl
o Place your 2nd and 3rd finger on the
old human at rest is about 120
anterior surface of the wrist, where
mmHg/70 mmHg
the radial artery passes over the
BLOOD PRESSURE GRADIENT
distal end of radius
o Count the beats you feel in 15
seconds. Multiply this number by 4
to get your heart rate. For instance,
20 beats in 15 seconds equals a
heart rate of 80 beats per minute
(bpm)
Pulse Strength – can be assessed by receptors
in your fingertips

Note:
c
Normal pulse rate is 60-100 per minute • The flow of the blood from high
concentration to low concentration
• By the time it reaches the vena cava the
pressure will almost be 0
 Anatomy and Physiology (Lab)
Shane Valerie C. Diez

SPHYGMOMANOMETER

2 types of pressure
• Systolic Pressure
- Peak of ventricular contraction
- Always higher than diastolic
• Diastolic Pressure
- When the ventricles are relaxed

Note:
Blood pressure for a healthy 20-year-
old human at rest is about 120 mmHg at systole
and 70 mmHg at diastole 1. Cuff – should cover 80% of the arm
• Too small = falsely blood high
Millimeter of Mercury pressure reading
• Measure of the pressure of the body • Too Big = falsely low blood
fluids in units pressure reading
Sphygmomanometer 2. Pressure gauge – where we read
• A manometer with an air cuff attached systolic and diastolic pressure
to the reservoir 3. Pressure gauge holder
• Used to indirectly measure the 4. Tubes
changing blood pressure associated 5. Valve – before taking BP make sure the
with the pulse valve is close
• Close the valve – turn clockwise
Korotkoff Sound • Release the valve – counter
• Caused by the pulsing of BP against the clockwise
wall of the artery 6. Inflation Valve – used to inflate the cuff
• When the blood starts to flow to the STETHOSCOPE
brachial artery
• Systolic Pressure- first sound; highest
pressure in the arteries
• Diastolic Pressure – when the sounds
disappear; lower than systolic pressure
• systolic over diastolic
(120mmHg/80mmHg)

1. Chest-piece
a. Bell
b. Diaphragm
2. Tubing
3. Earpiece
 Anatomy and Physiology (Lab)
Shane Valerie C. Diez

Parasympathetic NS • Medications
• Little to no effect on blood pressure o Caffeine may increase or
Sympathetic to NS decrease
BP
• Fight or flight response o Epinephrine- increase BP
• Have effect on BP increase HR
• Because if activated it leads to o Nicotine lead to
vasoconstriction vasoconstriction
Vasoconstriction • Obesity
• Contraction of smooth muscle in the o Predispose to hypertension
• Diurnal variations
arteriole wall
o BP is lowest early in AM,
• Narrowing of blood vessels rises in the day peaks in late
• Increases BP PM or early evening
Vasodilation • Disease process
• Relaxation of smooth muscles in the
arteriole wall
Note:
• Causes BP to flow
mmHg – millimeter of mercury

Factors Affecting Blood Pressure

• Age
o Pressure rises with age,
reaching at peak at onset of
puberty
o In elders, elasticity of
arteries decreases,
increases BP
• Exercise
o Increase cardiac output,
increase BP
o 20-30 mins rest is needed
• Stress
o Stimulation of the SNS (fight
or flight response) increases
CO and vasoconstriction thus
increase
BP
o Severe pain decreases BP
(inhibits vasomotor center
and produces vasodilation)
• Race
o African American males have
higher BP (35 y/o and above)
• Gender
o After puberty, females have
lower BP than males (hormonal
variations)
o After menopause, women
generally have higher BP
 Anatomy and Physiology (Lab)
Shane Valerie C. Diez

URINALYSIS • Urine is mostly water and some organic

Urinary System waste products, as well as excess ions
• major excretory system of the body
• consists of two kidneys, two ureters, Three major processes of urine formation:
the urinary bladder, and the urethra
• kidneys – primary excretory organs
• each kidney’s waste products are
carried by a ureter to a single
urinary bladder
• the waste is emptied from the
urinary bladder by the urethra
• Urine consists of: (1) excess water,
(2) excess ions, (3) metabolic
wastes, and (4) toxic substances
• The kidneys can suffer extensive
damage and still maintain
homeostasis
• The major function of the urinary
system is excretion or elimination,
which controls the composition and
volume of body fluids
1. Glomerular Filtration
URINALYSIS • Happens in Glomerulus
• Testing of urine for properties of it • Glomerulus: Filter or Strainer
• Examination of urine and its contents • Nonselective or passive process
• Part of routine examination • Filtrate – called after it passes
through glomerular filtration
URINE FORMATION - Blood plasma without blood
Kidneys (nephrons) proteins and blood cells
↓ NOTE:
Glomerulus
In urine sample you should not found
(toxins in the blood are first filtered here)
blood proteins or blood cells if there is, it should
↓
Tubular reabsorption only have trace amounts.
(not all toxic material is excreted) Kidney problem – if there is large
↓ amount of blood protein or blood clells
Tubular excretion
(excrete things that are not needed) 30ml of urine – produce at minimum in an hour
↓ 720ml of urine – in 24 hours
Formation of urine Oliguria - Abnormally low urine output (100ml
per day)
• sorts the substances from the blood for Anuria – less than 100ml per day; absence of
either removal in the urine or return to the urine output
blood
 Anatomy and Physiology (Lab)
Shane Valerie C. Diez

NOTE: • Pale straw color – Diluted;

As long as systemic blood pressure is normal normal color
filtrate is continuously produced because our • Reddish – the food that we take
kidneys are being perfused but if you are • Yellow – presence of urochrome
hypotensive that is when filtrates stops (BP (pigment of RBC breakdown)
• Yellow-brown to
drops)
greenish - high concentration of
bile pigments ; can indicate liver
2. Tubular reabsorption
disfunction
• Kidney eliminate waste and excess ions • Red-to-dark-brown color -
(potassium, hydrogen ions) but not all presence of blood
are eliminated • Hematuria -bloody urine
• But there is also important substance (common cause: due to stones or
that the kidney have to reabsorb which calculi as they pass through the
our body needs urinary system)
- Amino acid, water, glucose and 10- TEST STRIP TEST FOR THE FOLLWING
important ions – substances needed COMPONENTS:
by our body needs
1. Leukocyte
• Tubular Reabsorption happens in the - occasional WBCs are
proximal convoluted tubule normal
3. Tubular Secretion - High WBC = infection
• Remove substances that are not 2. Nitrite
needed by our body - Positive indicates the presence
o Urea, creatinine, uric acid, of large amounts of bacteria
ammonia, potassium ions (99% - Useful if one has a cloudy
are excreted in the urine), urine sample
- Helpful if you don’t have a
• Substances include by-products of
microscope
metabolism that become toxic in high 3. Urobilinogen
concentrations and drugs or other - Derivative of biliburin
molecules not normally produced by - High levels of urobilinogen
the body may indicate excessive RBC
PHYSICAL CHARACTERISTIC destruction or liver
Disease or disfunction
OF URINE:
4. Protein
1. Transparency - Albumin (small protein
molecule) is normally
• Normal urine is clear to slightly absent or present only in
cloudy (especially after standing) trace amounts
• Very Cloudy – there could be an - Excessive Exercising can
infection (pus) produce protein in urine
- Can also be b/c of UTI - Higher levels of protein
Color may indicate hypertension
or kidney disease
• Amber – dehydration; normal - Proteinuria or
range Albuminuria – presence of
protein in the urine
 Anatomy and Physiology (Lab)
Shane Valerie C. Diez

5. pH - May indicate liver disease

- normal urine pH = 4.6-8 or bile tract obstruction if
- lower pH = acidosis, starvation, present
and dehydration 10. Glucose
- higher pH = urinary - Normally no glucose in the
infections and alkalosis urine
6. Occult blood - Trace amount – after
- "occult“– hidden eating a high carb meal
- Test for hidden blood - Continued high levels in
- Blood in the urine is too the urine may indicate
small to cause diabetes mellitus or
discoloration of the urine pituitary problems
but still clinically
significant MICROSCOPY
- Normally not present,
hemoglobin may indicate • Place urine sample in
kidney infection or the centrifuge to separate the
presence of stones in the sediments in the liquids
kidney, ureter, or bladder • Look for formed cellular elements,
7. Specific gravity casts, bacteria, parasites, and
- Ratio of urine density to crystals
water density • Cells
- Urine (water + solutes) ➢ Epithelial cells –
- Urine (water) = 1.000 possibly seen (only little
- Normal Urine (with amount); reason why in
solutes) = 1.000-1.030 getting sample it should
- Lower values: kidney disease, be midstream
diluted urine (over hydration), ➢ WBC = indicate infection (UTI)
hyposthenuria, diabetes ➢ RBC = menstruation;
insipidus hematuria can be due to
- Higher values: high solute hemorrhage inflammation
concentration and may occur necrosis trauma or neoplasia,
during dehydration, caused by surgery
hypersthenuria, diabetes ➢ Trichomonas – if may STD
mellitus
• Artifacts
- Urine should not be too
- Materials that have accidentally
dilute or thick
gotten into the sample
8. Ketone
➢ Cotton fibers
- By product if fat metabolism
➢ Hair
- Positive: during fasting,
➢ Powder
diabetes mellitus, or a low-carb
diet ➢ Fat droplets or air
9. Bilirubin bubbles
- Normally not present, or
present in trace amounts
 Anatomy and Physiology (Lab)
Shane Valerie C. Diez

• Crystals

- Very tiny crystals of normal urine

components or drugs may be
visible under high power
➢ Urinary retention – inability to
void urine from the bladder (large
amount of crystals)
➢ Stones or calculi – large
masses of crystals
• Casts
- Chunks of material that have
hardened somewhere in the urinary
channel and sloughed off into the
urine
- Cylindrical appearance
- May be normal or not normal
➢ Hyaline cast = associated with
proteinuria or renal disease (most
common)
➢ Cellular casts = ischemia
(damage to walls of artery)
infraction or nephrotocity

➢ Waxy cast = chronic renal

failure (hypertensive high
blood pressure) and
glomerulonephritis
o High blood pressure damage to
walls of kidneys and will have
renal problem later on
o So hypertensive -> renal problem
of diabetes